Cynthia Hlako

Results-driven healthcare and contact centre professional with over 9 years of experience in medical scheme administration, pharmaceutical claims, customer care, quality assurance, and team leadership within the healthcare industry. Holds a Bachelor of Business Administration (BBA), strengthening expertise in operational management, leadership, business processes, and service delivery. Proven expertise in quality monitoring, SLA management, coaching, escalation handling, compliance auditing, claims administration, and operational support within high-volume contact centre environments.

Demonstrated ability to improve service delivery through quality evaluations, workflow monitoring, process improvement initiatives, and staff coaching. Strong understanding of medical scheme operations, customer satisfaction management, call centre best practices, SOP adherence, and performance reporting. Recognized for service excellence, leadership support, and continuous improvement contributions.

Well-suited for both Quality Assurance Consultant and Call Centre Team Leader roles through strong analytical ability, leadership capability, quality management expertise, and customer-centric service delivery.

Assistant Team Leader | Claims & Client Services - Universal Healthcare

(2019-01)

• Lead and support client service teams in achieving departmental KPIs, SLA targets, and quality standards within a high-volume healthcare contact centre environment.
• Conduct quality assurance audits and moderation assessments to ensure compliance with operational procedures and customer service standards.
• Monitor consultant performance through coaching, feedback sessions, and continuous performance improvement initiatives.
• Handle escalated member, provider, and stakeholder queries with professionalism and efficiency.
• Analyse operational reports and identify service delivery gaps, recommending corrective actions and process improvements.
• Support workflow management and ensure adherence to SOPs, medical scheme rules, and compliance requirements.
• Collaborate with internal departments to improve turnaround times and enhance customer satisfaction.
• Assist with staff development, onboarding support, and coaching initiatives to improve team effectiveness and service quality.
• Monitor operational risks, service trends, and complaint patterns to drive continuous improvement initiatives.
• Ensure accurate reporting and documentation aligned with departmental quality assurance requirements.

Customer Care Consultant – Pharmaceutical Claims - Medikredit Integrated Healthcare

(2018-01 - 2019-12)

• Processed and validated pharmaceutical claims using NAPPI codes and medical scheme guidelines.
• Assisted members and healthcare providers with claims, benefit, and chronic medicine queries.
• Investigated claim discrepancies and resolved provider escalations effectively.
• Verified prescriptions and ensured accurate data capturing and claims processing.
• Maintained compliance with medical scheme rules, operational procedures, and quality standards.
• Managed chronic medicine applications, renewals, and supporting documentation.
• Delivered professional customer service while maintaining SLA requirements and turnaround times.

Senior Educational & Script Renewal Agent - Universal Healthcare

(2017-01 - 2018-12)

• Assisted members with chronic medication renewals and treatment authorisations.
• Assisted members with DSP (Designated Service Provider) allocations and provider selection for chronic medication management.
• Linked and updated member scripts accurately on the system to ensure uninterrupted chronic medication access.
• Guided members on allocated providers and medication collection processes in line with medical scheme rules and benefits.
• Educated members on benefits, medication processes, and healthcare procedures.
• Managed customer interactions professionally while ensuring service quality standards.
• Ensured accurate documentation, query resolution, and member communication.

Bachelor of Business Administration (BBA) - MANCOSA (2023-01 - 2025-12)

National Senior Certificate - Oxford Combined College (2005-01 - 2005-12)