Claims Resolution Specialist

2 hours ago

Sydney, New South Wales, Australia beBeeClaims Full time $90,000 - $115,000
Job Summary

We are seeking a skilled Claims Resolution Specialist to join our team. In this role, you will be responsible for ensuring that member/claimant claims are correctly set up in the initial claiming phase and paid accurately at the end of the claiming process.

Your key responsibilities will include taking ownership of handling member death, Total and Permanent Disability (TPD), Income Protection (IP), Public Indemnity (PI) or Total and Permanent Disablement (TPD) claims and communicating effectively throughout the life of the claim. You will also be expected to minimize delays through effective workflow management and take all required actions within agreed service level agreements.

Main Responsibilities
  • Take ownership of handling member death, Total and Permanent Disability (TPD), Income Protection (IP), Public Indemnity (PI) or Total and Permanent Disablement (TPD) claims and communicate effectively throughout the life of the claim.
  • Minimise delays through effective workflow management and take all required actions within agreed service level agreements.
  • Create a positive experience by quickly establishing rapport with members and beneficiaries.
  • Proactively manage a claims portfolio in accordance with quality case management principles and operating standards.
  • Ensure regular and proactive follow-up and phone contact to drive outcomes.
  • Consistently deliver high-quality work, including low errors and breaches, ensuring team and department results are delivered.
  • Listen carefully to members and beneficiaries and respond promptly to their concerns and queries.
  • Effectively manage difficult conversations by actively listening, empathising, identifying the member or beneficiary's real needs, and taking personal responsibility for resolving problems/issues.
  • Be an active team player and contribute to achieving shared team objectives and follow instructions from Specialists and/or Team Leaders.
  • Ensure all work completed adheres to service and quality standards.
  • Develop a high level of claims knowledge to provide best-in-class service to members or beneficiaries.
  • Embrace and support change to provide superior customer service to fund members or beneficiaries.
  • Take personal action to develop capability through appropriate development, including challenging on-the-job opportunities.
  • Contribute positively and collaboratively to the team's overall objective to achieve an end-to-end lifecycle for every claim that meets or exceeds the fund's service expectations.
  • Provide superior customer service to members, trustees, and all stakeholders by managing and processing requests within agreed timeframes and quality levels.
  • Ensure compliance with all legislative, financial, policy, procedural, and quality requirements.
  • Provide efficient and effective query resolution by anticipating claimant needs and taking ownership for first call resolution to ensure an outstanding claims experience.


Experience & Qualifications

To be successful in this role, you will require:
  • Show a good understanding of relevant legislation and industry knowledge.
  • Possess strong communication skills (verbal and written).
  • Able to self-manage, prioritise work, and handle multiple tasks.
  • Build effective relationships with team and key contacts.
  • Understand and empathise with members' needs.
  • Take ownership to deliver member outcomes in a fast, efficient, and effective way.
  • Able to effectively handle difficult conversations.
  • Accuracy and attention to detail.
  • Good investigation and problem-solving abilities.
  • Able to prioritise and time manage multiple tasks to meet tight deadlines.
  • Possess a sound knowledge of technical and compliance issues, understanding the relevant policies and legislation.

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