Senior Claims Administrator with Diploma in Human Resources Management
Resume:
Curriculum vitae for MabuselaTlou Daniel
Tokoza
1426
Tel: 071*******/081*******
Email: *********@*****.***
Personal Details
Date of Birth : 31 March 1986
ID No : 860**********
Nationality : South African
Gender : male
Drivers License : C1
Education Details:
Institution : Damelin College
Qualification : 3 year Diploma in Human Resource
Management (NQF6)
Modules
Human Resource Management
Industrial Psychology
Industrial relation
Training Management
Project Management
Work integrated learning
Institution : Damelin College
Qualification : Certificate in Human Resource Management (2008) Modules
Business Calculations
Human Resource Management
Industrial Psychology
Training and Development
Labor Law
Business Communications
Computer Skills
School attended : Thoko-Thaba High School
Highest grade passed : Grade 12
Year Completed : 2004
Work Experience
Company: Metal Industries Benefit Fund Administrators (MIBFA) Position: Senior Claims Administrator (Employee Benefits) Duties:
Administration of Claims nationally and internationally (Death, Retirement & Monies in Trust)
Corresponding with members/beneficiaries in receipt of a pension/Installment via mail or email
Calculating various benefits payable
Completing and submitting necessary statistical reports
Handling of tax queries and issuing certificates
Customer queries relating to pension maintenance and general enquiries
Liaise and collaborate with other departments to resolve problems and improve customer service levels
Period: From June 2016 to September 2022
Reason for leaving: To grow and explore other options externally Work Experience
Company: Metal Industries Benefit Fund Administrators (MIBFA) Position: Surplus Call Centre Agent
Duties: Handling Surplus Enquiries, Surplus Statements and, Payment confirmation
Document Checker and Funds Adviser
Administrative Duties: Spreadsheet logging, scanning and, printing of documents
Surplus Email queries and, multilingual communications agent Period: From March 2016 to May 2016
Reason for leaving: Promoted to another position
Work Experience
Company: Metal Industries Benefit Fund Administrators (MIBFA) Position: Surplus Administrators
Duties:
Handle mail from/to post office and internal departments/attend to Surplus Mailbox queries
Update incoming mail spreadsheets and compile statistics
Trace member records, establish Fund membership, membership status (i.e. Former Member, Current Member, Deceased etc)
Check, scan onto Oculus 8/validate or verify authenticity of surplus documentation as per departmental standards
Assist supervisor and team leader with on the job training if necessary
Finalize and close claims
Prepare claims for payment of surplus benefits
Undertake all administrative responsibilities such as faxing, posting and general office procedures
Correspond with members, Former Members telephonically and Emails
Assess surplus claims and requirements in line with company standards and procedures
Handle telephone queries professionally in a clear, courteous and professional manner as it relates to the fund/Transfer member queries to relevant department, I.e. Funds
Check that the documents received is surplus related, if not send to the relevant department
Specify if documents are a photo copy or faxed copy by using the relevant stamps
Filing
Data Capturing
Receiving and organizing post
Ensure that client submitted the correct documents: ID copy, Bank statement and Proof of residence
Stamping documents
Period: From May 2015 to February 2016
Reason for leaving: Promoted to another position
Work Experience
Company: Sanlam
Position: Claims Assessor
Duties
Reported to the team leader
Captured new claims on the system to be available for record purposes
Claims processed: x 40 per day
Ensured claims payments were being transferred to the correct banking details
Declined claims which were invalid based on the terms and conditions of the company
Responsible for writing letters to the clients when required
Wrote repudiations, limitations and requirement letters to clients on the reasons for requirements, repudiated or limited the claim, processed x 20 letters per day
Filed client documents on the Pavlov system, i.e.. identity document, claim forms, bank statements and hospital files
Ensured that client provided relevant documents e.g. complete claim forms, signed declaration by the policy holder, PMA report, copy and bank statement
Cancelled policies as advised by underwriters due to fraud or non-disclosure and refunded premiums
Updated clients banking details, contact details, addresses and rectified policy numbers
Filed documents on the system
Period: From July 2013 to January 2015
Reason for leaving: Contract ended
Work Experience
Company: Westfalia Fruit Estate
Position: Human Resources Management Intern
Duties:
Help management with recruitment process, methods and steps to follow in the recruitment process
Identified and hire the perfect candidate who meet the job requirements
Capturing employee’s information and disciplinary records on the system
Gathering information from job applicants in a form of asking questions to know the job applicant if he can do the job
Asking employees questions about their jobs, responsibility, expectations and working conditions
Writing down minutes of meetings for records purposes
Ensuring that employees’ information on the file is up to date, employees provided bank statement, qualifications and all other relevant information required in the file
Selecting candidates who meet the requirements of the job so that they could be interviewed
Identify employees who are reaching retirement age so that the company could start early with their pension fund
Assisting management in making decisions such as the methods of training to be used for staff and on hiring the best candidates who meet the job requirement
Calculating job applicants interviews scores
Assisting management on handling disciplinary actions Period: October 2011 to April 2012
Reason for leaving: Contract ended
Work Experience
Company: Hans Merensky Holdings (Pty) Ltd
Duties: Filing and General work as requested by supervisor Period: On an adhoc basis
Personal Skills and Competencies
Computer Skills : Microsoft Office (Microsoft Word, Excel, PowerPoint, Outlook and Access, Internet and Email)
Leadership skills : Strategic Decision Making, Conflict Management Skills Interpersonal skills : Punctual, Patience, Honestly and Integrity In-House Training
Customer Service, Retirement Fund, Effective Writing for Business Programme, Session System, CRM System, Oculus 8
and 7, The Alex System, Future Fit Session1, HIV Training, Conflict of interest, FICA,Pavlov, Athena
&Docix, Fafa Enquiry
Workshop, Fire marshal course
Achievements
Employee of the year 2019 (MIBFA)
Top performer for the month of January, September and October (Sanlam) References
1.Kenneth Molewa (Supervisor)
Metal Industries Benefit Fund Administrators (MIBFA) Contact Number: 082*******/011*******
2. Sanelisiwe Nyiphi (Claims Assessor/Checker)
Metal Industries Benefit Fund Administrators (MIBFA) Contact Number: 083*******/011*******
3. Mr. Richard Mabitsela (Supervisor)
Sanlam
Contact Number: 083*******/011*******
Email: ********@*********.**.**
4. Mr. Negroes Nonyane (Human Resources Manager)
Westfalia Fruit Estate (LTD) PTY
Contact Number: 079*******/082*******
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