Gabriel Lagos-Jay
Canberra,ACT
Summary
Detail-oriented claims advisor with 4 years of experience in the specialist ACT jurisdiction. Strong command of conflict resolution and negotiation combined with excellent reporting and research skills. Thorough understanding of claims process and current legislation.
Prior to joining Suncorp I have 10 years of hospitality experience in setting up restaurants and stores, developing operating systems, implementing talent development programs, negotiating with suppliers and developing brand strategy. My goal is to continue working for an organization that is proud of it's products, services and passion for customers.
Overview
9
9
years of professional experience
Work History
Claims Advisor
GIO ACT Workers Compensation
11.2020 - Current
- Responsible for a portfolio of up to 75 Workers Compensation Claims from initial contact to final return to work.
- Required to accurately review and assess claims in line with the ACT Workers Compensation Act and internal policies and procedures.
- Required to engage with client employers, the ACT Market, medical professionals, rehabilitation providers, local and national Brokers to enable collaborative portfolio management and quality reviews.
- Conduct day-to-day administrative tasks to maintain best in class claims service to all parties involved in the claims process .
- Provided exceptional customer service by addressing customer concerns and keeping them informed throughout the claims process - maintaining NPS scores above 30 on a rolling month basis.
- Maintained comprehensive knowledge of industry regulations, ensuring compliance in all claim handling procedures.
- Performed administrative duties by verifying documentation, researching facts and contacting other parties involved assist in liability determinations and reduce overall claim costs.
- Contributed to overall department success by consistently meeting or exceeding established performance metrics and goals.
- Researched claims and incident information to deliver solutions and resolve problems.
- Trained new employees on Suncorp policies, claims management software, and best practices for efficient work performance.
- Passionate about learning and committed to continual improvement.
- Developed strong relationships with external partners including medical professionals, rehabilitation providers, investigators and legal representatives to facilitate seamless claim resolutions.
- Worked effectively in fast-paced environments.
- Worked well in a team setting, providing support and guidance.
- Assisted with day-to-day operations, working efficiently and productively with all team members.
- Self-motivated, with a strong sense of personal responsibility.
- Proven ability to develop and implement creative solutions to complex problems.
- Applied effective time management techniques to meet tight deadlines.
- Excellent communication skills, both verbal and written.
Assignment Officer; ASCO Customer Contact Centre
Suncorp Motor Claims
02.2020 - 11.2020
- This team had the challenge of addressing pain points around reducing customer effort and improving communication with customers during their claim.
- At time of pilot launch the repair model for Motor Claims required a large amount of communication between our repairers and customers. The data indicated a clear opportunity to improve the customer experience by reducing customer effort and proactively managing customer pain points.
- At launch; Call analysis indicated 43% of measurable inbound repeat calls are made after the repair has been authorised to commence.
- Level 1 complaint data indicated 2 of the top 5 issues related to concerns around timeframes of the claim
- The team implemented processes for proactively contacting customers 5 days after the assessment of their vehicle
- The goal; to make it easy for our customers and to produce a lift in the overall VOC settlement metric, reduced repeat calls into Claims Services and ASCO teams, and a reduction in Motor Claim complaint volumes.
- Required to review complaints and grievances using negotiating and problem-solving skills.
- Learned and adapted quickly to new technology and software applications.
- Skilled at working independently and collaboratively in a team environment.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Established effective relationships with key stakeholders both internally and externally for increased collaboration opportunities.
- Researched claims and incident information to deliver solutions and resolve problems.
AAMI, SUN & GIO Specialist
Suncorp Direct Distribution
01.2019 - 02.2020
- Required to deliver a seamless customer experience on various insurance products that provides value for our customers
- Identify the appropriate insurance policies to meet customer requirements
- Trained in specialised products across all Suncorp brands; home, landlord, strata, motor, bike; boat; caravan
- Created additional customer value through quality referrals and leads - Measured as a percentage of referrals/leads to calls
- Achieved 0% variance for both paid metrics consistently.
- Required to effectively utilise the conversation model to deliver customer value - Measured through the team's Voice of the Customer results
- Protected our customers and business by adhering to process, licencing, legislative and regulatory obligations and contributing towards creating a positive risk culture.
- Display effective risk management in all aspects of of my role; achieved consistent successful call monitoring results - measured an average QA result.
- Contributed to Suncorp's digital strategic capability by proactively discussing digital contact with our customers.
General Manager/Operations Specialist
Vagabond Wines
06.2015 - 12.2019
- Wine shop, Wine Bar, Wholesaler, Importer and Wine producer based in London. Vagabond showcases lesser-known producers, regions and grape varieties from all over the world as well as producing award winning products at their Urban Winery in Battersea. Their vision is to create a wine revolution, bringing win to the people, making wine more approachable to the everyday consumer.
- Streamlined operations processes for increased efficiency and enhanced customer experiences.
- Developed and managed budgets, effectively reducing operational costs while maintaining quality service
- Conducted regular audits of internal processes to maintain compliance with regulatory requirements.
- Tracked employee attendance and punctuality, addressing repeat problems quickly to prevent long-term habits.
- Supervised daily operations and sales functions to maximize revenue, customer satisfaction, and employee productivity.
- Oversaw vendor relationships, ensuring timely delivery of products and services while maintaining cost controls.
- Developed comprehensive onboarding and training programs for new employees, accelerating their integration into the team environment.
- Mentored team members in developing their skills and advancing their careers within the organization.
- Recruited, hired, and trained initial personnel, working to establish key internal functions and outline scope of positions for new organization.
- Demonstrated strong organizational and time management skills while managing multiple projects.
Education
WSET Level 2,3,4 Awards in Wine And Spirits -
Wine And Spirit Education Trust School
London07.2014
Diploma - Organisational Leadership
Management Futures Consulting Limited
London UK03.2014
Diploma - General Managers Programme
The Watershed Independent School of Management
London, UK12.2012
Skills
- Claims Centre
- Customer Workbench
- Knowledge
- Microsoft Office Suite
- Cloudapp Functionality
- Working knowledge of Protect
- Relationship Building
- Critical Thinking
- Problem-Solving
- Human relations
- Active Listening
- Public Speaking
- Team Leadership
Timeline
Claims Advisor
GIO ACT Workers Compensation
11.2020 - Current
Assignment Officer; ASCO Customer Contact Centre
Suncorp Motor Claims
02.2020 - 11.2020
AAMI, SUN & GIO Specialist
Suncorp Direct Distribution
01.2019 - 02.2020
General Manager/Operations Specialist
Vagabond Wines
06.2015 - 12.2019
WSET Level 2,3,4 Awards in Wine And Spirits -
Wine And Spirit Education Trust School
Diploma - Organisational Leadership
Management Futures Consulting Limited
Diploma - General Managers Programme
The Watershed Independent School of Management
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