Remote Insurance Claims Adjuster - Specialized Policies

Placements24; Queenstown; Híbrido; NZD 51 000 - 68 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Fully remote

Competitive salary

Bonuses

Medical aid and retirement fund

Resumo da oferta

Placements24 in South Africa is seeking a seasoned Remote Insurance Claims Adjuster to manage complex claims end-to-end from initiation to closure. The role requires investigating claim validity, reviewing documentation, and negotiating settlements with policyholders and legal representatives.

A strong analytical mindset and familiarity with niche insurance products are essential. The position is fully remote, offering flexibility to work from anywhere within South Africa.

Qualificações

• Minimum of 5 years of experience as an Insurance Claims Adjuster with complex or specialized claims (e.g., liability, professional indemnity, cyber).
• Strong policy interpretation and claims adjudication expertise.
• Excellent analytical, problem-solving, and decision-making skills.

Responsabilidades

• Manage and process complex and specialized insurance claims independently from initiation to closure.
• Conduct thorough investigations into the circumstances and validity of claims.
• Obtain and review all necessary documentation, including expert reports and legal opinions.
• Communicate professionally and empathetically with policyholders, claimants, legal representatives, and other stakeholders.
• Assess policy coverage and determine appropriate claim settlements based on policy terms and conditions.
• Negotiate settlements effectively, striving for fair and timely resolutions.

Conhecimentos

Analytical thinking

Negotiation

Communication

Claims handling

Formação académica

ACII

FLMI

Ferramentas

Claims management software

Descrição da oferta de emprego

About the Role

Our client, a leading innovator in the **insurance** sector, is seeking experienced and highly motivated Remote Insurance Claims Adjusters specializing in complex policy types. This is a fully remote position, offering the flexibility to work from anywhere within **South Africa**, serving clients nationwide. You will be entrusted with the end-to-end management of specialized claims, requiring in-depth investigation, meticulous documentation, and fair adjudication. The ideal candidate possesses a strong analytical mind, exceptional negotiation skills, and a comprehensive understanding of niche insurance products. This role is critical for maintaining our client's reputation for excellence and efficiency in handling challenging claims.

Key Responsibilities

• Manage and process complex and specialized insurance claims independently from initiation to closure.
• Conduct thorough investigations into the circumstances and validity of claims.
• Obtain and review all necessary documentation, including expert reports and legal opinions.
• Communicate professionally and empathetically with policyholders, claimants, legal representatives, and other stakeholders.
• Assess policy coverage and determine appropriate claim settlements based on policy terms and conditions.
• Negotiate settlements effectively, striving for fair and timely resolutions.
• Ensure accurate and detailed record-keeping of all claim activities and decisions within the claims management system.
• Adhere strictly to all company policies, procedures, and relevant **insurance** regulations.
• Identify potential subrogation or recovery opportunities.
• Provide expert advice and support to internal teams on claim-related matters.

Requirements

• Minimum of 5 years of experience as an Insurance Claims Adjuster, with a significant portion handling specialized or complex claims (e.g., liability, professional indemnity, cyber).
• Demonstrated expertise in policy interpretation and claims adjudication.
• Excellent analytical, problem-solving, and decision-making skills.
• Exceptional written and verbal communication and negotiation abilities.
• Proficiency in claims management software and digital collaboration tools.
• Ability to work autonomously and manage a high volume of complex cases effectively in a remote setting.
• A strong understanding of **insurance** principles and practices.
• Relevant professional qualifications (e.g., ACII, FLMI) are highly desirable.
• A dedicated home office setup with reliable internet connectivity.
• A proactive attitude and commitment to professional integrity.

Benefits

• This **Full-time** role offers the significant advantage of being **Yes** (fully remote), allowing you to work from any location.
• Our client provides a competitive salary, performance-based bonuses, and a comprehensive benefits package, including medical aid and retirement fund contributions.
• You will benefit from extensive remote training, continuous professional development opportunities, and the chance to work with a forward-thinking **insurance** company.
• This is an excellent opportunity to advance your career in claims management within a supportive, remote-first environment.