
Nico Mocumi
Customer Service Specialist
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About
Customer service and policy administration specialist with over 4 years of experience across healthcare, finance, and insurance industries. Proven expertise in managing hospital authorizations, trauma cover claims, and high-volume client queries within a fast-paced corporate environment. Skilled at explaining complex policy benefits to clients with empathy and clarity, ensuring a high standard of customer service and adherence to turnaround times.
Recognized for adaptability, team development, problem solving, and a commitment to enhancing customer satisfaction across diverse roles and industries.
Experience
New Markets Service Specialist at Discovery Limited (2025-10 – Present)
- Handled multiple telephonic queries from Discovery FlexiCare members, brokers, employers and franchises.
- Resolved complex claim disputes by logging inquiries and maintain service level agreements by keeping clients up to date with queries.
- Provided product knowledge, policy clarification, benefits information and more importantly claim queries.
Finance Administrator at Discovery Limited (2024-08 – 2025-09)
- Servicing all key stakeholders telephonically and via other servicing channels as required until the query has been resolved.
- Administered high volume financial accuracy to ensure successful debit orders and claim refunds.
- Financial maintenance (bank detail changes, forced EFT's, early MSA refunds) with attention to procedures and rules relating to financial maintenance
- Required to work overtime during busy periods.
- Knowledge of billing and debit order processes like allocating payments, processing refunds.
- Conducted daily, weekly and monthly QA of debit order and refund files.
Health Partner Service Agent at Discovery Limited (2023-06 – 2024-07)
- Resolved rejected healthcare claims by identifying discrepancies and coordinating resolutions.
- Logging inquiries for claims reprocessing and ensuring correspondence is sent to the stakeholders with the specified turnaround time.
- Provided benefit confirmations and claims guidance to healthcare professionals.
- Advised stakeholders on missing documentation required for successful claim processing.
Field Sales Agent at Blue Labels (2021-10 – 2023-02)
- Directly selling all South African network SIM cards to prospective customers.
- Assisted with the RICA process and products upselling.
Education
Bachelor of Commence Business Informatics in Business Informatics – UNISA (2025-01)