Experienced Claims Operations Specialist

7 days ago

Melbourne, Victoria, Australia beBeeClaims Full time $99,799 - $105,999

Job Title: Experienced Claims Operations Specialist

About the Role:

The Experienced Claims Operations Specialist will lead and execute the technical and quality capability of the Claims Intake team, ensuring accurate, consistent, and timely delivery of indemnity assessments and decision-making activities.

Key Responsibilities:

  • Manage escalated decision activities in line with process standards, collaborating with internal stakeholders, and using insights to uplift team knowledge and reduce future escalations.
  • Provide expert support to the CI team in handling declined claims, responding to complex member enquiries, and managing complaints with professionalism and empathy.
  • Act as a subject matter expert in CI systems and processes.
  • Assist the Senior Manager, Claims Operations in daily workflow allocation, focusing on timely handling of urgent and declined matters.
  • Manage a small portfolio of indemnity assessments and decisions end-to-end.

Requirements:

  • 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 Qualifications:

  • Understanding of Medical Indemnity insurance.
  • Understanding of Medico Legal claim types.
  • General understanding of medical terminology preferable.
  • Experience in coaching or team leadership preferred.

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