Insurance Claims Examiner

2 weeks ago

Sydney, New South Wales, Australia beBeeClaims Full time $90,000 - $120,000
Job Overview:The primary purpose of this role is to produce high-quality work products on low-value claims by conducting thorough investigations, effective reserving, and timely adjustments.
Key Responsibilities
  • Manage liability claims portfolios in accordance with industry best practices.
  • Analyse first reports to determine loss nature, coverage, and injury/damage scope.
  • Conduct comprehensive investigations into reported claims, including potential fraud. Secure and verify supporting documentation for accuracy, relationship, and completeness.
  • Establish accurate and timely reserves based on thorough analysis.
  • Provide exceptional service standards aligned with industry best practices.
  • Maintain an active diary to achieve timely claim development and disposition.
  • Promptly document all claim developments on the claim file.
  • Exercise sound judgment when evaluating claim final disposition by considering loss nature, liability, injury/damage, coverage, and applicable limits.
  • Negotiate compromise settlements effectively where appropriate.
  • Communicate effectively with various stakeholders, including claim departments, customer services, loss control, underwriting departments, finance departments, brokers, insureds, service providers, third parties, and their legal representatives.
  • Recognise and pursue subrogation opportunities where applicable.
  • Comply with relevant statutory rules, regulations, and internal compliance obligations.

Required Skills and Qualifications
  • Relevant tertiary or insurance industry qualifications.
  • Minimum 2 years of liability claims experience.
  • Broad knowledge of insurance industry and claims processes.
  • Excellent written and verbal communication skills.
  • Effective workflow management skills.
  • Strong customer service focus.
  • Proven team player.

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