Summary
Overview
Work History
Education
Skills
Current Studies
Timeline
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KAY FASSOULARIS

Vincentia,NSW

Summary

Results-oriented professional with a proven track record in effectively managing complex claims and providing exceptional customer service. Skilled in analyzing and resolving issues, ensuring timely and accurate claim processing. Strong attention to detail and ability to multitask in fast-paced environments, consistently meeting or exceeding performance targets. Adept at building rapport with clients and collaborating with cross-functional teams to deliver optimal outcomes. I have a passion for assisting others with respect and giving back to my community, this can be seen with my advocacy for disability and mental health, and in my participation as an Aunty in the Indigenous community and as a firefighter with the RFS.

Overview

10
10
years of professional experience

Work History

SENIOR CASE MANAGER – Death

AustralianSuper
10.2023 - Current
  • Enhanced case processes to streamline operations and expedite resolutions within the Australian superannuation sector's death claims.
  • Fostered improved team collaboration through the establishment of clear communication channels and a supportive team environment.
  • Conducted ongoing training sessions to equip staff with best practices in managing death claims, thereby enhancing overall team efficiency.
  • Provided informal mentorship to new case managers and service coordinators, offering guidance and clarification on company procedures.
  • Offered leadership and support to team members, promoting professional development and cohesion.
  • Facilitated senior-level discussions to drive process improvements in death claims management within the Australian superannuation sector.
  • Managed AFCA complaints and media threat cases from start to finish, ensuring seamless resolution and effective communication throughout.
  • Assisted team members in effectively managing payout exits within the death claims process, ensuring efficient task execution and workflow
  • Collaborated with external agencies to secure resources for clients, ensuring optimal support and care.
  • Monitored clients' progress and tracked client services to provide crisis interventions.
  • Spearheaded initiatives aimed at streamlining workflows within the department, reducing administrative burdens on staff members while maintaining high-quality services for clients.
  • Formally mentored new case managers and service coordinators, answering questions, offering opportunities to shadow and observe and explaining basic information about company procedures.
  • Served as case coordinator, assuming responsibility for complex, high-volume assignments and guiding endeavors to successful completion.
  • Mentored junior case managers to enhance their skill sets and promote professional growth.
  • Delivered ongoing training sessions for staff members on best practices in case management, enhancing overall team performance.
  • Facilitated individual and group sessions to promote positive behavior change for clients.
  • Provided leadership, guidance and support to staff members.
  • Established and maintained relationships with key stakeholders.
  • Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
  • Monitored ongoing cases closely, adjusting case management strategies as needed based on evolving circumstances or new information.
  • Fostered open lines of communication with clients'' families and support networks, involving them in the case management process as appropriate.

CASE MANAGER RELATIONSHIPS – Death

LINK GROUP
05.2023 - 10.2023
  • Effectively manage multiple tasks and priorities.
  • Take ownership of claims and maintain regular proactive follow-up through phone contact to drive outcomes.
  • Support and adapt to change to enhance customer service for claimants.
  • Build effective relationships with team members and key contacts.
  • Listen attentively to claimants and promptly address their concerns with accurate information.
  • Handle difficult conversations by listening actively, empathizing, and resolving issues promptly.
  • Contribute to continuous improvement initiatives.
  • Provide excellent service by thoroughly understanding claimants' circumstances, expectations, and needs.
  • Take personal responsibility to ensure actions are completed on time and prioritize member experience.
  • Proactively manage claims portfolios according to quality case management standards.
  • Pursue development opportunities to enhance skills and capabilities.
  • Adhere to service and quality standards in all work.
  • Apply a thorough investigative approach to death claims to identify all eligible claimants promptly.
  • Minimize delays by managing documents effectively and coordinating with stakeholders.
  • Consistently deliver high-quality work with minimal errors or breaches to meet team and departmental goals.
  • Be an active team player and contribute to shared objectives.
  • Ensure compliance with legislative requirements and guidelines.

