Internal Dispute Resolution Manager

3 days ago

Sydney, New South Wales, Australia beBeeDisputeResolution Full time $90,000 - $125,000

Job Description

The primary objective of this role is to oversee the examination and resolution of client disputes within a professional framework.

This involves conducting thorough reviews of disputed CTP Care claims decisions under the Motor Accident Injuries Act 2017 (NSW) and Motor Accident Guidelines, providing recommendations that are fair, timely, and evidence-based.

Effective communication and informed decision-making are critical for optimal outcomes, requiring strong critical reasoning skills, knowledge of evidence-based treatment, and an understanding of reasonable and necessary criteria.

Duties and Responsibilities

  1. Conduct impartial internal reviews of disputed CTP Care claims decisions.
  2. Review claims, medical documentation, and previous decisions to provide sustainable and effective decisions relating to treatment and care.
  3. Maintain working relationships with internal and external stakeholders to facilitate dispute resolution.
  4. Display excellent written and verbal communication skills, providing clear rationale for decisions and open communication during internal review processes.
  5. Manage difficult conversations, demonstrating empathy in managing client and business concerns throughout dispute resolution.
  6. Liaise with internal and external legal stakeholders and the Personal Injury Commission to facilitate dispute processes.
  7. Contribute to service delivery evaluation and implementation for clients, including participating in quality assurance and improvement projects.

Required Skills and Qualifications

  • Relevant tertiary qualifications in a health or disability discipline or strong practical experience in identifying, reviewing, and coordinating services for people with chronic injuries or disabilities.
  • Sound understanding of the needs and perspectives of people with chronic injury within a legislated environment.
  • Critical reasoning skills to ensure high integrity in decision-making processes.
  • Excellent communication skills (written and verbal).
  • Able to build rapport and communicate complex information effectively with all stakeholders.
  • Ability to set clear expectations and engage in difficult conversations with clients and stakeholders.
  • Capability to work in a dynamic environment.
  • Qualifications in Insurance, Medical, Allied Health, or related disciplines.
  • Strong understanding of the Motor Accident Injuries Act 2017 (NSW) and Motor Accident Guidelines.

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