Senior Claims Assessor

Placements24; Upington; On-site; ZAR 420,000 - 600,000; Full time

Benefits offered by this job

Medical aid

Retirement fund contributions

Job summary

Placements24 is seeking a Senior Claims Assessor based in Upington, Northern Cape. You will evaluate and process complex insurance claims, determining coverage and settlement amounts while ensuring policy terms are met.

You will communicate with policyholders and gather documentation, with a focus on accurate, timely resolutions. The role requires 5+ years in claims assessment, strong knowledge of SA insurance laws, and the ability to manage a high workload.

Qualifications

• Bachelor's degree in Business, Law, or related field or equivalent practical experience.
• Minimum 5 years of experience as a Claims Assessor or Adjuster in the insurance industry.
• Strong knowledge of insurance products and claims handling procedures.
• Good understanding of South African insurance laws and regulations.
• Excellent analytical, problem-solving, and decision-making skills.
• Exceptional communication, negotiation, and interpersonal abilities.
• Meticulous attention to detail and strong organizational skills.

Responsibilities

• Investigate, evaluate, and process complex insurance claims, ensuring accuracy and adherence to policy terms and conditions.
• Determine coverage, liability, and settlement amounts for claims.
• Communicate effectively with policyholders, claimants, witnesses, and other relevant parties.
• Gather necessary documentation, conduct interviews, and obtain expert opinions when required.
• Negotiate settlements within authorized limits, striving for fair and timely resolutions.
• Identify potential fraudulent claims and escalate for further investigation.
• Maintain accurate and detailed claim files and documentation.
• Stay up-to-date with insurance policies, industry best practices and relevant legislation.
• Provide guidance and support to less experienced claims adjusters.
• Contribute to improving claims handling processes and efficiency.

Skills

Claims handling

Analytical skills

Communication

Negotiation

Attention to detail

Education

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

Tools

Claims management software

Job description

About the Role

Our client, a leading insurance provider with a commitment to exceptional customer service, is looking for a Senior Claims Assessor to join their dedicated team. This position is vital in evaluating and processing complex insurance claims accurately and efficiently, ensuring fair settlements for policyholders. The successful candidate will possess extensive knowledge of claims handling procedures, strong analytical skills, and the ability to manage a challenging workload. Based in **Upington, Northern Cape**, this role offers a fantastic opportunity to contribute to a respected organization and grow your career within the insurance sector. We are looking for a meticulous and experienced professional to uphold our client's reputation for integrity and service excellence.

Key Responsibilities

• Investigate, evaluate, and process complex insurance claims, ensuring accuracy and adherence to policy terms and conditions.
• Determine coverage, liability, and settlement amounts for claims.
• Communicate effectively with policyholders, claimants, witnesses, and other relevant parties.
• Gather necessary documentation, conduct interviews, and obtain expert opinions when required.
• Negotiate settlements within authorized limits, striving for fair and timely resolutions.
• Identify potential fraudulent claims and **escalate** for further investigation.
• Maintain accurate and detailed claim files and documentation.
• Stay up-to-date with insurance policies, industry best practices and relevant legislation.
• Provide guidance and support to less experienced claims adjusters.
• Contribute to improving claims handling processes and efficiency.

Requirements

• Bachelor's degree in Business, Law, or a related field, or equivalent practical experience.
• Minimum of 5 years of experience as a Claims Assessor or Adjuster in the insurance industry.
• In-depth knowledge of various insurance products and claims handling procedures.
• Strong understanding of relevant South African insurance laws and regulations.
• Excellent analytical, problem-solving, and decision-making skills.
• Exceptional communication, negotiation, and interpersonal abilities.
• Meticulous attention to detail and strong organizational skills.
• Proficiency in claims management software and standard office applications.
• Ability to manage a high volume of claims efficiently and effectively.
• Professional designations or certifications in claims management are a plus.

Benefits

Our client offers a competitive annual salary, performance incentives, and a comprehensive benefits package, including medical aid and retirement fund contributions. This role is located in **Upington, Northern Cape**, offering a stable and supportive work environment. We provide opportunities for professional development and career advancement within the company. Join a team dedicated to delivering outstanding service and upholding the highest standards of integrity.