Senior Claims Adjuster

Placements24; Randburg; Hybrid; ZAR 700,000 - 1,000,000; Full time

Benefits offered by this job

Remote work

Medical, dental, and vision insurance

Retirement plan

Professional development

Performance incentives

Job summary

Placements24 is partnering with a well-established insurance company to recruit a Senior Claims Adjuster for fully remote support centered in Randburg, Gauteng. You will manage complex claims from inception to settlement with strong policy knowledge and negotiation skills.

Responsibilities include independent claim handling, regulatory compliance, mentoring juniors, and delivering exceptional service to policyholders in South Africa.

Qualifications

• 6+ years experience as a Claims Adjuster, focusing on complex claims.
• Strong knowledge of insurance claims processes, policy wordings, and legal frameworks.
• Excellent negotiation, communication, and conflict-resolution skills.
• Ability to work independently in a remote setting and manage a caseload.

Responsibilities

• Investigate, evaluate, and negotiate settlement of complex claims.
• Interpret policy coverage to determine liability and validity.
• Gather and analyse relevant documentation, evidence, and expert reports.
• Interview claimants, witnesses, and other parties.
• Assess damages and determine settlements within authorized limits.
• Communicate claim status clearly to stakeholders.
• Identify subrogation or salvage opportunities.
• Ensure compliance with legal and regulatory requirements.
• Mentor junior claims adjusters and maintain detailed records.

Skills

Negotiation skills

Analytical thinking

Communication skills

Conflict resolution

Remote work ability

Education

CIP

NQF Level 4

Tools

Claims management software

MS Office

Job description

About the Role

Our client, a well-established insurance company, is seeking an experienced Senior Claims Adjuster to join their team, remotely supporting operations in Randburg, Gauteng. This vital role involves managing and resolving complex insurance claims from inception to settlement. The ideal candidate will possess a strong understanding of insurance policies, excellent negotiation skills, and a proven ability to investigate and assess damages accurately. You will be responsible for ensuring that claims are handled efficiently, fairly, and in compliance with company procedures and regulatory standards. This is a fully remote position, offering the flexibility to work from anywhere while contributing to the success of our client's claims department. We are looking for a dedicated professional with a meticulous approach to detail and a commitment to providing exceptional service to policyholders during challenging times. Your expertise will be crucial in maintaining client satisfaction and upholding the company's reputation for integrity and efficiency within South Africa.

Key Responsibilities

• Investigate, evaluate, and negotiate settlement of complex insurance claims.
• Interpret policy coverage, terms, and conditions to determine liability and claim validity.
• Gather and analyze all relevant documentation, evidence, and expert reports.
• Conduct thorough interviews with claimants, witnesses, and other relevant parties.
• Assess damages and determine appropriate settlement amounts within authorized limits.
• Communicate claim status and decisions clearly and professionally to all stakeholders.
• Identify potential subrogation or salvage opportunities.
• Ensure compliance with all legal and regulatory requirements.
• Mentor and provide guidance to junior claims adjusters.
• Maintain accurate and detailed records of all claim activities in the claims management system.

Requirements

• A minimum of 6 years of experience as a Claims Adjuster, preferably with a focus on complex claims.
• In-depth knowledge of insurance claims processes, policy wordings, and legal frameworks.
• Proven negotiation, communication, and conflict resolution skills.
• Strong analytical and problem-solving abilities.
• Ability to work independently and manage a caseload effectively in a remote setting.
• Proficiency in claims management software and standard office applications.
• Relevant insurance certifications (e.g., CIP, NQF Level 4) are highly desirable.
• Demonstrated ability to make sound judgments and decisions under pressure.
• Commitment to ethical practices and excellent customer service.

Benefits

• Competitive salary and performance-based incentives.
• Fully remote work arrangement for optimal flexibility.
• Comprehensive medical, dental, and vision insurance.
• Retirement savings plan with employer contribution.
• Opportunities for professional development and continuing education.
• Supportive team environment and access to industry-leading resources.
• A role in a reputable and financially stable insurance organization.