Claims Technical Specialist Retail

5 months ago

Sydney, Australia TAL Full time

**Company Description**
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 discover where we can go?

he Claims Technical Specialist is responsible for providing technical advice, guidance and support to the Claims team on technical assessment and case management matters, to assist in reaching desired claims durations and outcomes in line with the terms and conditions of the policy.

A key focus of the role is to optimise assessment quality within the Income Protection, Life, Trauma and TPD portfolios and support Claims Managers to build their capability in line with the TAL claims capability and delegated authority frameworks.
- Contribute towards a culture of process improvement. Along with the Team Manager, ensure that change initiatives are embedded and that best practices are adopted, while ensuring a best practice approach to claims handling
- Contribute to department and company projects as required.
- Maintain current knowledge of life insurance guidelines, processes and policy changes.
- Ensure claims handling and service approach reflects industry best practice and TAL processes and policies.
- Other ad-hoc duties as required

Technical Support
- Provide adverse decision review and sign off on assessment, which may require referral to internal Claims review body
- Support Claims Consultants to use effective communication with customers, treating health practitioners and other stakeholders to drive the best service experience and appropriate claim outcomes for the customer
- Support Client Managers and Team Managers in their reporting to funds and attendance at fund meetings/case conferences related to technical claim outcomes as required
- Development/ enhancement of claims handling procedures and guidelines as required. Assist with embedment

Team Capability
- Drive processes to support development of technical capability within claims and implement strategies lto develop technical skills in line with the TAL claims capability framework resulting in progression of delegated authorities in a timely manner
- Coaching Claims Consultants in appropriately executing assessment practices ensuring the timely and quality management of claims. Including completing ‘above delegation’ and ‘within delegation’ reviews of individuals work and recording outcomes and opportunities for development
- Provide insights into Case Manager technical capabilities for the purpose of performance management and support the Team Manager in development planning for individuals to uplift their capability in line with TAL’s capability framework.
- Deliver training as required

Compliance
- Contribute to the implementation of appropriate governance structures and quality assurance to successfully deliver business solutions.
- Ensure compliance with TAL policies, procedures and guidelines procedures, ensuring claims management is in accordance with the TAL claims philosophy
- Adherence to external regulations (eg. Privacy and Life Insurance Code of Practice) and all relevant legislation and industry guidelines
- Ensure all interactions with Customers, Advisers and other internal and external stakeholders adhere to TAL’s Customer Service Culture through the provision of high-quality, accurate and compliant work

**Qualifications**
- At least 2 years’ demonstrated experience in a similar role within Life Insurance or 5 years’ experience as a Life Insurance Claims Manager or similar.
- Experience in coaching and embedding knowledge, including an uplift of skills of case managers.
- Ability to identify and develop strategies to overcome barriers in claims assessment and management.
- Strong written and verbal communication, negotiation and influencing.
- Demonstrated ability to provide excellent customer service to a wide range of clients and stakeholders.
- Relevant tertiary qualifications in Business, Commerce, Health or Allied Health (desirable).
- Diploma or Cert IV in Life Insurance, or equivalent (desirable).

**Additional Information**

To provide you with the best experience, we can accommodate you at any stage of the recruitment process. Simply inform our Recruitment team at any time.

TAL is recognised by the Workplace Gender Equality Agency as an Employer of Choice. We are proud to be a member of Diversity Council Australia and the Australian Network on Disability. For information on our reconciliation journey, take a look at our Innovate Reconciliation Action Plan.

We acknowledge the Traditional Custodians of the Land in which our Head Office is based, the land of the Gadigal people of the Eora Na

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