Thomas Zanekile
Cape Town
Summary
Personal Profile: I am a hard Working individual who believe in giving the best in every task am requested to do .I am friendly, honest, confident, punctual, energetic, self-disciplined, helpful and always willing and eager to learn.
Overview
16
16
years of professional experience
1
1
Language
Work History
Customer service Advocate
kryterion
03.2021 - 03.2024
- Customer Support Advocate (CSA) is the principle operational point of contact for support for all Kryterion exam platform. I am responsible for determining when an escalation is necessary, and I will determine the correct escalation path based on the issue(s). As CSA I use strong problem-solving skills, combined with excellent communication and support skill to maintain high levels of customer satisfaction. I track issues through system while I also documenting troubleshooting solution for use in a knowledge for common support.
Claims Assessor Gap Cover Insurance
Zestlife
01.2015 - 01.2020
- To adhere to the claims process and update the client information on the vinmware and magpi systems and capturing claims on the magpi and updating the zest life claims register accordingly
- To strive for 99% accuracy when capturing claim and client information
- To strive to archive a target of 20 claims pre capture per day
- To validate and pre capture a minimum of 15 gap claims per day within turnaround time
- To not exceeded the maximum turnaround time of 48 hours for all pre capture of claims onto the system
- To maintain your stats records on a daily basis for workflow management
- Interacting professionally and timeously with customers telephonically or via email in respect of their claim
- Reason for Leaving: Seeking New Challenge
Commercial Claims Administrator
Overseas Administration Management
04.2019 - 12.2019
- Assessing the claim as per damages, value
- First, a provision (maximum possible reimbursement amount) has to be registered in NSI in order to assess the risk.
- Given a client a preference for repairs of the items than to replace unless it’s in total loss.
- Give clients preference to provide repair quotes with one or 2 registered repairers of his choice.
- Should quotation not being reasonable, OAM will source another repairer locally.
- Capture a settlement proposal on NSI with the breakdown of the claim and go for validation
- Salvage on behalf of the insurers when the proposal corresponds to 100 % of the item value.
- Should the client not accept the proposal
- The file is reviewed taking in consideration the disagreement.
- The file is re-assessed in line with insurance policy, claims policy, the terms and conditions and insurance application form.
- The file will remain open and active until a settlement has been agreed on.
- When a client complete and return the Form of Discharge and Subrogation, email is sent to him to confirm that payment will be made between 10 – 15 working days
- Reason for Leaving: Seeking for growth
Gems Medical Aid Claims Specialist Clerk
Metropolitan Health
01.2010 - 01.2014
- Investigations, escalated complaints, and Client service queries
- Provide quality written feedback to claims queries.
- Liaise with external business partners.
- Create and update manuals and process flows.
- Provide feedback on reports to external partners.
- Assess both electronically and paper claims.
- Facilitate amendments to re-pricing of MHRS hospital claims
- Summarise major issues and take action, which will benefit both the client and the business
- Reason for Leaving: Promoted
Gems Medical Aid Claims assessor
Metropolitan Health
01.2009 - 01.2010
- Capturing and processing of all incoming paper image and/ or EDI claims within service level agreement
- Ensuring that all claims are paid according to the Rules of the Medical Schemes Act and Scheme Rules
- Achieving predetermined standards and quality levels.
- Reprising of claims and or preparation of international claims where applicable
- Escalating of queries where necessary for further investigation
- Filing of Documentation when the need arises.
- Reason for Leaving: Promoted
Claims Management Consultant
Dental Information Services (DENIS)
02.2009 - 12.2009
- Processing claims
- Answering internal and external telephone calls regarding products.
- Offered on the Dental Insurance and application procedures Managing the clients that are suspended monthly.
- Capturing application forms Assisting clients with competing their application forms.
- Filling of all correspondence received manually and electronically.
- Reason for Leaving: New Challenge
Customer Care Consultant
Medway Marketing co.
02.2008 - 01.2009
- Providing effective and efficient customer service telephonically and in writing to customers and office departments internal/external
- Updating the existing database.
- Capturing of data, typing and compiling document
- Taking ownership of queries and ensuring they are resolved timeously and effectively
- Reason for Leaving: Retrenched
Education
Certificate - COB Short-term insurance commercial line
Moonstone
Cape Town, South Africa01.2020
Advance Diploma in Financial Planning - Management in Financial Planning Level 7
University of Western Cape
Cape Town, South Africa 04.2001 -
RE5 Certificate -
Moonstone
Cape Town, South Africa01.2019
Wealth Management NQF Level 5 -216 credit - Long and short term
INSETA
Cape Town, South Africa12.2014
Grade 12 -
DR Nelson Mandela High School
Cape Town, South Africa01.2006
Skills
Problem-solving
Analytic Thinking
Strategic Planning
Claims Processing
Report Writing
Troubleshooting
Interpersonal Skills
Claims Management
Conflict Resolution
Administration
Quality Control
Data Capturing
Quality Assurance
Change Management
Implementation Management
Crisis Management
Communication Skills
Computer Literate
Customer Service
Negotiation
Ms Word
Ms Excel
Internet
References
- Sylvia, Africa, Team Leader, 021 8183373, 0648350374, Overseas administration management
- Tania, Adams, Team Leader, 021 11804382, 0826068902, Zestlife
- Gerhard, Riffel, Team leader Claim Specialist, 021 468 2669, 071 8755 268, Metropolitan heath group
- Mrs Pumla, Mukeba, Manager, 021 9406188, 084 843 3566, Medway Marketing co.
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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PRIVATE AND CONFIDENTIAL PROFILE
- Cell: 0837753840
- E-Mail: 72tomzito@gmail.com
- PROFILE OF THOMAS ZANEKILE
- Current Employment: Unemployed
- Availability/Notice Period: None
- Surname: Zanekile
- First Names: Thomas
- Citizenship: South African
- Identity No.:
- Gender: Male
- Driver's licence: Code 8
- Residing in: Cape Town
- Areas to consider: Willing to Relocate
- Languages Spoken: English
- Expectation: Negotiable
Languages
English
Bilingual or Proficient (C2)
Xhosa
Advanced (C1)
Timeline
Customer service Advocate
kryterion
03.2021 - 03.2024
Commercial Claims Administrator
Overseas Administration Management
04.2019 - 12.2019
Claims Assessor Gap Cover Insurance
Zestlife
01.2015 - 01.2020
Gems Medical Aid Claims Specialist Clerk
Metropolitan Health
01.2010 - 01.2014
Claims Management Consultant
Dental Information Services (DENIS)
02.2009 - 12.2009
Gems Medical Aid Claims assessor
Metropolitan Health
01.2009 - 01.2010
Customer Care Consultant
Medway Marketing co.
02.2008 - 01.2009
Advance Diploma in Financial Planning - Management in Financial Planning Level 7
University of Western Cape
04.2001 -
Certificate - COB Short-term insurance commercial line
Moonstone
RE5 Certificate -
Moonstone
Wealth Management NQF Level 5 -216 credit - Long and short term
INSETA
Grade 12 -
DR Nelson Mandela High School