Expert Claims Assessment Professional

7 days ago

Melbourne, Victoria, Australia beBeeClaims Full time $120,000 - $150,000
Job Description:

We seek a seasoned claims assessment expert to provide specialized claims assessment services to insurers and trustees of superannuation funds.

  • Assess terminal illness, total and permanent disablement, and income protection claims.
  • Provide assessment services for a portfolio of claims in accordance with clearly defined assessment practices and procedures.
Key Responsibilities:
  1. Manage the initial and ongoing assessment of complex new and existing terminal illness, total and permanent disablement, and income protection claims within agreed service standards.
  2. Undertake claim notification interviews as required.
  3. Guide and support less experienced claims assessors and case managers with the ongoing management of claim files.
  4. Instruct third-party service providers (IME, rehab, functional, vocational assessments) and monitor the service provided.
  5. Peer review cases of other team members as required.
  6. Ensure claim remediation as directed by senior management is actioned in accordance with agreed timeframes.
  7. Undertake facilitated case discussions to ensure claims are being assessed in accordance with contracted service standards.
  8. Provide training to other assessors, trainee assessors, and administration support staff as required.
  9. Research and keep up-to-date with current trends within the medico-legal sphere.
Requirements:
  • A minimum of 3 years retail/group claims assessment insurance experience, including a high level of knowledge of product, medical, system, and legislation impacting the life insurance industry.
  • Sound knowledge of life insurance - terminal illness, total and permanent disablement, and income protection.
  • Strong superannuation knowledge and experience.
  • Medical knowledge and understanding of legislative requirements.
  • Experience identifying key issues and escalating an assessment.
  • Experience interpreting legislation and insurance policies.
  • Sound analytical and problem-solving skills.
  • Customer service focus and experience.
  • The ability to work as part of a team and contribute to team objectives.
  • Strong communication skills - verbal and written.
  • Strong attention to detail.
  • Solid knowledge of Microsoft Office Suite (Word, Excel, PowerPoint, Access).

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