Sithembile Mncube

Customer-focused and detail-oriented Customer Service Representative with 8 years experience in health insurance, medical aid, retirement funds, group risk, contact center environment, and employee benefits. Skilled in handling high volume inbound customer enquiries across the phone, email and digital channels while delivering professional and empathetic service. Experienced in claim support, policy administration membership updates, escalation handling, and resolving customer queries within Service Level Agreement.

Employee Benefits Consultant - Growthpoint Properties - Johannesburg

(2024-01 - 2025-05)

• Assisted employees with medical aid, GAP cover, and claims-related enquiries across email, phone, and digital communication channels.
• Resolved customer queries relating to unpaid claims, dependent changes, and benefit administration withing agreed turnaround times.
• Logged and followed up on escalated service issues with the external services providers to ensure timely resolution and exceptional customer satisfaction.
• Maintained accurate records and reporting while ensuring compliance with internal procedures and insurer requirements.

Broker Consultant (Medical Aid Consultant) - Remote - Betaplus Group Solutions - Cape Town

(2019-02 - 2023-12)

• Provided end-to-end medical aid administration support to multiple corporate clients, handling billing queries, financial changes, and benefit updates with high accuracy.
• Assisted employees with claims processing, authorisations, tax certificates, and plan changes, reducing repeat queries and escalations.
• Conducted employee onboarding, advising new joiners on available medical aid options and benefit structures.
• Coordinated international travel letters and benefit confirmations for employees travelling abroad.
• Delivered retirement fund and group risk benefit presentations to employer groups, improving awareness and informed decision-making.
• Supported the planning and execution of corporate wellness days, contributing to increased employee engagement.
• Maintained strong relationships with multiple service providers including Discovery, Fedhealth, Bonitas, Momentum, Stratum GAP, ADMED GAP, ensuring seamless service delivery.

Contact Centre Consultant (Inbound) - Discovery Health - Johannesburg

(2015-09 - 2019-01)

• Managed high volumes of inbound customer service calls and follow-up queries from medical aid members and external brokers in a fast-paced contact center environment.
• Assisted clients with policy enquiries, membership updates, benefit information, claims queries, pre-authorization and policy amendments.
• Responded to customer queries within service level agreement while maintaining high quality customer service standards.
• Logged customer interactions, escalations, and resources accurately on the CRM system to maintain full audit trails.
• Collaborated with pre-authorization, finance, health partner, and new department departments to resolve complex customer queries effectively.
• Managed difficult and irate client interaction professionally while maintaining empathy and customer satisfaction.
• Assisted with policy upgrades and downgrades, cancellations and membership administration during the Year End season.

Outbound Client Services (Outbound) - Discovery Health - Johannesburg

(2015-09 - 2019-01)

• Processed new memberships, withdrawals, dependent updates, and policy amendments accurately and efficiently.
• Followed up on outstanding documentation and assisted with customer communication to improve turnaround times.
• Supported administrative reporting and maintaining accurate customer records across multiple systems.

Matric Certificate - Sandringham High School (1999-01 - 2003-12)

National Diploma in Legal Assistance in Law - Law - Tshwane University of Technology (2004-01 - 2007-06)