Senior Claims Assessor - Remote

Placements24; Pietermaritzburg; Híbrido; ZAR 480.000 - 720.000; Tempo integral

Benefícios oferecidos por esta vaga

Competitive salary package

Medical and retirement benefits

Generous annual leave

Remote work technology & support

Performance-based bonuses

Wellness programs

Professional development opportunities

Resumo da vaga

Placements24 is seeking a highly experienced Senior Claims Assessor to join a remote-first team serving clients across South Africa. You will assess complex insurance claims, interpret policy wordings, determine coverage and settlements, and ensure compliant outcomes.

The role requires at least 5 years in claims assessment within insurance, strong analytical and negotiation skills, and the ability to mentor junior assessors while helping enhance claims procedures.

Qualificações

• Minimum 5 years of demonstrable claims assessing experience.
• Tertiary qualification in Insurance, Law, Commerce or related field.
• In-depth knowledge of SA insurance legislation and practices.
• Experience with short-term, long-term, property and liability claims.

Responsabilidades

• Thoroughly investigate, evaluate, and adjudicate complex insurance claims across various policy types.
• Interpret policy wordings, determine coverage, and assess liability accurately.
• Communicate effectively with policyholders, brokers, and other stakeholders to gather information and explain claim decisions.
• Negotiate settlements within approved authority limits.
• Prepare detailed assessment reports and maintain accurate claim records.
• Identify potential fraud indicators and elevate as necessary.
• Collaborate with legal and technical experts when required.
• Mentor and guide junior claims assessors, providing training and support.
• Contribute to the development and refinement of claims handling procedures and best practices.
• Ensure adherence to regulatory requirements and company standards.

Conhecimentos

Analytical skills

Negotiation

Communication skills

Remote work

Time management

Formação

Tertiary qualification in Insurance, Law, Commerce, or related field

Ferramentas

Claims management software

Descrição da vaga

Our client, a leading provider in the insurance sector, is seeking a highly experienced and motivated Senior Claims Assessor to join their dynamic team. This is a completely remote-first position, offering flexibility and the opportunity to work from anywhere within South Africa. You will play a crucial role in the efficient and accurate assessment of complex insurance claims, ensuring compliance with policy terms and conditions. This role demands a meticulous approach, strong analytical skills, and a deep understanding of the insurance landscape. As a senior member of the team, you will also contribute to mentoring junior assessors and improving our claims handling processes. The ideal candidate will be proactive, possess excellent communication skills, and be adept at managing a diverse caseload. Join us to make a significant impact in a supportive, remote work environment based in Pietermaritzburg, KwaZulu-Natal, ZA.

Key Responsibilities

• Thoroughly investigate, evaluate, and adjudicate complex insurance claims across various policy types.
• Interpret policy wordings, determine coverage, and assess liability accurately.
• Communicate effectively with policyholders, brokers, and other stakeholders to gather necessary information and explain claim decisions.
• Negotiate settlements within approved authority limits.
• Prepare detailed assessment reports and maintain accurate claim records.
• Identify potential fraud indicators and elevate as necessary.
• Collaborate with legal and technical experts when required.
• Mentor and guide junior claims assessors, providing training and support.
• Contribute to the development and refinement of claims handling procedures and best practices.
• Ensure adherence to regulatory requirements and company standards.

Requirements

• A relevant tertiary qualification in Insurance, Law, Commerce, or a related field.
• A minimum of 5 years of demonstrable experience in claims assessing within the insurance industry.
• Proven expertise in handling a wide range of insurance claims (e.g., short-term, long-term, property, liability).
• In-depth knowledge of insurance legislation, regulations, and industry practices in South Africa.
• Exceptional analytical, problem-solving, and decision-making abilities.
• Strong negotiation and conflict-resolution skills.
• Excellent written and verbal communication skills, with the ability to explain complex information clearly.
• Proficiency in claims management software and standard office applications.
• Ability to work independently and manage time effectively in a remote setting.
• A strong commitment to ethical conduct and professional integrity.

Benefits

• Competitive annual salary package.
• Comprehensive medical and retirement benefits.
• Generous annual leave allowance.
• Opportunities for professional development and continuous learning.
• Access to cutting-edge remote work technology and support.
• A collaborative and supportive virtual team environment.
• The flexibility to work from home across South Africa.
• Performance-based bonuses.
• Employee wellness programs.