Insurance Claims Handler - Complex Claims

Placements24; Vereeniging; On-site; ZAR 300,000 - 520,000; Full time

Benefits offered by this job

Competitive salary

Medical aid

Retirement savings plan

Generous leave

Professional development

Collaborative team

Job summary

Placements24 in Vereeniging, Gauteng, seeks an experienced Insurance Claims Handler to manage complex claims in a busy office. You will investigate, assess, and resolve claims fairly, serving as the main contact for policyholders in challenging situations.

The role requires empathy, strong negotiation skills, and knowledge of claims processes, policies, and relevant legislation. Based in Vereeniging, it offers comprehensive benefits and opportunities for professional growth.

Qualifications

• Experience in handling insurance claims, including complex cases.
• Strong understanding of policies, legal principles and claims processes.
• Excellent communication and negotiation abilities.

Responsibilities

• Investigate, evaluate, and settle complex insurance claims.
• Gather documentation, interview parties, and analyze evidence.
• Communicate empathetically with claimants and policyholders.
• Negotiate settlements within authorized limits.
• Appoint/manage external service providers when needed.
• Identify potential fraud or misrepresentation.
• Maintain accurate claim files and records.
• Keep up with legislation and policy updates.

Skills

Claims handling

Communication

Negotiation

Analytical skills

Microsoft Office

Education

FAIS accreditation advantageous

Tools

Claims management software

Microsoft Office Suite

Job description

About the Role Our client is looking for a seasoned and empathetic Insurance Claims Handler to manage complex claims within their busy office in Vereeniging, Gauteng . This vital role requires a methodical approach to investigate, assess, and resolve intricate claims efficiently and fairly, ensuring adherence to policy terms and conditions. You will be the primary point of contact for policyholders navigating challenging claim situations, requiring exceptional communication and negotiation skills. This is an excellent opportunity for an experienced claims professional to apply their expertise in a supportive environment within the bustling economic hub of Vereeniging .

Key Responsibilities

• Investigate, evaluate, and settle assigned insurance claims, with a focus on those involving significant complexity or potential dispute.
• Gather all necessary documentation, conduct thorough interviews, and analyze evidence to determine liability and coverage.
• Communicate clearly and empathetically with claimants, policyholders, and legal representatives throughout the claims process.
• Negotiate settlements within authorized limits, ensuring fair and timely resolution.
• Appoint and manage external service providers such as assessors, investigators, and legal counsel when required.
• Identify and report any instances of potential fraud or misrepresentation.
• Maintain accurate and detailed claim files and records in compliance with company standards.
• Keep abreast of relevant legislation, industry best practices, and policy updates.
• Contribute to team efforts and provide support to colleagues as needed.

Requirements

• A minimum of 3 years of experience in handling insurance claims, with demonstrable experience in complex claims.
• Solid understanding of insurance policies, legal principles, and claims management processes.
• Strong investigative, analytical, and problem-solving skills.
• Excellent communication, negotiation, and interpersonal skills, with a high degree of empathy.
• Proficiency in claims management software and Microsoft Office Suite.
• Ability to manage a demanding caseload and work under pressure.
• Relevant insurance qualifications (e.g., FAIS accreditation) are advantageous.
• Must be based in or willing to relocate to the Vereeniging area.

Benefits

• A competitive annual salary of ZAR ,
• Opportunity to work on challenging and rewarding claims.
• Comprehensive medical aid and retirement savings plan.
• Generous leave entitlement.
• Professional development and training opportunities.
• A collaborative and supportive team environment.