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Remote Senior Claims Adjuster

Remote · South Africa Full-time

Our client, a leading insurance provider, is looking for an experienced Senior Claims Adjuster to join their fully remote team. This position offers the flexibility to work from anywhere in the US, managing a portfolio of complex insurance claims. The ideal candidate will possess a deep understanding of insurance policies, strong investigative skills, and excellent negotiation abilities. You will play a critical role in ensuring fair and efficient claims resolution, upholding the company's commitment to customer service and integrity within the Insurance sector.

Responsibilities

Investigate, evaluate, and negotiate complex insurance claims, ensuring adherence to policy terms and conditions. Conduct thorough reviews of claim documentation, including reports, statements, and supporting evidence. Determine coverage validity and assess liability for assigned claims. Communicate effectively with policyholders, claimants, witnesses, and legal counsel throughout the claims process. Negotiate settlements within authorized guidelines, aiming for fair and timely resolutions. Document all claim activity accurately and comprehensively in the claims management system. Identify potential fraudulent claims and escalate them for further investigation. Provide exceptional customer service, offering guidance and support to policyholders during challenging times. Stay current with relevant laws, regulations, and industry best practices. Mentor and guide junior claims adjusters, sharing expertise and best practices. Collaborate with underwriters, legal, and other departments as needed to resolve claims.

Qualifications

High school diploma or equivalent required; Associate's or Bachelor's degree preferred. Minimum of 5 years of experience as a Claims Adjuster, with a strong focus on complex claims. Relevant state Adjuster licenses are required or must be obtained promptly. In-depth knowledge of various insurance policies (e.g., property, casualty, auto). Proven ability in claims investigation, evaluation, and negotiation. Excellent analytical and problem-solving skills. Strong written and verbal communication skills. Proficiency with claims management software and standard office applications. Ability to work independently, manage time effectively, and handle a high volume of claims. Demonstrated customer service orientation and strong interpersonal skills. Integrity and a commitment to ethical claims handling. This fully remote position offers a competitive salary and benefits package for a skilled Senior Claims Adjuster ready to contribute to a respected insurance organization. Apply To this Job

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