Senior Claims Specialist — Remote & High-Value Claims

Placements24; Vereeniging; Hybrid; ZAR 520,000 - 780,000; Full time

Benefits offered by this job

Competitive salary

Medical aid

Life cover

Disability benefits

Generous annual leave

Sick leave policies

Professional development and certs

Fully remote work

Bonuses and incentives

Retirement fund

Job summary

Placements24 is seeking a Senior Claims Handler to join a fully remote team in South Africa. The role focuses on investigating, assessing, and negotiating complex insurance claims while upholding service quality for policyholders nationwide.

You will manage liability, coverage, and settlements, mentor junior staff, and ensure compliance with industry regulations. Remote, fully virtual team collaboration and advanced digital tools are emphasized.

Qualifications

• A relevant tertiary qualification (e.g., Law, Business, Insurance).
• A minimum of 5 years of proven experience in handling a variety of insurance claims.
• In-depth knowledge of insurance law, policy wordings, and claims best practices.
• Exceptional negotiation, analytical, and problem-solving skills.
• Strong communication and interpersonal abilities, crucial for remote interaction.
• Proficiency in claims management systems and relevant software.
• Ability to manage a demanding workload independently and prioritize effectively.
• A commitment to delivering excellent customer service.
• Experience working remotely in a professional capacity is highly desirable.

Responsibilities

• Manage a portfolio of complex and high-value insurance claims from initiation to closure.
• Conduct thorough investigations, including reviewing policy documents, evidence, and reports.
• Assess liability, determine coverage, and calculate appropriate settlement amounts.
• Negotiate effectively with claimants, legal representatives, and other parties to achieve fair settlements.
• Provide clear and empathetic communication to all stakeholders throughout the claims process.
• Ensure compliance with all relevant legal and regulatory requirements, as well as company policies.
• Mentor and provide guidance to junior claims handlers, fostering skill development.
• Identify potential fraudulent claims and implement appropriate investigation protocols.
• Contribute to the development and refinement of claims handling best practices and procedures.
• Utilize advanced claims management software and technology to optimize workflows.

Skills

Negotiation skills

Analytical skills

Problem-solving

Communication skills

Remote communication

Claims management software

Independent work

Interpersonal skills

Education

Tertiary qualification in Law/Business/Insurance

Tools

Claims management software

Job description

Placements24 is seeking a Senior Claims Handler to join a fully remote team in South Africa. The role focuses on investigating, assessing, and negotiating complex insurance claims while upholding service quality for policyholders nationwide.

You will manage liability, coverage, and settlements, mentor junior staff, and ensure compliance with industry regulations. Remote, fully virtual team collaboration and advanced digital tools are emphasized.