Remote Claims Assessor — Fast, Fair Settlements

Placements24; Cape Town; Hybrid; ZAR 420,000 - 540,000; Full time

Benefits offered by this job

Medical aid

Provident fund

Paid time off

Professional development

Remote work

Job summary

Placements24 seeks a dedicated Claims Assessor Specialist for a fully remote role. You will manage claims from initiation to settlement, review coverage and documentation, and communicate clearly with policyholders.

You will collaborate with adjusters, legal counsel, and internal teams to resolve complex claims while ensuring compliance with regulations and company standards. A strong emphasis on customer service and accuracy is required.

Qualifications

• Bachelor's degree in Business Administration, Law, or related field preferred.
• Minimum 3 years hands-on claims assessment experience in insurance.
• Understanding of insurance policies, claim investigation, and settlement procedures.
• Excellent communication, negotiation, and problem-solving with empathy and customer care.

Responsibilities

• Investigate, evaluate, and process a high volume of insurance claims from initiation to settlement.
• Review policy coverage, claim details, and documentation to determine validity and payout amounts.
• Explain procedures, coverage, and settlements with policyholders clearly and empathetically.
• Collaborate with external adjusters, legal counsel, and third parties to resolve complex claims.
• Ensure compliance with legal requirements, regulatory mandates, and company practices.
• Maintain accurate claim files in the claims management system.
• Identify potentially fraudulent claims and escalate as needed.
• Provide exceptional customer service to ensure timely and fair resolutions.
• Assist in process improvements to enhance efficiency and customer experience.

Skills

Claims assessment

Communication

Negotiation

Problem solving

Empathy

Customer care

Education

Bachelor's degree (Business Administration / Law / related)

Tools

Claims management system

Job description

Placements24 seeks a dedicated Claims Assessor Specialist for a fully remote role. You will manage claims from initiation to settlement, review coverage and documentation, and communicate clearly with policyholders.

You will collaborate with adjusters, legal counsel, and internal teams to resolve complex claims while ensuring compliance with regulations and company standards. A strong emphasis on customer service and accuracy is required.