Afe Nafatali
@afenafatali
I am an experienced workers' compensation claims manager specializing in liability and case management.
What I'm looking for
I am a workers' compensation claims manager with extensive experience making liability determinations and managing diverse portfolios across public and private sectors.
At Marsh McLennan I manage multiple council portfolios, making acceptance, cessation, and rejection determinations. I review specialist reports and liaise with treating clinicians to reach fair decisions.
Previously I held claims and case manager roles at JBS, Allianz, WorkCover QLD and Broadspire/Crawford, handling high-volume caseloads, wage calculations, invoice approvals, and return-to-work planning. I hold a Certificate IV in Mental Health and a Certificate II in Business Administration.
I bring strong customer service, conflict resolution, and case analysis skills, and I work well independently or as part of a team to support injured workers and stakeholders. I focus on fair outcomes, clear communication, and continuous improvement.
Experience
Work history, roles, and key accomplishments
Claims Manager
Marsh McLennan
Oct 2024 - Present (11 months)
Managed two self-insurance workers' compensation portfolios (Gympie Regional Council & Central Highlands Council), making determinations on physical and psychological claims and issuing reasoned decisions. Reviewed medical and specialist reports, calculated wages, and facilitated claim reviews with clients.
Claims Advisor
JBS Australia
Jul 2023 - Sep 2024 (1 year 2 months)
Managed four self-insurance workers' compensation portfolios across multiple abattoirs, accepting, ceasing, and rejecting physical injury claims and producing 'Reasons for Decision' letters. Coordinated with providers, organised return-to-work plans, and approved treatments and surgery requests.
Case Manager
Allianz Insurance
Aug 2022 - Mar 2023 (7 months)
Managed a portfolio of 200–300 personal injury and COVID-19 claims for the Department of Education, assessing provisional liability and authorising medical and wage payments. Reviewed reports from doctors and rehab consultants and updated claim estimations.
Liability Claims Assessor
Broadspire & Crawford and Company
Mar 2022 - Aug 2022 (5 months)
Assessed liability claims by reviewing client reports and CCTV footage, declining or approving claims and liaising with stakeholders to resolve customer complaints. Conducted outbound calls to injured clients and collaborated with colleagues on coaching to improve customer outcomes.
Case Manager
WorkCover QLD
Jun 2021 - Mar 2022 (9 months)
Managed government portfolios, lodging and registering new claims and determining liability from medical evidence to support return-to-work outcomes. Processed time-loss wage payments and coordinated with health practitioners and employers for holistic case support.
Insurance Consultant & Team Leader
Allianz Global Assistance
May 2015 - Nov 2020 (5 years 6 months)
Handled inbound customer enquiries, processed travel insurance sales and payments, and managed a team including training, side-by-side coaching and call monitoring. Led dispute resolution and liaised with AFCA on policy breaches and refund disputes.
Servicing Consultant
DB Marketing Solutions
May 2014 - Apr 2015 (11 months)
Managed inbound and outbound customer calls to schedule services, update customer records and maintain booking databases to support service delivery. Resolved customer enquiries and maintained accurate records.
Membership Consultant
GMF Health Insurance
Apr 2012 - Mar 2013 (11 months)
Handled inbound calls to process membership applications, update customer details and sell health insurance products over the phone while resolving customer enquiries. Maintained accurate membership records.
Recruitment Administration Officer
ATIVO
Jan 2012 - Mar 2012 (2 months)
Managed placement records, conducted inductions and coordinated crew assemblies for mine sites by contacting employees for availability and processing placement IDs. Supported recruitment admin tasks to ensure site readiness.
Duty Supervisor
SUPA IGA
Jun 2011 - Jan 2012 (7 months)
Supervised front-end operations, handled customer enquiries and conflicts, and processed weekly sales reconciliation to maintain service standards. Provided frontline support and resolved issues both in-person and by phone.
Administration
Queensland Health Department
Oct 2010 - May 2011 (7 months)
Provided administrative support including phone handling, processing AVAC and leave forms, data entry, filing and scanning to maintain departmental records and workflows. Uploaded documents into internal systems for recordkeeping.
Reception
Hills Industry
Jan 2007 - Feb 2008 (1 year 1 month)
Managed reception duties including answering calls, data entry and mail handling to support office operations. Provided client-facing support and administrative assistance.
Reception
Insurserv Australia
Feb 2006 - Dec 2006 (10 months)
Greeted clients, managed incoming calls and mail, processed invoices and banking tasks, and transferred calls across departments to support business operations. Maintained front-desk efficiency.
Customer Service
Woolworths Supermarket
Apr 2003 - Dec 2005 (2 years 8 months)
Assisted customers with grocery enquiries, processed EFT payments, handled stock ordering and supported the deli department to maintain customer service standards. Resolved customer issues and supported store operations.
Education
Degrees, certifications, and relevant coursework
Courses 4 Me
Certificate IV in Mental Health, Mental Health
2020 -
Completed Certificate IV in Mental Health in 2020.
Skills@TopOffice
Certificate II in Business Administration, Business Administration
2010 -
Completed Certificate II in Business Administration in 2010.
Glenala State High School
High School Studies, Secondary Education
2005 -
Attended Glenala State High School in 2005.
Corinda State High School
High School Studies, Secondary Education
2001 - 2004
Attended Corinda State High School and completed Years 8–11 from 2001 to 2004.
Availability
Location
Authorized to work in
Job categories
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