Remote Senior Claims Specialist: Complex Claims Expert

Placements24; Pretoria; Remote; ZAR 350,000 - 700,000; Full time

Benefits offered by this job

Fully remote work

Health benefits

Professional development

Retirement plan

Collaborative virtual team

Job summary

Placements24 is seeking an experienced Claims Adjuster Specialist to join our team. This role is based in Centurion, Gauteng but offered as remote work with flexible scheduling.

You will investigate, evaluate, and settle complex claims, negotiate settlements, and maintain thorough documentation using our claims management systems. Strong analytical and communication skills are essential, as is the ability to work independently in a remote environment.

Qualifications

• Bachelor's degree preferred or equivalent professional experience; claims certifications are a plus.
• Minimum 5 years of experience as a Claims Adjuster handling complex claims.
• Solid understanding of insurance policies, legal principles, and claims investigation techniques.
• Strong written and verbal communication; ability to negotiate effectively.

Responsibilities

• Investigate insurance claims by gathering information through interviews, reviewing documents, and conducting site visits (if necessary and feasible remotely or locally).
• Evaluate the extent of liability and coverage based on policy terms and conditions.
• Assess the value of damages and negotiate fair settlements with policyholders and third parties.
• Prepare detailed claim reports, documenting findings, actions taken, and settlement recommendations.
• Manage a caseload of assigned claims from initial reporting through to final resolution, ensuring timely processing.
• Maintain accurate and organized claim files, utilizing company claims management systems effectively.
• Communicate clearly and empathetically with claimants, providing updates and explaining the claims process.
• Identify potential subrogation or salvage opportunities.

Skills

Analytical thinking

Communication

Remote work

Negotiation

Education

Bachelor's degree or equivalent experience

Claims adjusting certifications (preferred)

Job description

Placements24 is seeking an experienced Claims Adjuster Specialist to join our team. This role is based in Centurion, Gauteng but offered as remote work with flexible scheduling.

You will investigate, evaluate, and settle complex claims, negotiate settlements, and maintain thorough documentation using our claims management systems. Strong analytical and communication skills are essential, as is the ability to work independently in a remote environment.