Claims Technical Specialist

4 weeks ago

Melbourne, Australia TAL Full time

**Company Description**
Welcome to This Australian Life.

From the millions of Australians we protect, to those that make it happen every day at TAL, people really are what we’re all about. We want to grow with you. Achieve with you. And support you to do your best work. That's why we're focused on developing leadership, promoting diversity, rewarding excellence and retaining great talent.

We're always looking for people who want to go further with us. People who do what’s right, aim high, and work smart. Why not see where we can go?
- Provide ongoing coaching and mentoring to Case Managers (and/or external stakeholders) on the claims management process, enabling them to provide exceptional customer service to clients, including guidance on handling communication with clients relating to the management of their claim and attending to client’s enquiries;
- Being the escalation point for technical advice for Case Managers, undertake duties including:

- Authorise and review claims (and associated benefits payments), including where above delegated authority of Case Managers;
- Interpretation and advice regarding hypothetical claims scenarios;
- undertake quality assurance reviews of claims files;
- provide advice on the technical interpretation of policies and contract requirements; and
- take accountability for the resolution of customer complaints or requests for decision reviews (within authority);
- Continuously support the Claims Team Manager (or Senior Claims Specialists), including acting as the second-in-charge for the relevant Claims Team, triaging of claims files to Case Managers, providing feedback to the Claims Team Manager on the successes and development opportunities for Case Managers, as required;
- Liaising with internal and external stakeholders, to ensure the timely and quality management of claims, including participating in case conferences, peer case discussions and working closely with the Claims Technical Training team to identify and develop training package needs;
- Generation of reports for the Claims Team and Claims Leadership Team (such as Traffic Light reports), to enable the efficient and effective management of the team;
- Continuously reviewing Claims processes and frameworks to seek out opportunities for improvement in the overall claims experience for customers;
- Participate in business area and/or Company projects as required

**Qualifications**
- Experience in a similar role, within Retail or Group Life Insurance (including income protection, lump sum or trauma claims assessment)
- Ability to build rapport and empathy with customers and stakeholders during difficult times.
- Meticulous with a strong attention to detail
- Medical, vocational or rehabilitation background (Desirable)

**Additional Information**
Work is a big part of this Australian life, and we work hard to make it one of the best parts. We don’t just say it; we do it. We offer a workplace that’s inclusive and flexible, supporting our people with options that let them make the most of their careers.

We know the value of having different people from all walks of life, with varied points of view and attributes regardless of their age, ethnicity, religion, sexual orientation, gender identity, intersex status or any disabilities they might be living with. We strive for a diverse and inclusive workplace where a sense of belonging encourages people to bring their full selves to work.

LI-Hybrid #InsuranceClaims

Everyone at TAL has a responsibility to do the right thing and is accountable for the way they conduct themselves. Our expectations are that you follow the principles set out in our Code of Conduct when you come to work every day. Risk management is everyone’s responsibility.

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