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Claims handler

Location:
Johannesburg, Gauteng, South Africa
Posted:
May 29, 2023

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Resume:

Name: Mbali Buyisile Mbambo

ID Number: 840**********

Email address: adxd11@r.postjobfree.com

EE Status: African Female

Contact number: 065*******/072*******

Residential Area: SouthFork Johannesburg South

Own Reliable Transport: Yes

Drivers License: Yes

Notice Period: immediately available

INSURANCE RELATED QUALIFICATIONS

First Level Regulatory Examination: Representatives, Moonstone, 2015

Assessment Facilitated by Intec School of Insurance (77 Credits), 2007

Claims Handling Management, Munich, 2019

Currently registered with Moonstone for COB Personal Lines and Commercial lines EDUCATION QUALIFICATION : 2nd year LLB Unisa 2006

Highest Grade Passed: Grade 12

School: RAUCALL

Year: 2002

COMPUTER LITERACY

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

Microsoft Outlook

CAREER CHRONOLOGY

Company Position Period

SASRIA Claims service consultant Jan 2022-Nov 2022 NNAC Claims Handler Jun 2018 – September 2021

Regent Insurance Claims Technician Nov 2013 – May 2018 NMG Benefits Personal Assistant May 2013 – Sept 2013 PPS Insurance Member Relations Consultant Jan 2007 – Jan 2013 EMPLOYMENT HISTORY

Company: NNAC

Period: June 2018 – September 2021

Title: Claims Handler (Personal/Commercial/Motor/Non-Motor) Job Description:

Handling Non-Motor Personal and Commercial Claims

Sourcing Replacement Quotes

Appointing of Glaziers

Appointing Assessors / Investigators for Building Claims

Replacing or Repairing Insured Items

Drawing AOL or Rejection Letters

Assessing Commercial and Personal motor non-motor claims from start to authorisation of payments this involves adequate reserving of claims, communicating with clients and responsible parties by telephone and or written communication.

Ensure timely claims management and settlement by obtaining comparative quotes from suppliers for replacements or repairs.

Keep the client informed and adhere to the serve levels.

Authorise payments within mandate and consult with management for problematic claims. Reason for Leaving: Financial and personal growth

Company: Regent Insurance

Period: April 2015 – May 2018

Title: Claims Technician

Job Description:

Claims Technician (April 2015 – May 2018)

As a claim’s technician in the Vaps department I handled claims related to Vaps products which include Gap cover, Deposit protector and the Violation covet.

The various finance houses submit claims on behalf of clients whose vehicles have been written off or high jacked/stolen and not recovered to claim for the Gap cover.

Upon receipt of the necessary claim’s documents, I did a compliance check to check if the claim is valid.

Both the bank and clients are informed of the receipt of the claim and kept updated on any outstanding documents and progress of claim.

Successful claims are paid timeously within the turnaround time. Proof of payment is made available to the finance house and claimants.

Life Claims Administrator (February 2014 – March 2015)

Initiator of new claims and see to the completion of existing claims.

Upon receipt of a claim, it is checked to make sure all the claim documents are valid, correct and completed.

Register the claim and assign the claim to the relevant assessor.

Send a successful claim for payment on time daily before 10am.

Make sure the relevant parties are kept informed on the progress of a claim and proof of payment is sent to the flaming parties.

Where a claim was unsuccessful, I would send a reflection letter clearly staying out the reasons for the rejection and steps to follow in order to dispute the outcome if need be.

Claim is closed and sent for scanning and filing.

Adhoc office admin and making sure the staff has sufficient stationery.

Payment of invoices, telephone accounts, ITC and Mettis invoices. Customer Service Consultant (November 2013 – February 2014)

. To ensure a high level of satisfaction by providing effective quality service to Regent Insurance existing holders.

Achievement of daily, weekly, and monthly service targets and company performance standards.

Establish and maintain key stakeholder relationships.

Adhere to all compliance and legislative requirements as stipulated, documents and requested by organisational management.

Ensure that all administrative issues are dealt with in a professional manner, provide feedback regularly to management on matters of significance.

Ensure compliance of all turn-around times and service level agreements. Reason for Leaving: Regent was bought by Hollard therefore career uncertainty Company: NMG Benefits

Period: May 2013 – September 2013

Title: Personal Assistant

Job Description:

Assisting 2 brokers with scheduling appointments for reviews.

Prepare meeting packs which include the client's portfolio requested from Astute and client’s statement of benefits from the different companies by emailing a letter of authority for permission to request client’s information.

Prepare quotes for the different products which include investments plans, lifestyle protector, income protector, preservation provident and pension fund, endowment an RA, s, and application forms.

Prepare factfinders for first meetings and register the new clients on the system.

When the brokers return with accepted signed quotes and application forms, check the application forms for accuracy, and any outstanding FICA documents.

Weekly meetings with the admin team leader for servicing feedback and progress of new business and service changes made.

Complete telephone and email queries from clients and always give feedback to the consultants regarding their clients.

Reason for Leaving: Temporary position. (maternity relief) Company: PPS Insurance

Period: January 2007 – January 2013

Title: Member Relations Consultant

Job Description:

Managed a team of 15 brokers responsible for servicing intermediaries and PPS members with queries related to new and existing business.

When a broker has signed new business, it is her responsibility to conduct a compliance audit check.

Capture the application form and arrange appointments with nurses on behalf of the clients for medicals to be conducted or obtain medical reports from attending doctors.

These medicals are sent to the underwriters who then conclude whether the new business is accepted with loadings, exclusions, or declined.

Disclose all pertinent information to the applicant and broker.

Meet with the intermediaries on 1-1 basis to accept new business and advice on progress of existing business.

Reason for Leaving: Loading policies became tedious I wanted to be more involved in practical business.



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