Summary
Overview
Work History
Education
Skills
Other Skills
Languages
Timeline
Generic

SEBASTIAN GONZALEZ

Gladesville,NSW

Summary

Dedicated and results-oriented Claims Consultant with a comprehensive background in managing end-to-end claims portfolios. Specializing in heavy machinery and bus/coach insurance, I bring a unique blend of technical expertise, stakeholder relationship management, and compliance adherence. Proven success in evaluating, processing, and settling claims, with a focus on maintaining positive client relationships. Adept at handling Catastrophic (CAT) claims and providing detailed monthly reporting. Demonstrated leadership in team environments, coupled with fluency in English and Spanish.

Overview

9
9
years of professional experience

Work History

Claims Consultant

HMIA
04.2021 - Current
  • Demonstrated proficiency in applying technical skills and understanding of the PDS to manage end-to-end claims portfolios to ensure accurate processing.
  • Cultivated strong relationships with internal and external stakeholders, fostering collaboration and effective claims resolution.
  • Exhibited expertise in liaising with assessors, investigators,and solicitors to thoroughly evaluate and process claims.
  • Handled aggregate claims with precision, ensuring timely and accurate resolution.
  • Adhered strictly to the General Insurance Code of Practice,demonstrating a commitment to ethical and compliant claims management.
  • Continuously self-educated on industry practices, staying abreast of regulatory changes and best practices.
  • Possessed valuable CAT claims handling exposure,demonstrating the ability to manage claims in high-volume,high-pressure situations.
  • Generated insightful monthly claims, aggregate transaction,and performance reports, providing valuable insights into claims trends and performance.
  • Displayed strong administrative skills, effectively verifying documentation, researching facts, and contacting other parties involved to determine fault percentages and minimize potential losses.

Claims Consultant

SURA Pty Ltd
07.2019 - 04.2021
  • End-to-end claims portfolio management including over and under excess claims.
  • Oversaw payment processing, recoveries, and implemented financial controls for transparent management of the insured's trust fund account.
  • Fostered positive relationships with insureds and brokers, ensuring high client satisfaction.
  • Consistently followed the General Insurance Code of Practice, maintaining ethical practices.
  • Facilitated onboarding, providing comprehensive training for a skilled workforce.

Customer Service Representative

The NRMA
09.2018 - 06.2019
  • Processing payments and updating member's accounts and insurance policies.
  • Offering new products to new and existing members as well as up selling/upgrading existing accounts.
  • Cross-selling between insurance products, roadside assistance and memberships.
  • Identifying customers wants and needs.
  • Representing well-known brands with outstanding customer service.
  • Setting up of new policies and memberships, as well as amendments and cancellations (CTP, Roadside assistance memberships, car and motorcycle insurance).

Team Leader

Teleperformance Colombia
07.2016 - 05.2017
  • Managing lines of service through inbound and outbound calls, chats and emails
  • Provided training on sales and customer service.
  • Handling of escalations.
  • Weekly audits and reporting.
  • Payroll approval.
  • Monitored team performance and provided constructive feedback to increase productivity and maintain quality standards.

Team Leader

Convergys/AT&T
06.2014 - 07.2016
  • Develop and implement strategic plans that promote improvement in KPIs.
  • Effectively manage staff schedules and utilize Avaya skills based on real-time call queue.
  • Provide comprehensive training and follow-up as part of team development.
  • Handle case escalations promptly and effectively.
  • Conduct weekly and monthly audits/reporting (individual and team).
  • Consolidate data to pay commissions.
  • Approve payroll and casualties.

Education

High School Diploma -

Casa Academica Cultural
Bogota, Colombia
12.2015

Skills

  • Documentation Review
  • Coverage Assessments
  • Settlement Negotiations
  • File and Record Management
  • Active Listening
  • Team Collaboration
  • Critical Thinking
  • Liability Determination
  • Relationship Building
  • Computer Skills
  • Microsoft Office Suite
  • Coaching and Mentoring

Other Skills

Microsoft Office Suite, Adobe Acrobat, Microsoft and MacOS, English and Spanish.

Languages

English
Spanish

Timeline

Claims Consultant

HMIA
04.2021 - Current

Claims Consultant

SURA Pty Ltd
07.2019 - 04.2021

Customer Service Representative

The NRMA
09.2018 - 06.2019

Team Leader

Teleperformance Colombia
07.2016 - 05.2017

Team Leader

Convergys/AT&T
06.2014 - 07.2016

High School Diploma -

Casa Academica Cultural

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SEBASTIAN GONZALEZ