Senior Claims Handler - Complex Cases

Placements24; Southampton; Sur place; GBP 42 000 - 64 000; Plein temps

Résumé du poste

Placements24 is seeking a Senior Claims Handler to manage complex insurance claims from inception to closure in Randburg. You will investigate, assess, and resolve high-value cases, interpreting policy terms and negotiating settlements with stakeholders.

The role requires a minimum of 5 years in claims handling, strong analytical and negotiation skills, and a professional insurance qualification. You will work in a structured team with opportunities for progression and professional development.

Qualifications

• Minimum 5 years of proven claims handling experience.
• Strong knowledge of insurance products and processes.
• Ability to work independently and meet deadlines.
• Excellent negotiation and communication skills.
• Professional insurance qualifications preferred (CIP/FAIS).

Responsabilités

• Manage a portfolio of complex and potentially high-value insurance claims from inception to closure.
• Conduct in-depth investigations into claim circumstances, gathering all necessary evidence and documentation.
• Interpret policy wordings, coverage details, and applicable legislation to determine claim validity.
• Assess damages, liabilities, and potential for subrogation or fraud.
• Negotiate settlements with claimants, policyholders, legal representatives, and third parties.
• Communicate effectively and empathetically with all stakeholders throughout the claims process.
• Maintain accurate, detailed, and timely records of all claim activities in the claims management system.
• Ensure compliance with company procedures, service level agreements, and regulatory standards.
• Identify trends in complex claims and provide feedback to relevant departments for process improvement.
• Mentor and guide junior claims handlers, sharing expertise and best practices.

Connaissances

Claims handling

Negotiation

Investigation

Policy interpretation

Analytical thinking

Communication

Time management

Formation

Professional insurance qualification (CIP/FAIS)

Outils

Claims management software

MS Office

Description du poste

About the Role

Our client, a leading insurance provider, is seeking an experienced and meticulous Senior Claims Handler to manage complex claims cases within their established operations in Randburg , this vital role involves the thorough investigation, assessment, and resolution of intricate insurance claims across various lines of business. The Senior Claims Handler will be responsible for ensuring accurate claim evaluations, negotiating fair settlements, and providing exceptional service to policyholders, while adhering strictly to policy terms and legal requirements. The ideal candidate possesses a strong understanding of insurance principles, excellent analytical and problem-solving skills, and a commitment to upholding the company's reputation for integrity and efficiency. This is a significant career opportunity for a dedicated professional to contribute to a well-respected organization in Randburg , handling challenging cases and developing expertise in complex claims management. Join our client and become an integral part of their commitment to providing reliable support during critical times for their customers.

Key Responsibilities

• Manage a portfolio of complex and potentially high-value insurance claims from inception to closure.
• Conduct in-depth investigations into claim circumstances, gathering all necessary evidence and documentation.
• Interpret policy wordings, coverage details, and applicable legislation to determine claim validity.
• Assess damages, liabilities, and potential for subrogation or fraud.
• Negotiate settlements with claimants, policyholders, legal representatives, and third parties.
• Communicate effectively and empathetically with all stakeholders throughout the claims process.
• Maintain accurate, detailed, and timely records of all claim activities in the claims management system.
• Ensure compliance with company procedures, service level agreements, and regulatory standards.
• Identify trends in complex claims and provide feedback to relevant departments for process improvement.
• Mentor and guide junior claims handlers, sharing expertise and best practices.

Requirements

• A relevant tertiary qualification or professional insurance qualification (e.g., CIP, FAIS accreditation) is highly preferred.
• Minimum of 5 years of proven experience in claims handling, with a demonstrated ability to manage complex and challenging cases.
• Comprehensive knowledge of various insurance products and claims processes.
• Strong analytical, critical thinking, and problem-solving skills.
• Excellent negotiation, communication, and interpersonal abilities.
• High level of integrity, attention to detail, and organizational skills.
• Proficiency in using claims management software and standard office applications.
• Ability to work independently, manage time effectively, and meet deadlines.
• A proactive approach to claim resolution and customer service.
• Experience in specific lines of insurance such as Commercial, Liability, or Marine claims is an advantage.

Benefits

• Competitive salary package commensurate with experience.
• Comprehensive medical aid and retirement fund benefits.
• Opportunities for professional development and career advancement within the insurance industry.
• A professional and supportive work environment in Randburg .
• Exposure to a wide range of complex claims, enhancing expertise.
• Potential for flexible working arrangements based on role and performance.