Claims Operations Specialist
1 week ago
We are seeking an experienced Claims Operations Specialist to join our team at Tal Services Limited. This is a key position that will play a critical role in ensuring the efficient and effective management of claims.
Job SummaryThe successful candidate will be responsible for providing technical advice and support to Case Managers, as well as escalating complex claims to senior management. They will also work closely with internal and external stakeholders to ensure timely and quality management of claims.
Key Responsibilities- Provide ongoing coaching and mentoring to Case Managers on the claims management process, including guidance on handling communication with clients relating to the management of their claim.
- Authorise and review claims, including where above delegated authority of Case Managers.
- Interpretation and advice regarding hypothetical claims scenarios.
- Undertake quality assurance reviews of claims files.
- Provide advice on the technical interpretation of policies and contract requirements.
- Take accountability for the resolution of customer complaints or requests for decision reviews (within authority).
- Experience in a similar role within Retail or Group Life Insurance, including income protection, lump sum or trauma claims assessment.
- Ability to build rapport and empathy with customers and stakeholders during difficult times.
- Meticulous with a strong attention to detail.
- Medical, vocational or rehabilitation background (desirable).
Around $120,000 - $150,000 per annum, depending on experience.
Why Work with Us?Tal Services Limited offers a dynamic and inclusive work environment that values diversity and supports professional growth. We prioritize employee well-being and offer opportunities for career advancement.
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