Transformative Claims Review Role

2 weeks ago

Melbourne, Victoria, Australia beBeeClaims Full time
Claims Review Specialist

We are seeking a detail-oriented and experienced claims professional to conduct high-volume, high-quality claim reviews. This role plays a pivotal part in driving meaningful change in the social-insurance landscape.

  • Supporting a variety of exciting and dynamic engagements as a claims specialist.
  • Apply legislative frameworks and clinical guidelines to assess liability, treatment appropriateness, and return-to-work strategies.
  • Perform targeted claim reviews to drive improved injured-worker and claim outcomes.
  • Facilitate case conferences with treating providers to review treatment progress, clarify recovery goals, and discuss alignment with clinical frameworks.
  • Identify claims management gaps, delays, or missed opportunities and provide actionable insights.
  • Deliver a high level of customer service within relevant service charters.
  • Collaborate with internal teams and client stakeholders to ensure alignment on review findings and recommendations.
  • Utilize various claims management systems, maintaining accurate documentation and data entry.

Key Responsibilities:
  • Conducting claim reviews.
  • Applying legislative frameworks.
  • Collaborating with stakeholders.
Key Strengths:
  • Claims management expertise.
  • Legislative knowledge.
  • Attention to detail.
  • Critical assessment skills.
  • Customer service skills.
  • Independent working.

Why this role is ideal for you:

KPMG's Insurance Claims and Workplace Health practice offers a supportive environment where you can grow and develop your skills. You will have the opportunity to work with a team of passionate professionals who share your passion for driving meaningful change.

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