Human Resource Case Management

MAMUSCKA MCKAY

Resume

**************@*****.***

+264-**-***-****

Windhoek, Namibia

CONTACTS

Advanced Diploma in Human

Resource Management

International Training College Lingua

2012

Grade 12 Certificate

DBHS 2009

EDUCATION

JOB EXPERIENCE

Digital Non-Motor Assessor, Mar 2018 – Present

Santam Insurance

• Communicate with brokers and clients to handle and process a variety of non- motor claims.

• Investigate potentially fraudulent claims with a focus on thoroughness, quality, and cost control.

• Conduct claim and estimate re-inspections.

• Review data to verify the validity of claims and determine case management actions.

• Recommend settlement offers and negotiate payment arrangements.

• Identify and collect evidence to properly assess claim conditions. Commercial Claims Negotiator (Motor), Sept 2013 – Feb 2018 Old Mutual Short-Term Insurance

• Handled and processed commercial motor claims.

• Conducted thorough investigations and negotiations with suppliers.

• Summarized claims and maintained communication with brokers and customers.

• Managed client queries related to claims, both personal and commercial.

• Loaded payments/orders and expedited handling of queries.

• Drafted rejection letters and managed ex-gratia payments.

• Conducted claim and estimate re-inspections and verified claims settlement data.

OBJECTIVE

A driven claims professional with over 12 years of experience in digital non-motor assessments and commercial motor claims negotiation. Skilled in utilizing digital tools for in-depth claim evaluations and negotiating fair settlements for complex commercial motor claims. Possesses a strong understanding of insurance policies, effective communication skills, and a commitment to professional development. Thrives in fast-paced environments, prioritizing tasks effectively to meet deadlines and optimize claim resolution processes.

• English (Excellent)

• Afrikaans (Excellent)

LANGUAGES

SKILLS

• Claims Processing: Expertise in handling and processing a variety of non-motor and commercial motor claims.

• Negotiation: Proficient in negotiating settlement offers and payment arrangements.

• Communication: Strong communication skills for interacting with clients, brokers, and internal stakeholders.

• Data Analysis: Ability to review and analyze claims data to verify validity and determine case management actions.

• Time Management: Effective at prioritizing tasks to meet deadlines in fast-paced environments.

• Attention to Detail: High attention to detail in conducting claim and estimate re- inspections.

• Customer Service: Excellent customer service skills for managing client queries and maintaining clear communication.

• Digital Tools: Proficient in utilizing digital tools for in-depth claim evaluations.

• Team Collaboration: Ability to work collaboratively with team members to achieve positive outcomes.

Sonja Fourie

General Moderator and Quality

Control: Claims

Santam Insurance

Tel: +264-**-******

Tolloso Bernardo

Operational Claims Manager

Santam Insurance

Tel: +264-**-***-****

REFERENCE

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