Summary
Overview
Work History
Skills
Certification
References
Timeline
Generic

Aroha Nyman

Brisbane,Australia

Summary

I am a highly-motivated employee with a desire to take on new challenges. I am a skilled professional prepared for leadership roles, adept at facilitating effective communication and collaboration within teams. With a keen understanding of both team and business objectives, I excel in developing plans to achieve them. I demonstrate empathy and proficiency in conflict resolution skills, effectively managing interpersonal dynamics. My strong decision-making abilities and adaptability enable me to navigate challenges seamlessly. I possess exceptional problem-solving skills and have a proven track record of motivating others to perform at their best. Additionally, I excel in delegating tasks and ensuring accountability among team members. When conflicts arise, I approach them with a positive mindset, seeking constructive resolutions. I am genuinely committed to building a strong and cohesive team environment through open communication and trust-building efforts while continuously striving for personal and professional growth.

Overview

11
11
years of professional experience
1
1
Certification

Work History

Senior Claim Officer

Cover More Travel Insurance
Brisbane, Queensland
06.2023 - Current
  • Efficiently coordinated daily claims assignments for Claims Officers to optimize workflow
  • Timely distributed 4- and 12-month updates to relevant Claims Officers
  • Conducted thorough reviews of Audit reports, promptly addressing any discrepancies
  • Provided valuable assistance to Claims Officers in resolving Audit findings promptly
  • Reviewed and supported the resolution of active complaints within the team
  • Managed enquiries from the Ask your SCO channel with prompt and informative responses
  • Maintained accurate records by updating bank account details as required
  • Handled merge requests promptly and accurately to streamline processes
  • Ensured accuracy and compliance in denial letters and overturned Outcome Reviews by meticulously verifying policy wording, grammar, and case note application
  • Confirmed and updated primary and secondary reasons for denial to maintain consistency and accuracy
  • Managed the escalation inbox efficiently, assigning tasks to Claims Officers or reassigning as necessary for timely resolution
  • Addressed call and claim escalations from Team Leaders and the Executive team with urgency and professionalism
  • Submitted internal breaches through Tickit, adhering to established protocols
  • Provided comprehensive coaching support to Claims Officers to enhance performance and skill development
  • Offered specialized assistance to Claims Officers in managing highly complex claims to achieve timely resolutions
  • Communicated updates on remaining tasks to the team to encourage transparency and accountability
  • Provided ongoing support to Claims Officers requiring assistance with their claims to ensure their needs are met effectively
  • Assisted during the Hour of Power by efficiently assessing claims to expedite processing
  • Maintained up-to-date knowledge and understanding of claim-related questions to provide accurate support
  • Identified training and learning opportunities and provided constructive feedback to Team Leader for continuous improvement
  • Facilitated effective collaboration with Internal Dispute Resolution, Audit, Accounts, Medical Assessors Team, and other Team Leaders to maximize team performance
  • Actively engaged with the team to gather feedback and suggestions for enhancing team effectiveness
  • Served as a reliable point of contact for Claims Officers in other teams requiring support and guidance
  • Assumed responsibilities as a point of contact in the absence of the Team Leader, ensuring smooth operations
  • Executed additional duties as assigned, including organizing team engagement activities to foster team cohesion and morale.

Claim Officer

Cover More Travel Insurance
Brisbane, Queensland
05.2022 - 06.2023
  • Autonomous effective portfolio management, prioritizing claims in line with GICOP (General Insurance Code of Practice) and departmental processes and procedures
  • Ensure communication both verbal and written is in line with our trade partnerships branding
  • Effective decision making on Claims assessments that comply with policy/product conditions and benefits
  • Adhere to internal guidelines and procedures during claims settlements as designed by Claims Technical Operations team, to mitigate claims leakage
  • Identifying suspicious or potentially fraudulent claims in line with Investigations Referral Guidelines to the Claims Technical Operations Unit
  • Effective complaints management, whilst maintaining a positive customer experience, in line with the General Insurance Code of Practice and internal complaints protocol to ensure no breaches in the code and minimize impacts to AFCA (Australian Financial Complaints Authority)
  • Analyze claim forms, travel itineraries, medical documents to ensure the appropriate assessment has been completed in line with the product disclosure statement.