IP, TPD AND TIB CLAIMS ASSESSOR

LINK GROUP
02.2023 - 01.2024
  • Offer guidance, coaching, and support to new team members during their onboarding and integration process.
  • Take ownership of portfolios and associated workflows to ensure customer requirements are met.
  • Establish rapport with customers over the phone, maintaining regular contact and identifying appropriate support services.
  • Evaluate claims against policy terms, providing clear rationale for decisions and weighting of evidence.
  • Handle incoming work items according to service level agreements and departmental objectives.
  • Ensure all written communication is timely, accurate, and professional.
  • Identified fraudulent claims with comprehensive investigations, minimizing company losses and maintaining integrity in the claims process.
  • Maintained accurate records of all claims assessed, facilitating easy retrieval when needed for audits or internal reviews.
  • Established trust among clients by consistently demonstrating empathy and understanding throughout the entire claims assessment process.
  • Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
  • Reviewed questionable claims by conducting agent and claimant interviews to correct omissions and errors.
  • Handled sensitive information with discretion, ensuring confidentiality of personal and financial details for claimants throughout the claims examination process.
  • Utilized analytical skills to evaluate medical bills for accuracy and appropriateness of charges before approving payments as part of the claims process.
  • Reduced claim processing time by implementing efficient workflow strategies and prioritizing tasks effectively.
  • Maintained detailed records of all claims activities, ensuring compliance with regulatory requirements and company policies.
  • Analyzed information gathered by investigation and reported findings and recommendations.
  • Provided exceptional customer service by empathetically addressing claimants'' concerns and effectively explaining the claims process to them.
  • Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
  • Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
  • Examined claims forms and other records to determine insurance coverage.
  • Conducted day-to-day administrative tasks to maintain information files and process paperwork.
  • Researched claims and incident information to deliver solutions and resolve problems.

WORKERS COMPENSATION CLAIMS ADVISOR

SUNCORP
01.2020 - 01.2021
  • Offer guidance, coaching, and support to new team members during their onboarding and integration process.
  • Conducted day-to-day administrative tasks to maintain information files and process paperwork.
  • Maintained contact with claimants and attorneys to determine treatment status.
  • Followed up on potentially fraudulent claims initiated by claims representatives.
  • Evaluated original investigation reports and documents to resolve secondary concerns.
  • Worked with private investigators and attorneys on preparation of evidence, witness statements, and other documentation in preparation for trial.
  • Take ownership of portfolios and associated workflows to ensure customer requirements are met.
  • Proactively oversee claims from start to finish, aligned with the claims philosophy.
  • Establish rapport with customers over the phone, maintaining regular contact and identifying appropriate support services.
  • Manage stakeholder expectations to ensure a seamless customer experience.
  • Evaluate claims against policy terms, providing clear rationale for decisions and weighting of evidence.
  • Engage third parties for claim assessment support as necessary, based on cost-benefit analysis.
  • Handle incoming work items according to service level agreements and departmental objectives.
  • Manage claims within risk and governance frameworks such as the Life Insurance Code of Practice.
  • Recognize, categorize, and prioritize work with minimal intervention required.
  • Ensure all written communication is timely, accurate, and professional.
  • Process claim payments and calculate CPI increases within delegated authority.
  • Contribute to special projects within the team when needed.
  • Review cases of other team members as necessary.
  • Ensure timely action on claim remediation directed by Tower or Senior Management.
  • Apply medical, legal, claims assessment, and superannuation knowledge consistently to evaluate claims.
  • Provide training to assessors, trainee assessors, and administrative support staff as needed.

AAMI and GIO Event Claims Customer Service Officer

Suncorp
01.2019 - 01.2020
  • Provided constructive feedback to peers and management on potential process improvements, aiding continuous enhancement of service quality.
  • Enhanced customer satisfaction by efficiently addressing and resolving their inquiries and concerns.
  • Assisted call-in customers with questions and orders.
  • Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
  • Addressed customer complaints and mitigated dissatisfaction by employing timely and on-point solutions.
  • Streamlined communication between customers and internal departments for timely issue resolution.
  • Managed escalated cases with diplomacy, skillfully negotiating resolutions that satisfied both the customer and company interests.
  • Participated in regular meetings with supervisors to discuss challenges faced during daily operations, identifying opportunities for growth and development.
  • Maintained a high level of product knowledge to effectively assist customers with accurate information and recommendations.
  • Increased customer retention with prompt follow-ups on pending issues and proactive problem-solving strategies.
  • Exceeded customer expectations by going the extra mile, ensuring a memorable experience that fostered brand loyalty and advocacy.
  • Responded to customer requests, offering excellent support and tailored recommendations to address needs.
  • Cross-trained and backed up other customer service managers.
  • Sought ways to improve processes and services provided.
  • Followed up with customers about resolved issues to maintain high standards of customer service.
  • Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
  • Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
  • Developed rapport with customers through active listening skills, leading to higher retention rates and positive feedback from clients.

