Remote Claims Processing Specialist

Placements24; Stellenbosch; Hybrid; ZAR 201,000 - 335,000; Full time

Benefits offered by this job

Fully remote environment

Competitive salary

Comprehensive medical aid

Retirement savings plan

Continuous learning and development

Flexible work-life balance

Job summary

Placements24 is seeking a highly organized Remote Claims Processing Specialist to join its dedicated remote team. You will ensure accurate and timely insurance claim processing from a home office, serving clients across South Africa.

This fully remote role offers flexibility and the chance to support customers nationwide from Stellenbosch to Paarl and beyond. The position requires attention to detail, strong data-entry skills, and experience with claims management software.

Qualifications

• Minimum 3 years of experience in claims processing or related roles.
• Proficiency in data entry and claims management software.
• Strong attention to detail and accuracy.
• Ability to work independently in a remote setting.

Responsibilities

• Receive, review, and verify insurance claim forms for completeness.
• Enter claim data into the claims management system with precision.
• Identify discrepancies and liaise with claimants or agents to obtain missing details.
• Process payments following established protocols and authorization levels.
• Maintain organized claim files and documentation.
• Communicate claim status with internal teams.
• Generate reports on processing volumes and turnaround times.
• Support process improvements within the claims department.
• Maintain confidentiality of sensitive information.

Skills

Data entry

Claims software

Microsoft Office

Education

High school diploma

Associate's degree or certification

Tools

Claims management software

Microsoft Office Suite

Job description

About the Role

Our client is seeking a highly organized and efficient Remote Claims Processing Specialist to join their dedicated remote team. In this fully remote position, you will be responsible for the accurate and timely processing of insurance claims, ensuring that all documentation is complete and compliant with company policies and regulatory standards. The ideal candidate will have a meticulous approach to data entry, excellent administrative skills, and a solid understanding of the insurance claims lifecycle. This role is perfect for individuals who thrive in an independent work environment and are committed to providing exceptional service. You will contribute to the smooth operation of our claims department from the convenience of your home office, serving clients across South Africa .

Key Responsibilities

• Receive, review, and verify insurance claim forms and supporting documents for completeness and accuracy.
• Enter claim data into the company's claims management system with a high degree of precision.
• Identify discrepancies or missing information and liaise with claimants, agents, or other parties to obtain necessary details.
• Process claims payments and ensure adherence to payment protocols and authorization levels.
• Categorize and manage claim files, ensuring proper documentation and organization.
• Follow established procedures for claim adjudication and resolution.
• Communicate with internal departments regarding claim status and requirements.
• Maintain confidentiality of all sensitive information handled during the claims process.
• Assist in generating reports related to claim processing volumes and turnaround times.
• Contribute to process improvement initiatives within the claims department.

Requirements

• High school diploma or equivalent; an associate's degree or relevant certification is a plus.
• Minimum of 3 years of experience in claims processing, administration, or a related role within the insurance industry.
• Proficiency in data entry and working with claims management software.
• Strong understanding of insurance terminology and basic claims procedures.
• Exceptional attention to detail and accuracy.
• Excellent organizational and time management skills.
• Effective written and verbal communication skills for remote interaction.
• Ability to work independently with minimal supervision in a remote setting.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook).
• A commitment to maintaining high standards of service and data integrity.

Benefits

• fully remote work environment
• competitive salary
• comprehensive medical aid
• participation in a retirement savings plan
• opportunities for continuous learning and professional development
• flexibility to manage your work and personal life seamlessly
• contribution to our mission from the comfort of your location, possibly near Paarl, Western Cape , or anywhere else in South Africa