QSuper | Claims Manager

Brisbane
Queensland
04.2018 - 05.2022
  • Efficiently manage a portfolio of 50+ life, disability and income protection claim through proactive claims management, and triaging to work to tight deadlines and manage multiple priorities
  • Critically analyzed medical, occupation, functional and policy related details, and incorporated potential impacts of bio-psychosocial factors and information from multiple sources into claims management and decision making
  • Delivered strong written and verbal communications by preparing and delivering correspondence, information, decision outcomes and reports for matters relating to QInsure policy requirements
  • Delivered superior customer service to members who are unwell through empathetic, concise, and respectful clear communication whilst maintaining private and confidential information
  • Proven ability to build and maintain positive relationships with a range of stakeholders such as Medical Practitioners, Medical Specialist and Allied Health Professionals
  • Identified and discussed complex claims with internal stakeholders such as, Principal Claims Manager, Senior Claims Manager, Injury Management Advisors to ensure Claims are assessed and managed in line with QInsure Policy and Superannuation Trust Deed 1990
  • Identified barriers that prevented a return to work and health goals, and worked with the Member and treatment team to create strategies to overcome the barriers
  • Promotes, drives, and supports a return to work and health goals with each Member.

Large Loss Case Manager (6 Month Temp)

Cunningham Lindsey
Brisbane, Queensland
04.2017 - 10.2017
  • Proactively managed the end-to-end assessments of 80 building insurance claims by ensuring claim files are managed efficiently and effectively in accordance with legislative requirements, business procedures and service level agreements
  • Liaise with property Adjusters to schedule appointments to attend and assess property damages to determine what works are to be carried out
  • Collated information from Adjusters and contractors such as electricians, builders, plumbers etc
  • To request reports and quotation for the works to be carried out
  • Prepared and delivered repots to the insurer that outlined the recommended repairs required and cost to seek approval from insurer to commence works
  • Prepared and delivered insurance reports that outlined the works carried out on the claim in a timely manner to the insurer.

Customer Resolutions Specialist

AGL
Melbourne, Victoria
09.2012 - 10.2016
  • Responsible for coaching and mentoring to ensure appropriate advice, application of process, career progression and ensuring meeting monthly KPI targets
  • Set performance expectations as outlined by the Team Leader with team members and provide observations, feedback and coaching to improve target results, quality of work, behaviors and efficiency
  • Handle customer complaint escalations as required via email or phone, including investigation, development of draft written responses, stakeholder management, identify areas of improvement and ensure the appropriate coaching is provided
  • Active support for the Team Leader in managing daily requirements such as conducting team meetings and trainings, side by side phone coaching and any requirements of the Team Leader
  • Provide support to the team members in answering any difficult enquiries to ensure they are responding to the customer and their demands
  • Provided detailed monthly team reports and updates to senior management
  • Defused volatile customer situations calmly and courteously, accurately documented, researched and resolved customer service issues
  • Consistently met daily, weekly, and monthly targets.

Skills

  • Effective Communication
  • Empathy and Emotional Intelligence
  • Decision Making
  • Conflict Resolution
  • Problem Solving
  • Motivation
  • Delegation
  • Time Management
  • Adaptability
  • Leadership
  • Team Building
  • Feedback and Coaching
  • Accountability
  • Continuous Learning

Certification

Emerging leadership program, 2015

I successfully completed an Emerging Leadership Program, which provided comprehensive training in essential leadership skills. The program focused on self-awareness, emotional intelligence, and resilience, while also teaching effective communication strategies, team building techniques, and conflict resolution. Through interactive workshops and practical exercises, I gained valuable insights into inspiring and motivating teams, driving innovation, and navigating challenges with strategic thinking and problem-solving skills. This program has equipped me with the necessary tools and knowledge to lead confidently and effectively in dynamic work environments.

Certificate III and IV in Business Administration, 2013

Completing the Certificate III and IV in Business Administration has equipped me with comprehensive administrative skills essential for leadership roles. This includes expertise in customer service, communication, and organizational proficiency, providing a strong foundation for effectively leading and managing teams.

Linked in learning – How to Build Credibility as a Leader, 2023

I successfully completed a comprehensive course focusing on building credibility as a leader. This course covers essential strategies for establishing and maintaining credibility in leadership roles, including effective communication, demonstrating competence, building trust, and leading by example. Topics also include understanding the importance of integrity, authenticity, and consistency in leadership, as well as practical techniques for enhancing credibility within teams and organizations.

References

References available upon request.

Timeline

Senior Claim Officer

Cover More Travel Insurance
06.2023 - Current

Claim Officer

Cover More Travel Insurance
05.2022 - 06.2023

QSuper | Claims Manager

Brisbane
04.2018 - 05.2022

Large Loss Case Manager (6 Month Temp)

Cunningham Lindsey
04.2017 - 10.2017

Customer Resolutions Specialist

AGL
09.2012 - 10.2016

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Aroha Nyman