Lead Claims Assessor - Tembisa Branch

Placements24; Kempton Park; On-site; ZAR 900,000 - 1,200,000; Full time

Benefits offered by this job

Competitive salary

Comprehensive health insurance

Pension and provident fund

Career advancement opportunities

Training and development

Annual performance bonuses

Job summary

Placements24 is seeking an experienced Lead Claims Assessor to oversee operations at the Tembisa, Gauteng branch. You will lead and mentor a team of claims assessors, drive end-to-end claims processing, and ensure fairness, timeliness, and regulatory compliance across complex claims.

You will develop procedures, monitor performance, and collaborate with legal and loss adjusters while maintaining high ethical standards and exceptional customer service.

Qualifications

• Bachelor's degree in Law, Business Administration, or related field; CIP certification advantageous.
• 7+ years in insurance claims assessment, with at least 2 years in a supervisory role.
• Strong knowledge of SA insurance policy frameworks and claims procedures.
• Proven ability to lead and motivate a team and maintain high ethical standards.

Responsibilities

• Lead and mentor a team of claims assessors.
• Oversee end-to-end claims assessment ensuring fairness and timeliness.
• Investigate and adjudicate complex/high-value claims.
• Develop procedures to improve efficiency and customer satisfaction.
• Ensure compliance with SA insurance law and company policies.
• Conduct quality assurance on assessments and documentation.
• Handle escalated complaints and resolve disputes.
• Train staff and support professional development.
• Analyze data to identify fraud risks and process improvements.
• Collaborate with legal and loss adjusters on complex cases.

Skills

Leadership

Analytical skills

Negotiation

Communication

Education

Bachelor's degree in Law or Business Administration

Tools

Claims management software

Job description

About the Role

Our client, a prominent insurance organization, is actively seeking an experienced and dedicated Lead Claims Assessor to oversee operations at their Tembisa, Gauteng branch. This leadership position is essential for ensuring the efficient and fair settlement of insurance claims, managing a team of claims assessors, and upholding the company's commitment to excellent customer service. The ideal candidate will possess a deep understanding of claims processing, strong investigative skills, and the ability to navigate complex insurance claims scenarios. This role offers a significant opportunity to make a tangible impact within a respected industry leader, contributing to both client satisfaction and the company's reputation. You will be instrumental in training and developing the claims team, ensuring adherence to regulatory standards and company policies, and driving process improvements within the Tembisa office. A proactive approach to problem-solving and a commitment to ethical practices are paramount for success in this role.

Key Responsibilities

• Lead, manage, and mentor a team of claims assessors, providing guidance and support.
• Oversee the end-to-end claims assessment process, ensuring accuracy, fairness, and timeliness.
• Investigate and adjudicate complex and high-value insurance claims across various policy types.
• Develop and implement claims handling procedures to enhance efficiency and customer satisfaction.
• Ensure compliance with all relevant South African insurance legislation and company policies.
• Conduct quality assurance checks on claims assessments and documentation.
• Handle escalated customer complaints and resolve disputes effectively.
• Collaborate with legal and external loss adjusters on complex claims matters.
• Analyze claims data to identify trends, potential fraud, and areas for process improvement.
• Train new team members and provide ongoing professional development for the claims department.

Requirements

• A Bachelor's degree in Law, Business Administration, or a related field; relevant professional certifications (e.g., CIP) are advantageous.
• Minimum of 7 years of experience in insurance claims assessment, with at least 2 years in a supervisory or lead capacity.
• In-depth knowledge of insurance policies, claims procedures, and South African insurance law.
• Proven ability to manage and motivate a team effectively.
• Excellent analytical, problem-solving, and decision-making skills.
• Strong communication, negotiation, and interpersonal skills.
• Experience with claims management software and systems.
• High level of integrity and ethical conduct.
• Ability to work under pressure and manage multiple priorities.

Benefits

• Competitive salary with performance-based incentives.
• Comprehensive health insurance coverage.
• Pension fund and provident fund benefits.
• Opportunities for career advancement and leadership training.
• A stable and supportive working environment in Tembisa .
• Employee wellness programs.
• Training and development opportunities.
• Annual performance bonuses.