Senior Claims Operations Consultant

Location: Melbourne, Sydney, Brisbane (Hybrid) Type: 12 Month Fixed Term Contract About the Role This role is responsible for leading and executing the technical and quality capability of the Claims Intake (CI) team, ensuring that indemnity assessments and decision-making activities are accurate, consistent, and delivered within established service standards.

This includes: Managing and executing escalated decision activities in line with defined process standards, collaborating with key internal stakeholders, and using insights to uplift team knowledge and reduce future escalations.

Providing expert support to the CI team in handling declined claims, responding to complex member enquiries, and managing complaints with professionalism and empathy.

Acting as a subject matter expert in CI systems and processes Assisting the Senior Manager, Claims Operations in daily workflow allocation, with a focus on timely handling of urgent and declined matters.

This role will also be expected manage a small portfolio of indemnity assessments and decisions end-to-end.

Key Accountabilities: Operational Process Execution Manage internal escalations and complaints, seeking expert input where required to ensure accurate and timely resolution.

Oversee daily workflow allocation, ensuring tasks are distributed evenly to the CI team.

Monitor urgent matters and the Notice of Intention (NOI) line to enable real-time issue resolution.

Support the Senior Operations Manager in implementing and executing training and development plans.

Technical Support, Coaching, and Feedback Provide continuous technical guidance, coaching, and constructive feedback to the Claims Intake (CI) team to: Apply logic-driven process standards to determine objective indemnity decision outcomes.

Make and document subjective decisions based on product and policy rules when objective outcomes are not possible.

Manage declined and withdrawn indemnity decisions directly with members, ensuring clear communication and resolution.

Promote a culture of learning and improvement by offering timely, respectful, and actionable feedback to Claims Intake and Claims Excellence Teams and Product.

Service to Members Provide dedicated contact point for all notifications (incident or claim) and support member to indemnity decision outcome, building rapport, representing Avant professionally, leveraging our Service Principles throughout all interactions with members Review, evaluate and process member enquires to appropriate owner.

Proactively manage end to end case management within Service Levels Key Capabilities Required (Qualifications, Experience And Skills)Demonstrated technical expertise with deep understanding of claims process and indemnity assessment.

Proven ability to coach effectively to process adherence, provide constructive, timely feedback and guidance that supports team learning, builds confidence, and enhances overall capability.

Strong written and verbal communication, with ability to explain complex decisions clearly.

Proven ability to work effectively with internal stakeholders and contribute to positive team culture.

Strong analytical skills and sound judgement in resolving complex or escalated matters Preferred Capabilities (Qualifications, Experience And Skills)Understanding of Medical Indemnity insurance Understanding of Medico Legal claim types General understanding of medical terminology preferable Experience in coaching or team leadership preferred.

Why work at Avant?At Avant, our people are the centre of everything we do for our members.

We offer a range of benefits and opportunities to enable you to make a difference, learn, and grow in your career.

We value our people by offering an inclusive workplace with a diverse range of benefits, flexible working options, career development, and internal mobility opportunities.

Our flexible working arrangements are designed to enable genuine work-life balance.

Your development is our priority and we have a variety of learning and development programs that will support you in your career.

We offer support to our people via Employee Assistance Program (EAP), Health and Wellbeing programs, Tertiary Education Sponsorship and Support.

We have a diverse and connected work environment where your contribution and ideas will be valued and respected and make a real difference to the lives of others.

For further information, please contact our Careers team at careers@avant.org.au.

Please note: Avant Mutual is a vaccinated employer.

Prior to the commencement of your employment by Avant, you are required to be fully vaccinated against the Covid-19 virus or have a medical certificate stating that you cannot receive a Covid-19 vaccination for valid medical reasons.

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