Senior Claims Specialist — Remote (Complex Claims)

Placements24; Bellville; Hybrid; ZAR 420,000 - 640,000; Full time

Benefits offered by this job

Fully remote role

Medical aid

Retirement fund contributions

Career development

Job summary

Placements24 is seeking an experienced Senior Claims Handler for a fully remote role. You will manage complex insurance claims, act as primary contact for policyholders, and ensure timely, fair settlements from your home office.

The ideal candidate has 5+ years in claims, deep policy knowledge, and strong investigation, negotiation, and communication skills to operate autonomously in a remote environment.

Qualifications

• Minimum 5 years' experience in handling insurance claims, including complex claims.
• In-depth knowledge of insurance policies, procedures, and relevant laws.
• Strong analytical, investigative, and problem-solving skills.
• Excellent communication, negotiation, and interpersonal abilities.
• Ability to work independently in a remote, high-volume environment.
• Proficiency with claims management software and standard office apps.

Responsibilities

• Manage and process a diverse range of insurance claims from inception to closure.
• Investigate claim details, gather necessary documentation, and assess liability.
• Interpret policy terms and conditions to ensure accurate coverage determination.
• Communicate effectively with policyholders, claimants, third parties, and legal representatives.
• Negotiate settlements in a fair and timely manner, adhering to company guidelines and authority limits.
• Maintain detailed and accurate claim records using the company's claims management system.
• Identify potential subrogation or salvage opportunities.
• Provide guidance and support to less experienced claims handlers.
• Stay abreast of industry changes, regulations, and best practices in claims handling.
• Contribute to the continuous improvement of claims handling processes.

Skills

Investigations

Negotiation

Communication

Analytical thinking

Remote work

Education

Insurance certifications

Tools

Claims management software

Job description

Placements24 is seeking an experienced Senior Claims Handler for a fully remote role. You will manage complex insurance claims, act as primary contact for policyholders, and ensure timely, fair settlements from your home office.

The ideal candidate has 5+ years in claims, deep policy knowledge, and strong investigation, negotiation, and communication skills to operate autonomously in a remote environment.