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Senior Claims Professional

2 months ago

Brisbane, Queensland, Australia GB - Global Full time
About the Role

We are seeking an experienced Senior Claims Consultant to join our Accident and Health team at GB Global, a leading Third-Party Administrator (TPA) in Australia. This is a permanent full-time opportunity with flexible hybrid working arrangements, allowing you to work from home and in our Brisbane CBD office.

Key Responsibilities
  • Review accident and health insurance claims to determine coverage eligibility and validity
  • Conduct thorough investigations into the circumstances surrounding each claim, gathering relevant information from various sources
  • Collate and review medical records, policy provisions, and other documentation to evaluate the extent of coverage and liability
  • Communicate with claimants, policyholders, healthcare providers, and other stakeholders to gather additional information and clarify details as needed
  • Make informed decisions regarding claim settlements, negotiating settlements within established authority limits
  • Ensure compliance with regulatory requirements and company policies throughout the claims process
  • Document claim decisions, activities, and communications accurately and thoroughly in the claims management system
  • Provide guidance and support to claims staff, assisting with complex claim reviews and sharing expertise in accident and health insurance
  • Collaborate with underwriters, insurers, and other stakeholders to provide insights and recommendations for improving claim processes and mitigating risks
Requirements
  • Minimum of 3 years of experience in accident and health insurance claims management, with a strong understanding of insurance principles and practices
  • Proficiency in interpreting insurance policy language and medical terminology
  • Excellent analytical skills and attention to detail, with the ability to assess complex situations and make sound decisions
  • Strong communication skills, both verbal and written, with the ability to effectively interact with diverse stakeholders
  • Proven ability to prioritise tasks, manage workloads efficiently and meet deadlines in a fast-paced environment
  • Certification in claims handling or insurance (ANZIIF) preferred
  • Familiarity with claims management systems and software applications used in the insurance industry
What We Offer
  • Competitive salary
  • Flexible and hybrid work arrangements
  • Paid parental leave
  • Excellent working environment, with a friendly, flexible and supportive team
  • Opportunities for ongoing education and career development
  • Service recognition awards
  • Employee assistance program for yourself and immediate family members
About GB Global

GB Global is Australia's largest Third-Party Administrator (TPA), with a focus on managing insurance claims on behalf of insurers, brokers, government bodies and self-insured corporations. We have six offices in Australia, employing over 1000 staff, and value our employees, offering a friendly, comfortable working environment that facilitates work-life balance.

Our Values

We value inclusion and diversity, and are committed to creating a workplace that is welcoming and inclusive for all employees. We believe that all persons are entitled to equal employment opportunity and prohibit any form of discrimination based on protected characteristics.