Senior Insurance Claims Adjuster

Placements24; Mossel Bay; Hybrid; ZAR 350,000 - 550,000; Full time

Benefits offered by this job

Competitive remuneration with bonus

Medical aid and retirement fund

Career development opportunities

Beautiful Mossel Bay location

Job summary

Placements24 is seeking a Senior Insurance Claims Adjuster for our Mossel Bay office. You will investigate, evaluate, and negotiate complex insurance claims, determine coverage, and communicate with policyholders and legal counsel.

You will mentor junior adjusters and ensure timely, accurate documentation of each file. The role requires at least 5 years in claims, deep policy knowledge, strong negotiation skills, and proficiency with claims software and MS Office.

Qualifications

• Minimum of 5 years of experience as an insurance claims adjuster.
• Proven track record handling high-value and complex claims.
• In-depth knowledge of insurance policies and regulatory frameworks.
• Strong negotiation and conflict-resolution abilities.
• Excellent analytical and problem-solving skills.

Responsibilities

• Investigate, evaluate, and negotiate complex insurance claims (property, casualty, liability).
• Determine coverage based on policy terms and conditions.
• Communicate with policyholders, claimants, and legal counsel.
• Manage claim files from inception to closure with accurate documentation.
• Provide mentorship to junior adjusters.
• Prepare detailed claim status reports.

Skills

Claims negotiations

Team mentorship

Analytical skills

Customer service

Communication skills

Education

Professional qualifications in insurance (advantageous)

Tools

Claims management software

MS Office

Job description

About the Role

Our client, a leading insurer, is seeking a highly skilled and experienced Senior Insurance Claims Adjuster to join their dynamic team in Mossel Bay, Western Cape. This pivotal role involves managing complex claims, providing expert guidance to junior adjusters, and ensuring efficient and fair claim resolution. The ideal candidate will possess a deep understanding of insurance policies, strong analytical skills, and a commitment to exceptional customer service. This position offers a unique opportunity to contribute to a reputable organization in a beautiful coastal region. You will be an integral part of a team dedicated to upholding the highest standards of integrity and professionalism within the insurance sector.

Key Responsibilities

• Investigate, evaluate, and negotiate complex insurance claims (e.g., property, casualty, liability).
• Determine coverage based on policy terms and conditions.
• Communicate effectively with policyholders, claimants, legal counsel, and other stakeholders.
• Manage claim files from inception to closure, ensuring accurate documentation and timely processing.
• Provide guidance and mentorship to junior claims adjusters.
• Conduct thorough investigations, including site visits and evidence gathering, as necessary.
• Analyze claim data to identify trends and recommend process improvements.
• Adhere to all relevant regulatory requirements and company policies.
• Prepare detailed reports on claim status and outcomes.

Requirements

• Minimum of 5 years of experience as an insurance claims adjuster.
• Proven track record of managing high-value and complex claims.
• In-depth knowledge of various insurance policies and legal frameworks.
• Strong negotiation and conflict resolution skills.
• Excellent analytical and problem-solving abilities.
• Proficiency in claims management software and standard office applications.
• A valid driver's license and willingness to travel within the Mossel Bay region for investigations.
• Strong ethical standards and commitment to fairness.
• Relevant professional qualifications or certifications in insurance are advantageous.

Benefits

• Our client offers a competitive remuneration package, including a performance-based bonus structure.
• Employees benefit from comprehensive medical aid and retirement fund contributions.
• Opportunities for professional development and career advancement within the organization are readily available.
• This role is based in the scenic Mossel Bay, providing an excellent work-life balance in a desirable location.
• You will also have access to a supportive team environment and the chance to work with cutting-edge tools and technologies in the insurance claims field.