Senior Claims Assessor - Remote

Placements24; Johannesburg; Hybrid; ZAR 600,000 - 850,000; Full time

Job summary

Placements24 in South Africa is seeking an experienced Senior Claims Assessor to join a fully remote team. You will evaluate, adjudicate, and settle insurance claims with a focus on accuracy, policy terms, and fair outcomes for policyholders.

You will mentor junior handlers and maintain meticulous claim files while upholding service standards. The role requires at least five years in claims assessment across property, casualty, and liability, plus strong communication, negotiation, and software

Qualifications

• Minimum of 5 years of claims assessment experience in insurance.
• Experience handling complex claims across property, casualty, liability.
• In-depth knowledge of insurance law, policy wordings, and claims procedures.
• Excellent analytical, problem-solving, and decision-making skills.
• Strong communication and negotiation abilities; able to handle difficult conversations.
• Proficiency in claims management software and standard office applications.

Responsibilities

• Investigate, assess, and adjudicate a variety of insurance claims, ensuring adherence to policy terms and conditions.
• Determine liability, calculate settlement amounts, and authorize payments within defined authority limits.
• Communicate effectively with claimants, policyholders, legal representatives, and other stakeholders throughout the claims process.
• Maintain accurate and comprehensive claim files, documenting all assessments, decisions, and communications.
• Identify potential fraud indicators and escape suspicious claims for further investigation.
• Mentor and support junior claims handlers, providing guidance and sharing best practices.

Skills

Claims assessment

Insurance knowledge

Analytical skills

Negotiation

Stakeholder comms

Tools

Claims software

Job description

About the Role

Our client, a leading insurance provider, is seeking an experienced and detail-oriented Senior Claims Assessor to join their dynamic team. This is a fully remote position, offering the flexibility to work from anywhere within South Africa. You will play a crucial role in evaluating, processing, and settling insurance claims efficiently and accurately. This opportunity is ideal for a proactive professional who excels in managing a complex caseload and contributing to a customer-centric claims process. You'll leverage your expertise to ensure fair outcomes for policyholders while upholding the company's standards and commitment to service excellence.

Key Responsibilities

• Investigate, assess, and adjudicate a variety of insurance claims, ensuring adherence to policy terms and conditions.
• Determine liability, calculate settlement amounts, and authorize payments within defined authority limits.
• Communicate effectively with claimants, policyholders, legal representatives, and other stakeholders throughout the claims process.
• Maintain accurate and comprehensive claim files, documenting all assessments, decisions, and communications.
• Identify potential fraud indicators and escape suspicious claims for further investigation.
• Mentor and support junior claims handlers, providing guidance and sharing best practices.

Requirements

• Minimum of 5 years of experience in claims assessment within the insurance industry.
• Proven track record in handling complex claims across various insurance lines (e.g., property, casualty, liability).
• In-depth knowledge of insurance law, policy wordings, and claims handling procedures.
• Excellent analytical, problem-solving, and decision-making skills.
• Strong communication, negotiation, and interpersonal skills, with the ability to manage difficult conversations.
• Proficiency in claims management software and standard office applications.

Benefits

• Competitive annual salary package.
• Comprehensive medical aid and retirement fund benefits.
• Generous annual leave allowance.
• Opportunities for professional development and continuous learning.
• A supportive and collaborative remote work environment.