Shaney Ellapen
Gauteng
Summary
Detail-oriented and customer-focused insurance consultant with experience in gap cover and client services within the health insurance environment. FAIS compliant with RE5 and COB (Personal Lines). Strong understanding of claims processes, policy interpretation, customer engagement, and regulatory requirements. Proven ability to manage queries, assess documentation requirements, and liaise effectively with brokers, service providers, and internal stakeholders.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Contact Centre Agent
Gap Cover Claims Environment
01.2024 - Current
- Respond to customer queries relating to gap cover benefits, claims, and documentation requirements
- Route and label incoming queries accurately according to internal processes
- Assist with claim pre-assessment support and verification of supporting documentation
- Liaise with brokers, medical service providers, and internal departments to resolve claim-related queries
- Provide professional responses to email and website enquiries within SLA timelines
- Support members with claim submission requirements and follow-ups
- Maintain high standards of customer service in line with TCF principles
- Apply POPIA requirements when handling member information
- Capture and update claim-related information accurately on internal systems
Sales Assistant
Le Coq Sportiff
Johannesburg
12.2017 - 02.2018
- Provided in-store and professional product support to customers.
- Executed customer transactions accurately and efficiently using point-of-sale systems.
- Managed customer queries, complaints, and returns in a calm and professional manner.
- Established strong customer relationships, contributing to enhanced customer loyalty and sales performance.
- Assisted with stock replenishment, visual merchandising, and store organisation.
- Assisted customers in locating products and provided detailed information to enhance shopping experience.
Education
BCom - Accounting
Mancosa
Johannesburg, GP01-2028
Matric - Commerce
Missourilaan Secondary
Johannesburg, GP01-2017
Skills
- Gap Cover Claims Administration Support
- Medical Aid & Health Insurance Product Knowledge
- Claims Documentation Verification
- Customer Query Resolution (Email & Telephonic)
- POPIA Compliance Application
- Treating Customers Fairly (TCF) Principles
- Strong Telephone Etiquette
- Data Capturing & Accuracy
- SLA Adherence
- Broker & Service Provider Liaison
- Microsoft Office
- Customer needs analysis
- Customer communications
- Call handling etiquette
- Attention to Detail
- Analytical Thinking
- Team Collaboration
- Adaptability in High-Volume Environments
Certification
- RE5 certificate
- Class of Business
Languages
- English
- Afrikaans
- Tswana
Timeline
Contact Centre Agent
Gap Cover Claims Environment
01.2024 - Current
Sales Assistant
Le Coq Sportiff
12.2017 - 02.2018
BCom - Accounting
Mancosa
Matric - Commerce
Missourilaan Secondary