SYLVIA KEDIBONE SEDIBE
Johannesburg
Summary
Professional with robust background in claims assessment, skilled in analyzing and evaluating complex information to support accurate decision-making. Strong collaborator, reliable in adapting to changing needs, and focused on achieving results. Expertise in data analysis, risk assessment, and compliance, combined with excellent communication and problem-solving abilities. Known for high standards and delivering impactful outcomes in team environments.
Overview
23
23
years of professional experience
Work History
Life Claims Assessor
Rand Mutual Assurance
12.2024 - Current
- Contributed towards continuous improvement initiatives within the department, identifying areas of potential growth or optimization opportunities.
- Provided ongoing support to colleagues through mentorship and training sessions, fostering a cohesive team environment that improved overall productivity.
- Consistently met or exceeded performance goals set by management, demonstrating commitment to excellence within the role of Claims Assessor.
- Escalated complex claims to senior management for further review, ensuring a collaborative approach to decision-making and fair outcomes.
- Identified fraudulent claims with comprehensive investigations, minimizing company losses and maintaining integrity in the claims process.
- Ensured compliance with regulatory guidelines by staying up-to-date on industry standards and integrating them into daily workflows.
- Streamlined the claims assessment process for increased efficiency through the development of standardized templates and checklists.
- Reduced turnaround time for claim settlements by prioritizing tasks, effectively managing caseloads, and collaborating with cross-functional teams.
- Participated in regular meetings with other departments to provide insights on emerging trends in claims activity, influencing strategic decision-making processes within the organization.
- Enhanced customer satisfaction rates by promptly addressing inquiries and providing detailed explanations regarding claim decisions.
- Effectively managed high-pressure situations during peak periods of claims activity while maintaining professional demeanor and efficient performance levels.
Freelance Burial Planner
Chithi Funeral Services
01.2022 - 11.2024
- Conducted detailed risk assessments for upcoming projects to mitigate potential issues with proactive solutions.
- Improved operational efficiency by standardizing planning procedures across projects, minimizing redundancies and streamlining tasks.
- Championed development of comprehensive emergency response plan, enhancing organizational preparedness for unforeseen events.
- Developed and implemented efficient inventory management system to reduce waste and optimize supply chain operations.
- Enhanced decision-making processes by providing detailed analysis reports, highlighting key data and trends relevant to project success.
- Improved stakeholder satisfaction by effectively communicating project updates and incorporating feedback into planning strategies.
- Achieved significant cost savings by renegotiating contracts with suppliers, leveraging market research and negotiation skills.
Claims Assessor
Momentum (MMI Holdings)
11.2019 - 10.2021
- Handled a variety of claim types including Critical Illness (Dread Disease), Disability, Funeral, Death, and Income Protector claims.
- Conducted due diligence to verify policy validity, including reviewing policy schedules and listening to sales or client service call recordings. Ensured all premiums were received and properly allocated.
- Reviewed and verified all required documentation related to claims, ensuring full disclosure by the life assured. Identified and escalated discrepancies or red flags to the relevant departments such as Forensics.
- Assessed all submitted documents and policy details to make informed decisions on the acceptance or rejection of claims. Ensured adherence to production targets, turnaround times, and service level agreements (SLAs).
- Verified and processed banking details to ensure accurate payments for approved claims. Prepared and distributed settlement documentation outlining payment details and reasoning to all relevant parties.
- Collaborated with medical professionals to obtain accurate information for precise assessments, resulting in fair claim outcomes.
- Improved claim processing accuracy by implementing a meticulous review system and conducting thorough investigations.
- Maintained accurate records of all claims assessed, facilitating easy retrieval when needed for audits or internal reviews.
- Enhanced customer satisfaction rates by promptly addressing inquiries and providing detailed explanations regarding claim decisions.
- Identified fraudulent claims with comprehensive investigations, minimizing company losses and maintaining integrity in the claims process.
- Established trust among clients by consistently demonstrating empathy and understanding throughout the entire claims assessment process.
Contact Centre Agent (Claims)
Momentum (MMI Holdings)
03.2016 - 10.2019
- Handled inbound calls related to Funeral, Death, Critical Illness, and Disability claims, providing clear guidance and empathetic support to clients during difficult times.
- Initiated claims by capturing accurate information and uploading supporting documentation to create new cases for assessment.
- Set initial claim requirements and assigned outstanding tasks to the relevant parties to ensure smooth processing.
- Indexed and categorized incoming claim documents to maintain organized and accessible digital records.
- Monitored and responded to incoming emails in a timely and professional manner, ensuring clients received prompt updates and resolutions.
- Proactively worked to reduce lost call rate, ensuring clients were assisted efficiently and within service level standards.
- De-escalated and resolved customer complaints with punctual, polite and professional service.
Sales Consultant
African Bank
02.2011 - 02.2016
- Actively promoted and sold products/services to new and existing clients, consistently meeting or exceeding sales targets.
- Built and maintained strong customer relationships through excellent communication and personalized service.
- Identified customer needs and provided tailored solutions to drive customer satisfaction and retention.
- Conducted outbound and inbound calls to generate leads, follow up on prospects, and close sales.
- Accurately captured customer information and processed transactions using internal systems.
- Maintained up-to-date knowledge of products, services, pricing, and promotions to effectively communicate value to clients.
- Handled customer queries, objections, and concerns professionally to ensure positive experiences and conversions.
- Collaborated with team members to share best practices and support collective sales goals.
Credit Analyst
First National Bank
02.2002 - 01.2010
- Assessed creditworthiness of individuals or businesses by analyzing financial statements, credit reports, and payment history.
- Conducted in-depth risk evaluations to determine appropriate credit limits, terms, and lending conditions.
- Prepared detailed credit proposals and recommendations for approval by senior management or credit committees.
- Monitored existing credit accounts to identify potential risks, ensure compliance with credit policies, and flag deteriorating credit behavior.
- Worked closely with sales, collections, and finance teams to support informed lending decisions and minimize bad debt.
- Ensured all credit assessments complied with internal policies, regulatory requirements, and industry standards.
- Used credit scoring models, financial ratios, and market analysis to guide decision-making and enhance portfolio performance.
- Maintained accurate and up-to-date customer records and credit files for auditing and reporting purposes.
Education
Bachelor of Laws (LLB) -
UNISA
04-2026
RE5
Moonstone
01-2015
National Certificate - Banking And Finance
UNISA
01-2010
Grade 12 -
Glen-Cowie Secondary
01.1995
Skills
- Documentation review
- Professional ethics
- Assertiveness
- Policy interpretation
- Claim evaluation
- Claims processing
- Investigative skills
- Teamwork
- Customer service
- Time management
- Computer skills
- Problem-solving
Languages
English
Advanced (C1)
Afrikaans
Upper intermediate (B2)
Sepedi
Bilingual or Proficient (C2)
Zulu
Advanced (C1)
REFERENCE
Available on request
Timeline
Life Claims Assessor
Rand Mutual Assurance
12.2024 - Current
Freelance Burial Planner
Chithi Funeral Services
01.2022 - 11.2024
Claims Assessor
Momentum (MMI Holdings)
11.2019 - 10.2021
Contact Centre Agent (Claims)
Momentum (MMI Holdings)
03.2016 - 10.2019
Sales Consultant
African Bank
02.2011 - 02.2016
Credit Analyst
First National Bank
02.2002 - 01.2010
Bachelor of Laws (LLB) -
UNISA
RE5
Moonstone
National Certificate - Banking And Finance
UNISA
Grade 12 -
Glen-Cowie Secondary
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