Summary
Overview
Work History
Education
Skills
Timeline
Generic

Lerato Mohaka

Johannesburg

Summary

Friendly insurance professional experienced in investigating and processing insurance claims. Hardworking and communicative individual excels at interpreting policies and negotiating payment solutions. Recognized for providing optimum service to policyholders and quickly identifying fraudulent claims. Enthusiastic Claims advisor examines, negotiates and processes settlements and verifies insurance coverage. Attentive team player consistently treats clients fairly and equitably. Motivated to succeed in fast-paced and deadline-driven professional environment. Service-oriented Claims Advisor skilled at applying creative approaches to solving complex problems. Adept at developing profitable and quality-focused processes.

Overview

13
13
years of professional experience

Work History

Claims Consultant

Telesure Investment Holdings
05.2018 - Current
  • Improved claims processing efficiency by streamlining workflows and implementing best practices.
  • Reduced claim resolution time with thorough investigations and effective negotiation techniques.
  • Enhanced client satisfaction by providing timely updates on claim status and offering personalized support.
  • Resolved complex claims, utilizing expert knowledge of policy coverage and industry regulations.

Team Leader

Conduent
01.2016 - 02.2018
  • Enhanced team productivity by implementing efficient work processes and regularly reviewing performance metrics.
  • Developed team members'' skills through targeted coaching sessions, resulting in improved individual performance.
  • Led cross-functional teams to execute projects on time, within budget, and with high-quality outcomes.
  • Streamlined workflows for increased efficiency, reducing turnaround times for critical tasks.

Team Leader

Merchants Vodacom Business Unit
01.2011 - 11.2015




Operations Management

Provide operational support services and sometimes act as first-line supervisor of a transactional operations area. Involves using existing systems and protocols.

Performance Management

Develop and propose own performance objectives; take appropriate actions to ensure achievement of agreed objectives, using the organization's performance management systems to improve personal performance. Manage and report on team performance; set appropriate performance objectives for direct reports or project / account team members and hold them accountable for achieving these, taking appropriate corrective action where necessary to ensure the achievement of team / personal objectives.

Customer Management (External)

Help manage clients by carrying out standard activities and providing support to others. Manage customer queries and complaints and resolve these, referring complex issues to others and ensuring that the customer receives an appropriate response.

Operational Compliance

Identify, within the team, instances of non-compliance with the organization's policies and procedures and/or relevant regulatory codes and codes of conduct, reporting these and escalating issues as appropriate.

Leadership and Direction

Explain the local action plan to support team members in their understanding of what needs to be done and and how this relates to the broader business plan and the organization's strategy, mission and vision; motivate people to achieve local business goals.

Capability Building

Use the organization's formal development framework to identify the team's individual development needs. Plan and implement actions to build their capabilities. Provide training or coaching in own area of expertise to enable others to improve performance and fulfill personal potential.

Customer Relationship Management (CRM) Data

Monitor team members' use of the customer relationship management system, identifying and resolving standard issues and escalating these to a senior manager as appropriate.

Insights and Reporting

Extract and combine data to generate standard reports. Identify gaps and suggest improvements to achieve targets and goals.

Education

No Degree - Call Centre

Cornerstone
Randburg
01.2007

High School Diploma -

Maxeke Secondary School
Evaton
01.2002

Skills

  • Professionalism
  • Active Listening
  • Attention to Detail
  • Organizational Skills
  • Problem Solving
  • Investigation Techniques
  • Decision Making
  • Time Management
  • Conflict Resolution
  • Multitasking

Timeline

Claims Consultant

Telesure Investment Holdings
05.2018 - Current

Team Leader

Conduent
01.2016 - 02.2018

Team Leader

Merchants Vodacom Business Unit
01.2011 - 11.2015

No Degree - Call Centre

Cornerstone

High School Diploma -

Maxeke Secondary School
Lerato Mohaka