1 Senior Insurance Claims Adjuster Remote jobs in WhatJobs Direct
Senior Insurance Claims Adjuster - Remote
Posted 5 days ago
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Job Description
Our client is seeking an experienced and detail-oriented Senior Insurance Claims Adjuster to join their fully remote team. In this critical role, you will be responsible for managing a caseload of complex insurance claims, ensuring fair and efficient settlement for policyholders while safeguarding the company's interests. You will investigate claims, determine coverage, assess damages, negotiate settlements, and facilitate payments. The ideal candidate will possess a deep understanding of insurance policies, claims processes, and relevant legal and regulatory frameworks. Strong analytical, investigative, and communication skills are paramount. As a remote-first position, you must be highly organized, self-disciplined, and proficient in using digital tools for communication, documentation, and claims management. You will conduct virtual investigations, review evidence, and communicate effectively with claimants, legal representatives, and other stakeholders. This role requires the ability to work independently, manage your time effectively, and maintain a high level of accuracy and professionalism. Responsibilities:
- Investigate, evaluate, and settle complex insurance claims in accordance with policy terms and conditions.
- Determine coverage and liability for assigned claims, conducting thorough research and analysis.
- Communicate effectively with policyholders, claimants, witnesses, and legal counsel to gather information and explain claim processes.
- Assess damages and negotiate fair and equitable settlements within authorized limits.
- Manage claims files, ensuring accurate and timely documentation of all activities and decisions.
- Identify potential fraudulent claims and escalate them for further investigation.
- Stay updated on insurance laws, regulations, and industry best practices.
- Maintain strong working relationships with internal departments and external partners.
- Provide excellent customer service to policyholders throughout the claims process.
- Adhere to all company policies and procedures regarding claims handling and ethical conduct.
- Bachelor's degree in Business Administration, Law, or a related field.
- A minimum of 6 years of experience as an Insurance Claims Adjuster, with a focus on handling complex claims.
- Proven expertise in evaluating insurance policies and determining coverage.
- Strong investigative, analytical, and problem-solving skills.
- Excellent negotiation and communication abilities, both written and verbal.
- Proficiency in claims management software and standard office applications.
- Ability to work independently and manage a caseload efficiently in a remote environment.
- Relevant professional certifications (e.g., ACII) are highly desirable.
- A thorough understanding of Kenyan insurance regulations.
- Demonstrated ability to handle sensitive information with discretion and integrity.
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