Remote Claims Resolution Specialist

Placements24; Paarl; Hybride; ZAR 320 000 - 520 000; Plein temps

Avantages offerts par ce poste

Competitive salary

Bonuses based on performance

Health, dental, and vision insurance

Retirement savings plan with company匹配

Extensive training and professional发展

Résumé du poste

Placements24 is seeking a dedicated Remote Claims Resolution Specialist to join a fully remote team. You will manage and resolve insurance claims, communicate with policyholders, and collaborate with internal departments to ensure timely settlements.

The role requires strong analytical abilities, exceptional communication, and a proactive approach to claim investigations, with the flexibility and support of a remote work environment.

Qualifications

• Experience handling insurance claims or resolving complex customer issues.
• Strong understanding of insurance principles, policy types, and claims procedures.
• Excellent communication, listening, and negotiation skills.
• Analytical thinking with meticulous attention to detail.

Responsabilités

• Manage a caseload of insurance claims from initiation to closure.
• Investigate claims using documentation such as police reports and medical records.
• Assess policy coverage and liability per terms and conditions.
• Communicate empathetically with policyholders and third parties.
• Negotiate fair settlements within guidelines and document all activities.

Connaissances

Insurance claims handling

Customer service

Empathy

Negotiation

Analytical thinking

Remote work

Formation

High school diploma

Insurance certifications (plus)

Outils

Claims management software

Description du poste

About the Role

Our client, a leading insurance provider committed to exceptional customer service, is seeking a dedicated and empathetic Remote Claims Resolution Specialist to join their fully remote team. In this vital role, you will be the primary point of contact for policyholders navigating the claims process. Your responsibilities will include managing, investigating, and resolving claims efficiently, ensuring policyholders receive fair and timely outcomes. This position requires excellent communication skills, strong analytical abilities, and a deep understanding of insurance policies and claims procedures. You will work independently from your home office, collaborating with internal teams and external parties to ensure smooth claim settlements. This is a fantastic opportunity to build a rewarding career with a company that values its employees and invests in their success, offering the flexibility and convenience of remote work. We pride ourselves on fostering a supportive virtual environment where problem-solving and customer advocacy are paramount.

Key Responsibilities

• Manage a caseload of insurance claims from initiation to closure.
• Investigate claims by gathering all relevant documentation, including police reports, medical records, and repair estimates.
• Assess claim validity against policy terms and conditions, determining coverage and liability.
• Communicate empathetically and professionally with policyholders, claimants, and third parties throughout the claims process.
• Negotiate fair settlements within established guidelines.
• Document all claim activities accurately and comprehensively in the claims management system.
• Identify and investigate potentially fraudulent claims, escalating as necessary.
• Ensure compliance with all company policies, procedures, and regulatory requirements.
• Provide clear explanations of policy coverage and claims decisions to policyholders.
• Collaborate with internal departments such as underwriting and legal as needed to resolve complex claims.

Requirements

• Proven experience in insurance claims handling or a related customer service role with complex issue resolution.
• Solid understanding of insurance principles, policy types, and claims procedures.
• Excellent communication, listening, and negotiation skills.
• Strong analytical and problem-solving abilities with meticulous attention to detail.
• Proficiency in using claims management software and standard office productivity tools.
• Ability to work independently, manage time effectively, and maintain productivity in a remote setting.
• A professional demeanor and a commitment to providing outstanding customer service.
• High school diploma or equivalent required; further education or relevant insurance certifications are a plus.
• Must have a reliable internet connection and a dedicated, distraction-free workspace.
• Demonstrated ability to handle sensitive information with discretion and integrity.

Benefits

• Competitive salary and performance-based bonuses.
• Comprehensive health, dental, and vision insurance.
• Retirement savings plan with company matching.
• Extensive training and ongoing professional development opportunities.
• Fully remote work arrangement offering significant flexibility.
• Supportive virtual team environment and regular check-ins.
• Opportunities for career advancement within the claims department.