Insurance Claims Assessor

Placements24; Benoni; Hybrid; ZAR 180,000 - 260,000; Full time

Benefits offered by this job

Competitive salary

Medical aid and retirement fund

Job summary

Placements24 is seeking a detail-oriented Insurance Claims Assessor for a hybrid role in Benoni, Gauteng. You will evaluate and process insurance claims, determine coverage, and negotiate settlements with policyholders and third parties.

The position requires strong analytical, communication, and interpersonal skills to manage end-to-end claims from initiation to closure. The role emphasizes empathy, integrity, and adherence to policies and legal frameworks, with a balance of office-based work

Job description

About the Role

Our client is looking for a detail-oriented and empathetic Insurance Claims Assessor to join their team in Benoni, Gauteng . This role is crucial in evaluating and processing insurance claims, ensuring fair and timely settlements for policyholders. You will investigate claims, determine coverage, negotiate settlements, and manage the entire claims process from initiation to closure. The successful candidate will possess strong analytical skills, excellent communication abilities, and a thorough understanding of insurance policies and claims procedures. This hybrid position allows for a blend of office-based work and remote flexibility, offering a balanced approach to your professional life.

Key Responsibilities

• Receive, register, and investigate insurance claims promptly and thoroughly.
• Assess the validity of claims based on policy terms, conditions, and relevant legislation.
• Determine the extent of liability and calculate the appropriate settlement amount.
• Communicate clearly with policyholders, claimants, and third parties throughout the claims process.
• Gather necessary documentation, including police reports, medical records, and repair estimates.
• Negotiate settlements with claimants and/or their representatives.
• Manage a portfolio of claims efficiently, ensuring adherence to service level agreements.
• Identify potential fraud indicators and elevate suspicious claims for further investigation.
• Maintain accurate and detailed records of all claim-related activities.
• Provide guidance and support to policyholders regarding the claims process.

Requirements

• A matriculation certificate is required;
• a relevant tertiary qualification or industry certification is advantageous.
• Proven experience as a Claims Assessor, Claims Handler, or similar role within the insurance industry.
• In-depth knowledge of insurance policies, claims procedures, and relevant legal frameworks.
• Strong analytical and problem-solving skills.
• Excellent communication, negotiation, and interpersonal skills.
• Proficiency in claims management software and Microsoft Office Suite.
• Ability to manage workload effectively and prioritize tasks.
• High level of integrity and attention to detail.
• Adaptability to work effectively in both office and remote environments.
• Customer-centric approach with a focus on empathy and fairness.

Benefits

• Our client offers a competitive salary, comprehensive medical aid, and retirement fund contributions.
• The hybrid work model provides flexibility and promotes a healthy work-life balance.
• Opportunities for professional development and career advancement within the claims department are available.
• You will be part of a respected insurance company known for its commitment to customer satisfaction and employee well-being.
• This role is based in Benoni, Gauteng , and offers a stable and rewarding career path.