Senior Claims Adjuster - Remote

Placements24; Johannesburg; Hybrid; ZAR 700,000 - 950,000; Full time

Benefits offered by this job

Health, dental, and vision insurance

Generous PTO

Professional development support

401(k) with company matching

Remote work from South Africa

Career advancement opportunities

Performance-based bonuses

Employee assistance programs

Job summary

Placements24 is seeking a highly experienced Senior Claims Adjuster to join our remote-first team in South Africa. The role centers on managing complex property and casualty claims from initiation to resolution, ensuring client satisfaction and strict adherence to policy terms and regulatory requirements.

The ideal candidate has 5+ years in insurance claims, proven negotiation and analytical abilities, and a track record of accurate settlements.

Qualifications

• Bachelor's degree in Business Administration, Finance, Law, or related field.
• AIC or CPCU certifications are a plus.
• Experience in insurance claims adjusting with strong analytical and negotiation skills.

Responsibilities

• Investigate, evaluate, and negotiate complex insurance claims, including liability, coverage, and damages.
• Manage a caseload of diverse claims with meticulous records in the claims management system.
• Communicate professionally with policyholders, claimants, and legal representatives throughout the process.
• Interpret policy terms to determine coverage and settlements.
• Collaborate with underwriting and legal to resolve complex claim issues.
• Provide guidance to junior adjusters and stay updated on insurance regulations and best practices.
• Contribute to process improvements in claims handling and timely payments.

Skills

Analytical skills

Negotiation skills

Problem-solving

Communication skills

Education

Bachelor's degree in Business Administration, Finance, Law, or related field

AIC or CPCU certifications (plus)

Tools

Claims management software

Office productivity tools

Job description

About the Role

Our client, a leading innovator in the insurance sector, is seeking a highly experienced and detail-oriented Senior Claims Adjuster to join their dynamic, fully remote team. This pivotal role is crucial in managing complex insurance claims from initiation to resolution, ensuring client satisfaction and adherence to company policies. As a remote-first organization, we provide a collaborative and supportive virtual environment where you can excel in your career while enjoying the flexibility of working from home. You will be instrumental in upholding our client's reputation for excellence and integrity in handling sensitive claims. The ideal candidate will possess a deep understanding of insurance regulations and a proven track record of success in claims management. This position offers a unique opportunity to contribute significantly to a growing company and to develop your professional skills in a challenging yet rewarding setting. We are committed to fostering a culture of continuous improvement and empowering our employees to reach their full potential. The role requires a proactive approach to problem-solving and a commitment to delivering outstanding service to our policyholders.

Key Responsibilities

• Investigate, evaluate, and negotiate complex insurance claims, including liability, coverage, and damages, ensuring accuracy and fairness.


• Manage a caseload of diverse claims, maintaining meticulous records and documentation within our digital claims management system.


• Communicate effectively and professionally with policyholders, claimants, legal representatives, and other stakeholders throughout the claims process.


• Interpret and apply policy terms, conditions, and exclusions to determine coverage and settlement amounts.


• Identify potential fraud indicators and ...


• Collaborate with internal departments, such as underwriting and legal, to resolve complex claim issues.


• Provide guidance and mentorship to junior claims adjusters, fostering a collaborative and knowledgeable team environment.


• Stay updated on relevant insurance laws, regulations, and industry best practices to ensure compliance and optimal claim handling.


• Contribute to the continuous improvement of claims handling processes and procedures.


• Ensure timely and accurate payment or denial of claims within designated authority limits.

Requirements

• Minimum of 5 years of experience in insurance claims adjusting, with a strong focus on complex property and casualty claims.


• Proven ability to manage a high volume of claims efficiently and effectively in a remote setting.


• In-depth knowledge of insurance policies, legal principles, and claims investigation techniques.


• Excellent analytical, negotiation, and problem-solving skills.


• Strong written and verbal communication abilities, with the capacity to explain complex information clearly.


• Proficiency in using claims management software and standard office productivity tools.


• Bachelor's degree in Business Administration, Finance, Law, or a related field; relevant professional certifications (e.g., AIC, CPCU) are a plus.


• Demonstrated ability to work independently, manage time effectively, and meet deadlines without direct supervision.


• A dedicated home office setup with reliable high-speed internet access to ensure seamless remote work.


• Strong ethical compass and commitment to upholding confidentiality.

Benefits

• Our client offers a competitive remuneration package, including a comprehensive health, dental, and vision insurance plan.


• Employees benefit from a generous paid time off (PTO) policy, allowing for a healthy work-life balance.


• We provide opportunities for professional development through ongoing training programs and support for obtaining industry certifications.


• A 401(k) retirement savings plan with company matching is available.


• As a fully remote position, employees enjoy the flexibility and autonomy of working from their chosen location within South Africa.


• We foster a supportive and inclusive company culture that values collaboration and innovation.


• Opportunities for career advancement within the organization are abundant.


• Performance-based bonuses and incentives are also part of our attractive compensation structure.


• Employee assistance programs are available to support well-being.


• This is an exceptional chance to join a forward-thinking company and build a rewarding career in the insurance industry.