Apia Insurance Sales, Service and Retention

Suncorp
01.2015 - 02.2018
  • Facilitated collaboration among team members by promoting open communication channels and providing ongoing feedback.
  • Streamlined internal processes for increased efficiency, improving overall team performance and productivity.
  • Actively participated in community events to promote company brand awareness among potential candidates.
  • Remained current with training and sought new training opportunities to further personal growth.
  • Provided constructive feedback to internal teams based on customer complaints, contributing to continuous improvement initiatives.
  • Managed high volumes of customer complaints, ensuring timely and effective resolutions for improved customer retention.
  • Served as a role model for other Complaints Officers by maintaining a professional demeanor and providing exceptional service in all customer interactions.
  • Demonstrated exceptional time management skills, consistently meeting deadlines for resolving complaints and reporting on complaint trends.
  • Maintained up-to-date knowledge of industry regulations and compliance requirements related to consumer complaints handling processes.
  • Conducted thorough investigations into complex complaint cases to determine appropriate resolution strategies.
  • Developed strong relationships with key stakeholders through clear communication and collaborative problem-solving efforts.
  • Responded to customer requests, offering excellent support and tailored recommendations to address needs.
  • Promoted superior experience by addressing customer concerns, demonstrating empathy, and resolving problems swiftly.

SPECTRUM SUPPORT WORKER

AUTASTIC VACATION CARE
01.2015 - 01.2017
  • Enhanced the quality of care for clients by providing personalized support and assistance with daily living activities.
  • Improved client satisfaction by promptly addressing concerns and implementing feedback in a timely manner.
  • Established trusting relationships with clients and their families through empathetic communication and active listening.
  • Contributed to the development of agency policies and procedures aimed at improving overall service delivery standards for all clients served.
  • Mentored new support workers by providing guidance, sharing best practices, and modeling effective client-centered care techniques.

Education

RG146 -

Kaplan Professional

Suncorp Network Training

TAFE NSW

Certificate III in Children’s Services -

Southern Solutions Training

Skills

  • Excellent relationship-building abilities with all stakeholders
  • Capability to perform effectively under pressure
  • Proficient in understanding and interpreting legislation
  • Exceptional communication skills, both verbal and written
  • Providing training to assessors and support staff as needed, fostering skill development
  • Proficient in conducting staff training sessions to enhance team capabilities
  • Experienced in leading discussions and implementing changes, particularly in the context of death claims management
  • Insurance collaboration
  • Cross-cultural sensitivity
  • Needs Assessment
  • Problem-Solving
  • Case Documentation
  • Decision-Making
  • Relationship Building
  • Conflict Resolution
  • Documentation And Reporting

Current Studies


  • Currently studying Cultural Competency
  • Currently studying Mental Health First Aid

Timeline

SENIOR CASE MANAGER – Death

AustralianSuper
10.2023 - Current

CASE MANAGER RELATIONSHIPS – Death

LINK GROUP
05.2023 - 10.2023

IP, TPD AND TIB CLAIMS ASSESSOR

LINK GROUP
02.2023 - 01.2024

WORKERS COMPENSATION CLAIMS ADVISOR

SUNCORP
01.2020 - 01.2021

AAMI and GIO Event Claims Customer Service Officer

Suncorp
01.2019 - 01.2020

Apia Insurance Sales, Service and Retention

Suncorp
01.2015 - 02.2018

SPECTRUM SUPPORT WORKER

AUTASTIC VACATION CARE
01.2015 - 01.2017

Suncorp Network Training

TAFE NSW

Certificate III in Children’s Services -

Southern Solutions Training

RG146 -

Kaplan Professional

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KAY FASSOULARIS