Senior Claims Assessor

Placements24; Soweto; Hybrid; ZAR 500,000 - 900,000; Full time

Benefits offered by this job

Medical aid

Retirement fund contributions

Professional development

Career advancement

Cutting-edge claims management tech

Employee assistance programs

Job summary

Placements24 is recruiting a Senior Claims Assessor in the Soweto, Gauteng region. The role focuses on accurate assessment of insurance claims, mentoring junior staff, and driving process improvements within a dynamic team environment.

You will investigate, evaluate, and settle claims, determine liability, and negotiate fair settlements while ensuring regulatory compliance and high service standards for policyholders. This position offers growth in a stable insurer setting.

Qualifications

• Minimum of 5 years of experience in insurance claims assessment.
• In-depth knowledge of policies, claims procedures, and relevant legislation.
• Proficiency with claims management software and standard office applications.
• Ability to work independently and as part of a team, managing a caseload.

Responsibilities

• Investigate, evaluate, and settle insurance claims in accordance with policy terms and conditions.
• Determine insurer liability and negotiate fair settlements with claimants and representatives.
• Gather and review documentation (police reports, medical records, repair estimates).
• Conduct site visits to verify details and assess damages.
• Explain policy coverage and claim procedures to policyholders clearly and concisely.
• Maintain accurate claim files and ensure regulatory compliance.
• Identify potentially fraudulent claims and escalate for investigation.
• Collaborate with legal and other departments on complex or disputed claims.
• Mentor junior claims assessors and provide training and support.
• Contribute to development and implementation of claims-handling best practices.

Skills

Negotiation

Analytical thinking

Communication

Team mentoring

Education

Tertiary qualification in insurance, law, or related field

Tools

Claims management software

Job description

About the Role

Our client, a leading insurance provider, is seeking a highly experienced Senior Claims Assessor to join their dynamic team in Soweto, Gauteng. This role is crucial in ensuring the efficient and accurate assessment of insurance claims, upholding the company's reputation for excellence and integrity. The successful candidate will play a pivotal role in supporting the claims department, mentoring junior staff, and contributing to process improvements. This is an exciting opportunity for a motivated professional to advance their career in the insurance sector within a supportive and growth-oriented environment. We are committed to providing top-tier services to our policyholders, and this role is central to that mission. The Soweto office is a hub of activity, offering a collaborative atmosphere where your expertise will be valued and recognized. You will be part of a team dedicated to delivering exceptional customer service and managing complex claims with professionalism and skill.

Key Responsibilities

• Investigate, evaluate, and settle insurance claims in accordance with policy terms and conditions.
• Determine the extent of the insurer's liability and negotiate fair settlements with claimants and their representatives.
• Gather and review necessary documentation, including police reports, medical records, and repair estimates.
• Conduct thorough investigations, including site visits when necessary, to verify claim details and assess damages.
• Provide clear and concise explanations of policy coverage and claim procedures to policyholders.
• Maintain accurate and detailed claim files and records, ensuring compliance with regulatory requirements.
• Identify potential fraudulent claims and escalate them for further investigation.
• Collaborate with legal counsel and other departments on complex or disputed claims.
• Mentor and guide junior claims assessors, providing training and support.
• Contribute to the development and implementation of claims handling best practices.

Requirements

• A minimum of 5 years of experience in insurance claims assessment, with a proven track record of success.
• In-depth knowledge of insurance policies, claims procedures, and relevant legislation.
• Strong analytical and problem-solving skills, with the ability to interpret complex information.
• Excellent negotiation, communication, and interpersonal skills.
• Proficiency in claims management software and standard office applications.
• A relevant tertiary qualification in insurance, law, or a related field is highly desirable.
• Ability to work independently and as part of a team, managing a caseload effectively.
• Attention to detail and a commitment to accuracy.
• Willingness to travel within the Soweto region and surrounding areas as required.
• A valid driver's license and reliable transportation.

Benefits

• Competitive salary package commensurate with experience and qualifications.
• Opportunity to work in a reputable and stable insurance company.
• Comprehensive medical aid and retirement fund contributions.
• Professional development and ongoing training opportunities.
• A supportive and collaborative work environment.
• Potential for career advancement within the organization.
• Access to cutting-edge claims management technology.
• Employee assistance programs and wellness initiatives.
• Exposure to a diverse range of insurance products and claim types.
• Contribute to a team that values professionalism and client satisfaction in Soweto.