Senior Claims Assessor - Remote, High-Impact Decisions

Placements24; Midrand; Hybrid; ZAR 420,000 - 700,000; Full time

Benefits offered by this job

Comprehensive remote setup support

Professional development & training

Access to advanced claims management‑/

Performance incentives & bonuses

Generous leave policy

Provident fund & medical aid

Job summary

Placements24 is seeking a Senior Claims Assessor for a fully remote role in South Africa. You will assess complex insurance claims, guide policy interpretation, and ensure compliance with SA regulations.

You will work independently, manage a caseload, and coordinate with stakeholders from anywhere in SA. The ideal candidate has 5+ years in claims assessment, strong analytical and negotiation skills, and a track record of accuracy and integrity.

Qualifications

• At least 5 years of proven experience in insurance claims assessment, focusing on complex claims.
• Strong knowledge of South African insurance legislation and regulatory frameworks.
• Excellent analytical, problem-solving, and decision-making skills.
• Excellent communication, negotiation, and interpersonal skills.
• Ability to work independently in a remote environment.
• Relevant tertiary qualification in Insurance, Law, Finance, or related field is highly desirable.
• Experience in short-term, long-term, or specialized policies is advantageous.
• Reliable internet connection and a dedicated home office setup.

Responsibilities

• Investigate, evaluate, and adjudicate complex insurance claims accurately and efficiently.
• Gather and analyze documentation to determine claim validity and payout amounts.
• Communicate professionally with policyholders, claimants, and other parties throughout the claims process.
• Maintain detailed records in the claims management system.
• Identify fraud indicators and escalate suspicious cases.
• Provide guidance to junior claims handlers.
• Stay updated on industry trends and regulatory changes.
• Contribute to development of claims handling procedures.
• Manage a caseload from inception to closure and ensure timely resolution.
• Participate in remote team meetings and contribute to departmental objectives.

Job description

Placements24 is seeking a Senior Claims Assessor for a fully remote role in South Africa. You will assess complex insurance claims, guide policy interpretation, and ensure compliance with SA regulations.

You will work independently, manage a caseload, and coordinate with stakeholders from anywhere in SA. The ideal candidate has 5+ years in claims assessment, strong analytical and negotiation skills, and a track record of accuracy and integrity.