Insurance Claims Professional
2 weeks ago
A highly skilled Claims Specialist is required to manage a portfolio of complex Retail Income Protection claims, ensuring customers receive high-quality service and fair outcomes. The successful candidate will have strong analytical skills and the ability to interpret policy terms, underwriting decisions, and non-disclosure matters.
The ideal candidate will possess excellent communication skills, with the ability to build rapport with customers, advisers, and treating practitioners via phone and written correspondence. A sound understanding of life insurance products, claims procedures, and legislative requirements is essential.
This challenging role involves proactive management of Retail Income Protection Claims in accordance with our claims philosophy, handling procedures, policy terms & conditions, and legislative requirements. Key responsibilities include:
- Managing a portfolio of complex Retail Income Protection claims, balancing customer needs with policy and business requirements.
- Communicating effectively with customers, advisers, and treating practitioners via phone and written correspondence.
- Interpreting policy terms, underwriting decisions, and non-disclosure matters to determine claim eligibility.
- Analysing complex financial and medical information to make sound, evidence-based claims decisions.
- Developing and monitoring Return to Work (RTW) plans in collaboration with customers and healthcare providers.
- Leading case conferences and employing strategies to gather critical information on customer conditions and work capacity.
- Collaborating with internal and external stakeholders, including underwriters, rehab consultants, legal and medical officers, and reinsurers.
- Mentoring junior staff and contributing to technical leadership across the claims team.
To be considered for this role, applicants should possess:
- At least 4-6 years' experience in Claims across Retail Income Protection Insurance.
- Ability to build rapport and empathy with customers during difficult times and a commitment to delivering proactive, high-quality customer service.
- Comfortable navigating claims systems (Fineos, Genesis, OneNote, and Excel).
- Diploma or Cert IV in Life Insurance, or equivalent (desirable).
- Relevant tertiary qualifications in Business, Commerce, Health, or Allied Health (desirable).
- Demonstrated analytical and problem-solving skills and attention to detail.
- Advanced time management and prioritisation skills.
We're committed to inclusion and supporting the career growth of our diverse workforce. We welcome applications from people with diverse experiences, perspectives, and backgrounds.
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