Senior Insurance Claims Assessor

Placements24; Noord-Kaap; Hybrid; ZAR 420,000 - 580,000; Full time

Benefits offered by this job

Competitive salary package

Medical aid & retirement fund

Generous leave provisions

Professional development

Flexible working arrangements

Job summary

Placements24 is seeking a Senior Insurance Claims Assessor in Kimberley, Northern Cape. This role focuses on thorough investigations, policy interpretation, and expert guidance to junior staff within a leading insurance provider.

Ideal candidates have 5+ years of experience, strong analytical skills, and the ability to mentor peers while ensuring accurate, compliant claims decisions. The position offers growth, competitive benefits, and a collaborative environment.

Qualifications

• 5+ years in insurance claims assessment.

Responsibilities

• Conduct investigations and assessments of complex insurance claims.
• Interpret policy wordings and regulations to determine coverage.
• Communicate with policyholders, claimants, witnesses and legal representatives.
• Negotiate settlements within authorized limits.
• Prepare detailed reports documenting findings and recommendations.
• Identify potential fraudulent claims and expedite them for further investigation.
• Mentor junior claims assessors.
• Maintain claim records in the CMS.
• Stay updated on industry trends and legislation affecting claims.
• Contribute to improved claims handling procedures.

Skills

Analytical thinking

Negotiation

Mentoring

Communication

Team leadership

Detail orientation

Self-motivation

Customer service

Education

Tertiary qualification in Law/Commerce/Risk Management

Tools

Claims software

Job description

About the Role

Our client, a prominent player in the insurance sector, is seeking a highly motivated and experienced Senior Insurance Claims Assessor to join their dynamic team in Kimberley, Northern Cape. This role is crucial in ensuring the efficient and accurate assessment of insurance claims, upholding the company's reputation for integrity and customer service. The successful candidate will be instrumental in managing complex claims portfolios, providing expert guidance to junior staff, and contributing to the continuous improvement of claims handling processes. This position offers a unique opportunity to grow within a supportive and forward-thinking organization, leveraging your expertise to make a significant impact. We are looking for an individual who possesses a deep understanding of insurance policies and claims legislation, coupled with exceptional analytical and problem-solving skills. The ideal candidate will thrive in a challenging yet rewarding environment, demonstrating a commitment to excellence in every aspect of their work. Join us in Kimberley and become a vital part of our client's success story, contributing to the financial security and peace of mind of their policyholders.

Key Responsibilities

• Conduct thorough investigations and assessments of complex insurance claims, including but not limited to, property, casualty, and life insurance.
• Interpret policy wordings, legal requirements, and technical reports to determine coverage and liability.
• Communicate effectively with policyholders, claimants, witnesses, and legal representatives to gather necessary information and explain claim decisions.
• Negotiate settlements within authorized limits, ensuring fairness and compliance with company guidelines.
• Prepare detailed reports documenting claim findings, assessments, and recommendations.
• Identify potential fraudulent claims and expedite them for further investigation.
• Mentor and provide guidance to junior claims assessors, fostering a collaborative team environment.
• Maintain accurate and up-to-date claim records in the company's claims management system.
• Stay abreast of industry trends, legislative changes, and best practices in claims assessment.
• Contribute to the development and implementation of improved claims handling procedures.

Requirements

• A relevant tertiary qualification in Law, Commerce, Risk Management, or a related field is highly preferred.
• Minimum of 5 years of proven experience in insurance claims assessment, with a strong understanding of various insurance types.
• In-depth knowledge of insurance legislation, regulations, and claims handling best practices.
• Excellent analytical, critical thinking, and problem-solving skills.
• Strong negotiation and conflict resolution abilities.
• Exceptional communication, interpersonal, and customer service skills.
• Proficiency in using claims management software and standard office applications.
• Ability to work independently and as part of a team, managing multiple priorities effectively.
• High level of integrity, ethical conduct, and attention to detail.
• Previous experience in a supervisory or mentoring role is advantageous.

Benefits

• Competitive salary package commensurate with experience and qualifications.
• Opportunity to work with a leading insurance provider in Kimberley.
• Comprehensive medical aid and retirement fund contributions.
• Generous leave provisions and other employee wellness programs.
• Ongoing professional development and training opportunities.
• A supportive and collaborative work environment with opportunities for career advancement.
• Potential for flexible working arrangements.