Claims Expert Lead

23 hours ago

Melbourne, Victoria, Australia beBeeClaims Full time $120,000 - $140,000
Job Description

This role is a key member of the Claims Intake team, responsible for leading and executing technical and quality capabilities. The successful candidate will ensure indemnity assessments and decision-making activities are accurate, consistent, and delivered within established service standards.

  • The primary responsibilities include managing escalated decision activities in line with defined process standards, collaborating with internal stakeholders, and using insights to uplift team knowledge and reduce future escalations.
  • The role also involves providing expert support to the CI team in handling declined claims, responding to complex member enquiries, and managing complaints with professionalism and empathy.
  • Acting as a subject matter expert in CI systems and processes is another critical aspect of this position.
  • Assisting the Senior Manager, Claims Operations in daily workflow allocation, with a focus on timely handling of urgent and declined matters, is also an essential responsibility.

Key Accountabilities
  • Manage internal escalations and complaints, seeking expert input where required to ensure accurate and timely resolution.
  • Oversee daily workflow allocation, ensuring tasks are distributed evenly to the CI team.
  • Monitor urgent matters and the Notice of Intention (NOI) line to enable real-time issue resolution.
  • Support the Senior Operations Manager in implementing and executing training and development plans.

Required Skills and Qualifications
  • Demonstrated technical expertise with a 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 skills, with the ability to explain complex decisions clearly.
  • Proven ability to work effectively with internal stakeholders and contribute to a positive team culture.
  • Strong analytical skills and sound judgment in resolving complex or escalated matters.

Benefits

This role offers a unique opportunity to make a meaningful contribution to the Claims Intake team. As a key member of the team, you will have the chance to develop your skills and expertise, working closely with internal stakeholders to deliver high-quality results.


Others

This role is ideal for someone who is passionate about supporting healthcare professionals and is looking for a challenging and rewarding career opportunity. If you are a motivated and experienced professional looking to take your career to the next level, this could be the perfect role for you.

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