Claims Adjuster - Complex Claims

Placements24; Bloemfontein; Hybride; ZAR 600 000 - 900 000; Plein temps

Avantages offerts par ce poste

Competitive salary

Performance incentives

Medical aid

Retirement fund contributions

Professional development

Résumé du poste

Placements24 in Bloemfontein seeks an experienced Claims Adjuster specializing in complex, high-value claims within the insurance sector. You will investigate, evaluate, and negotiate settlements while ensuring regulatory compliance and cost management.

The role requires a Bachelor's degree, 5+ years of experience, strong analytical and communication skills, and travel within the region as needed. A CIP/CPL certification is advantageous and proficiency with claims software and MS Office is

Qualifications

• Bachelor's degree in Law, Business Administration, Finance, or related field.
• CIP or CPL certification is advantageous.
• Minimum 5 years of experience as a Claims Adjuster, with complex/high-value claims.
• Strong knowledge of insurance contracts, investigation techniques, and settlement negotiations.
• Excellent analytical and problem-solving skills.
• Strong interpersonal and communication skills; professional handling of sensitive situations.
• Proficiency with claims management software and MS Office.
• Ability to work independently and meet deadlines.
• Understanding of South African legal and insurance landscape.
• Detail-oriented with high accuracy.
• Willingness to travel within the region.

Responsabilités

• Investigate complex insurance claims thoroughly and gather documentation.
• Analyze policy coverage to determine liability and adjudication.
• Evaluate damages and negotiate settlements with claimants and third parties.
• Manage a caseload of complex claims and meet settlement timelines.
• Conduct on-site inspections when required.
• Maintain detailed claim files and document communications.
• Collaborate with internal/external parties to resolve claims.
• Ensure compliance with regulations and company policies.
• Identify potential fraudulent claims and escalate as needed.
• Provide clear, empathetic communication to claimants.

Connaissances

Analytical skills

Negotiation

Communication

Attention to detail

Time management

Formation

Bachelor's degree in Law/Business/Finance

Outils

Claims software

Microsoft Office

Description du poste

About the Role

Our client, a reputable insurance provider, is looking for a dedicated and detail-oriented Claims Adjuster specializing in complex claims to join their growing team in Bloemfontein, Free State . This critical role involves investigating, evaluating, and negotiating settlements for high-value and intricate insurance claims across various lines of business. The ideal candidate will possess strong analytical skills, excellent communication abilities, and a thorough understanding of insurance policies and legal requirements. You will be responsible for ensuring fair and timely claim resolutions while managing costs effectively and maintaining customer satisfaction. This is an excellent opportunity to advance your career in claims management within a supportive and professional environment in Bloemfontein .

Key Responsibilities

• Investigate complex insurance claims thoroughly, gathering all necessary documentation, evidence, and statements.
• Analyze policy coverage to determine the extent of liability and ensure accurate claim adjudication.
• Evaluate damages and negotiate fair settlement amounts with claimants, legal representatives, and third parties.
• Manage a caseload of complex claims efficiently, prioritizing tasks and adhering to settlement timelines.
• Conduct on-site inspections and assessments as required to evaluate damages and loss circumstances.
• Maintain detailed and accurate claim files, documenting all activities, communications, and decisions.
• Collaborate with internal departments, external experts, and service providers to facilitate claim resolution.
• Ensure compliance with all relevant insurance regulations, company policies, and ethical standards.
• Identify potential fraudulent claims and escalated issues for further investigation.
• Provide clear and empathetic communication to claimants throughout the claims process.

Requirements

• A Bachelor's degree in Law, Business Administration, Finance, or a related field.
• Relevant professional certifications (e.g., CIP, CPL) are highly advantageous.
• A minimum of 5 years of experience as a Claims Adjuster, with significant exposure to complex and high-value claims.
• In-depth knowledge of insurance contracts, claims investigation techniques, and settlement negotiations.
• Strong analytical, critical thinking, and problem-solving skills.
• Excellent interpersonal and communication skills, with the ability to handle sensitive situations with professionalism.
• Proficiency in claims management software and Microsoft Office Suite.
• Ability to work independently, manage time effectively, and meet deadlines.
• Understanding of the South African legal and insurance landscape.
• Detail-oriented with a high level of accuracy.
• Willingness to travel within the region as needed for claim investigations.

Benefits

Our client offers a competitive salary, performance incentives, and a comprehensive benefits package, including medical aid and retirement fund contributions. Opportunities for professional development and ongoing training in claims management techniques are provided. Join a stable and reputable company that values its employees and offers a rewarding career path in Bloemfontein .