Claims Specialist
2 months ago
Job Title: Claims Consultant
Company: Tal Services Limited
Job Summary:
We are seeking a highly skilled Claims Consultant to join our team at Tal Services Limited. As a Claims Consultant, you will be responsible for the proactive management of a portfolio of life insurance claims in accordance with our claims philosophy, claims handling procedures, policy terms & conditions, and legislative and regulatory requirements.
Key Responsibilities:
- Claims Management: Adhere to external regulations (e.g. Privacy and Life Insurance Code of Practice) and all relevant legislation and industry guidelines.
- Customer Service: Ensure all interactions with customers, advisers, and other internal and external stakeholders adhere to our Customer Service Culture through the provision of high-quality, accurate, and compliant work.
- Departmental Projects: Contribute to department and company projects as required.
- Claims Strategy: Gather and interpret relevant information to form an appropriate claims strategy.
- Benefit Entitlement: Effectively determine correct benefit entitlement, ensuring that legitimate claims are paid in a timely manner in accordance with policy terms and conditions.
- Collaboration: Work collaboratively with Technical Specialists, Recovery & Support Specialists, Health Services, and other internal stakeholders.
- Case Conferences: Arrange and participate in case conferences and peer case discussions, including preparation of documentation, record keeping, and completion of agreed actions.
- Customer Service: Provide exceptional customer service, including proactively managing communication with customers and clients relating to the management of the claim and initiating support options, where appropriate.
- Stakeholder Management: Customer and partner stakeholder management (e.g. advisers, trustees, fund administrators) while monitoring service delivery and quality.
Requirements:
- Experience: Experience in a similar claims management role in the Financial Services or Insurance Industry.
- Customer Service: Ability to build rapport and empathy with customers during difficult times and a commitment to delivering proactive, high-quality customer service.
- Time Management: Advanced time management and prioritization skills.
- Analytical Skills: Demonstrated analytical and problem-solving skills and attention to detail.
- Qualifications: Relevant tertiary qualifications in Business, Commerce, Health, or Allied Health (desirable).
- Certifications: Diploma or Cert IV in Life Insurance, or equivalent (desirable).
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