Remote Senior Claims Adjuster | Complex Claims Expert

Placements24; Johannesburg; Remoto; ZAR 600.000 - 900.000; Tempo pieno

Vantaggi offerti da questo lavoro

Health insurance

Bonuses

Paid time off

Retirement plan

Fully remote

Professional development

Advanced claims technology

Descrizione del lavoro

Placements24 is seeking a Senior Insurance Claims Adjuster for a fully remote role, to manage complex claims across lines of business. You will investigate, evaluate, negotiate settlements, and ensure compliant, timely resolutions while upholding high ethics.

The ideal candidate has at least 7 years of experience, licenses, and strong analytics, with exceptional communication and proficiency in claims management software. Remote work requires autonomy and meticulous documentation.

Competenze

• Bachelor's degree in a related field.
• 7+ years as an Insurance Claims Adjuster handling complex claims.
• Current licenses and certifications in claims adjustment.
• In-depth knowledge of policies, laws, and investigation techniques.
• Strong negotiation, mediation and conflict-resolution skills.
• Analytical, critical thinking and problem-solving abilities.
• Proficiency with claims software and standard office tools.
• Exceptional written and verbal communication.
• Ability to work remotely with a high workload and discretion.
• High ethical standards and confidentiality.

Mansioni

• Investigate, evaluate, and resolve complex claims across multiple lines.
• Gather evidence, assess damages, and determine coverage.
• Negotiate fair settlements with policyholders and legal representatives.
• Maintain accurate claim files in the system.
• Communicate clearly and empathetically with all parties.
• Ensure compliance with legal/regulatory requirements and policies.
• Identify potential fraud and expedite investigations.
• Mentor junior adjusters as needed.
• Stay updated on industry trends and best practices.

Conoscenze

Analytical thinking

Negotiation

Communication

Remote work

Claims software

Formazione

Bachelor's degree in Business Administration/Finance/Law

Strumenti

Claims management software

Descrizione del lavoro

Senior Insurance Claims Adjuster - Remote

About the Role: Our client, a highly reputable and rapidly expanding insurance provider, is seeking an experienced Senior Insurance Claims Adjuster to join their dynamic, fully remote team. This pivotal role involves managing complex claims from initial investigation through to settlement, ensuring fair and efficient resolution for policyholders. You will leverage your extensive knowledge of insurance policies, claims procedures, and legal requirements to assess damages, negotiate settlements, and provide exceptional customer service. This is an outstanding opportunity for a seasoned professional who possesses strong analytical skills, a keen eye for detail, and the ability to work autonomously in a remote setting. As a Senior Adjuster, you will handle a portfolio of high-value and intricate claims, requiring meticulous documentation and strategic decision-making. Your expertise will be crucial in upholding the company’s commitment to integrity and customer satisfaction, contributing significantly to the company’s reputation for excellence. The ideal candidate will be adept at managing multiple complex cases simultaneously, demonstrating empathy and professionalism in every interaction. This role offers the flexibility and autonomy of remote work combined with the challenge of complex claims resolution.

Key Responsibilities

• Investigate, evaluate, and resolve complex insurance claims across various lines of business (e.g., property, casualty, auto).
• Conduct thorough assessments of damages and liabilities, gathering necessary evidence and documentation.
• Negotiate fair settlements with policyholders, claimants, and legal representatives.
• Interpret insurance policy terms and conditions to determine coverage and liability.
• Maintain detailed and accurate claim files, ensuring all activities are properly documented in the claims management system.
• Provide clear and empathetic communication to all parties involved in the claims process.
• Adhere to all relevant legal and regulatory requirements and company policies.
• Identify potential fraud indicators and expedite suspicious claims for further investigation.
• Mentor and provide guidance to junior claims adjusters as needed.
• Stay updated on industry trends, legislative changes, and best practices in claims management.

Requirements

• Bachelor's degree in Business Administration, Finance, Law, or a related field.
• Minimum of 7 years of experience as an Insurance Claims Adjuster, with a proven track record in handling complex claims.
• Current and relevant claims adjusting licenses and certifications.
• In-depth knowledge of insurance policies, legal principles, and claims investigation techniques.
• Strong negotiation, mediation, and conflict-resolution skills.
• Excellent analytical, critical thinking, and problem-solving abilities.
• Proficiency in claims management software and standard office applications.
• Exceptional written and verbal communication skills.
• Ability to manage a high workload and prioritize effectively in a remote environment.
• High ethical standards and commitment to confidentiality.

Benefits

• Competitive annual salary package.
• Comprehensive health, dental, and vision insurance.
• Performance-based bonuses and incentives.
• Generous paid time off and retirement savings plan.
• Fully remote work arrangement, offering excellent work-life balance.
• Opportunities for professional development and career advancement.
• Access to state-of-the-art claims management technology.