Nyabe Ntlhoka

I am an honest, punctual, hardworking, and goal-oriented professional with extensive experience in customer service, claims administration, and team leadership. I am proactive and solution-driven, with a strong ability to resolve complex customer issues while maintaining a high standard of service. I possess excellent communication, problem-solving, and interpersonal skills, allowing me to build positive relationships with customers and colleagues.

I am committed to delivering quality results, adapting to new challenges, and contributing positively to any organisation through professionalism, integrity, and teamwork.

Customer Care and Claims Consultant - Oneplan Insurance

(2024-05)

• Provide professional customer service through digital and telephonic communication channels.
• Assist customers with policy, claims, and account enquiries.
• Respond promptly and professionally to customer emails.
• Identify service failures and implement appropriate resolutions.
• Take ownership of customer enquiries until they are fully resolved.
• Capture and verify client demographic information, including names, dates of birth, addresses, and policy details.
• Confirm active policy cover and customer benefits before processing claims.
• Review submitted documents and invoices for completeness and accuracy.
• Verify ICD-10 diagnosis codes before claims processing.
• Submit verified claims to assessors for final assessment and approval.
• Maintain accurate records while ensuring compliance with company procedures and service standards.

Team Mentor / Coach - Webhelp SA

(2020-09 - 2023-05-15)

• Provided training, coaching, evaluations, and floor support to customer service advisors.
• Educated advisors on new products, systems, and procedures.
• Delivered hardware and software technical support.
• Monitored and improved quality standards by recommending process improvements.
• Resolved complex customer delivery and tracking enquiries.
• Managed escalated customer calls and emails.
• Liaised with couriers, depots, warehouses, suppliers, and other stakeholders.
• Assisted customers through inbound and outbound telephone, email, and webchat communication.
• Determined responsibility for customer credits and account adjustments.
• Resolved customer queries in line with operational and client policies.
• Diagnosed customer needs and identified the most effective solutions.
• Achieved first-contact resolution while meeting service level agreements (SLAs).
• Promoted client products and services where appropriate.
• Monitored high-risk customer accounts and ensured timely action.
• Escalated unresolved issues to management when necessary.
• Worked efficiently across multiple systems while consistently meeting operational targets.

Grade 12 - Matric - Kwa Mahlobo Secondary School