Senior Claims Assessor — Complex Claims Expert

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

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.