Remote Insurance Claims Assessor

Placements24; Gauteng; Hybrid; ZAR 420,000 - 620,000; Full time

Benefits offered by this job

Salary incentives

Medical aid

Provident fund

Professional development

Work-from-home stipend

Job summary

Placements24 is seeking a dedicated Remote Insurance Claims Assessor to join its virtual operations team in South Africa. You will investigate, evaluate, and settle claims from start to finish, working remotely with policyholders and stakeholders.

The ideal candidate has a Bachelor's degree and 3–5 years in claims assessment, strong knowledge of policies, excellent communication, and proficiency with claims software. You will work independently to ensure fair, timely resolutions.

Qualifications

• Bachelor's degree in a relevant field such as Law, Business, Finance, or equivalent experience.
• 3–5 years of experience in insurance claims assessment and processing.
• Knowledge of insurance policies, legal frameworks, and claims investigation techniques.
• Excellent verbal and written communication skills for clear explanations.
• Ability to work remotely with strong organizational and time-management skills.
• Proficiency in claims management software and standard office tools.

Responsibilities

• Receive, review, and process incoming insurance claims across lines of business.
• Investigate circumstances, gather documentation, and assess claim validity.
• Communicate with policyholders, claimants, and witnesses via phone, email, and video.
• Determine liability and authorize payments within delegated authority.
• Negotiate settlements when appropriate and maintain accurate files.
• Identify fraud indicators and escalate suspicious claims.
• Ensure compliance with regulatory requirements and best practices.
• Contribute to process improvements to enhance efficiency and satisfaction.

Skills

Claims assessment

Communication skills

Remote work

Time management

Attention to detail

Investigations

Education

Bachelor's degree in Law/Business/Finance or equivalent

Tools

Claims management software

Video conferencing tools

Office applications

Job description

About the Role

Our client is seeking a dedicated and detail-oriented Remote Insurance Claims Assessor to join their expanding virtual operations team. This role is crucial in managing and processing insurance claims efficiently and accurately from start to finish. As a remote-first position, you will have the flexibility to work from anywhere within South Africa, leveraging technology to deliver exceptional service to our policyholders. The successful candidate will be responsible for investigating, evaluating, and settling claims in accordance with policy terms and conditions, ensuring a fair and timely resolution for all parties involved. This is an excellent opportunity for an experienced claims professional looking for a flexible and autonomous work environment.

Key Responsibilities

• Receive, review, and process incoming insurance claims across various lines of business.
• Conduct thorough investigations into the circumstances of each claim, gathering necessary documentation and evidence.
• Evaluate claim validity based on policy coverage, legal requirements, and company guidelines.
• Communicate effectively with policyholders, claimants, witnesses, and other relevant parties via phone, email, and video conferencing.
• Determine the extent of liability and authorize payments within delegated authority limits.
• Negotiate settlements with claimants or their representatives where appropriate.
• Maintain accurate and up-to-date claim files in the company's claims management system.
• Identify potential fraud indicators and escalatest suspicious claims for further investigation.
• Adhere to all regulatory requirements and industry best practices for claims handling.
• Contribute to process improvement initiatives to enhance claims handling efficiency and customer satisfaction.

Requirements

• A Bachelor's degree in a relevant field such as Law, Business, Finance, or equivalent experience.
• Minimum of 3-5 years of experience in insurance claims assessment, with a strong understanding of claims processing procedures.
• Demonstrated knowledge of insurance policies, legal frameworks, and claims investigation techniques.
• Excellent verbal and written communication skills, with the ability to clearly explain complex information.
• Strong organizational and time management skills, with the ability to manage a high volume of claims remotely.
• Proficiency in using claims management software, virtual communication tools, and standard office applications.
• Self-motivated, disciplined, and able to work effectively with minimal supervision in a remote setting.
• Ability to conduct thorough investigations and make sound, evidence-based decisions.
• Experience with various insurance products (e.g., Auto, Home, Liability) is a plus.
• Must have a stable internet connection and a dedicated home office setup.

Benefits

This fully remote role offers unparalleled flexibility and autonomy. Our client provides a competitive annual salary, complemented by performance-based incentives. Access to a comprehensive medical aid plan and a generous provident fund contribution are included. Opportunities for ongoing professional development, including specialized claims training and certifications, are readily available. Employees also receive a work-from-home stipend to support their home office setup. This role allows you to contribute significantly to our client's success while maintaining a healthy work-life balance.