Senior Claims Assessor: Hybrid Role with Growth & Impact

Placements24; Midrand; Hybrid; ZAR 420,000 - 560,000; Full time

Benefits offered by this job

Hybrid work

Medical aid

Retirement fund

Professional development

Team-building

Wellness program

Annual leave

Bonuses

Job summary

Placements24 is seeking a Senior Claims Assessor in Midrand, Gauteng to manage complex insurance claims from initiation to settlement. You will determine coverage based on policy terms, gather evidence, and communicate decisions to stakeholders with clarity and integrity.

The role requires at least 5 years of claims experience, strong analytical and negotiation skills, and the ability to mentor juniors in a collaborative environment. A related Insurance/Law qualification is preferred.

Qualifications

• Minimum of 5 years of experience in insurance claims assessment, focusing on complex claims.
• Strong understanding of insurance principles, policy wordings and relevant legislation.
• Excellent analytical, problem-solving and decision-making skills.
• Strong negotiation and communication abilities, both written and verbal.
• Proficiency in using claims management software and MS Office Suite.
• Relevant tertiary qualification in Insurance, Law, or related field preferred.
• Ability to work independently and as part of a team.
• High level of integrity and ethical conduct.
• Experience mentoring junior staff is a plus.
• Commitment to continuous professional development in insurance.

Responsibilities

• Investigate, evaluate, and adjudicate complex insurance claims from initiation to settlement.
• Determine coverage based on policy terms, ensuring regulatory compliance.
• Communicate with claimants, policyholders, and legal representatives to gather information.
• Assess damages and liabilities using expert reports and evidence.
• Negotiate settlements within authority, aiming for fair outcomes.
• Prepare detailed reports documenting findings and actions.
• Mentor junior claims assessors and provide guidance.
• Identify potential fraud and escalate to relevant departments.
• Maintain accurate claim records in company systems.
• Contribute to process improvements in claims handling.

Skills

Analytical thinking

Negotiation

Communication

Problem solving

Team collaboration

Education

Insurance/Law degree

Tools

Claims management software

MS Office

Job description

Placements24 is seeking a Senior Claims Assessor in Midrand, Gauteng to manage complex insurance claims from initiation to settlement. You will determine coverage based on policy terms, gather evidence, and communicate decisions to stakeholders with clarity and integrity.

The role requires at least 5 years of claims experience, strong analytical and negotiation skills, and the ability to mentor juniors in a collaborative environment. A related Insurance/Law qualification is preferred.