Insurance Claims Specialist

3 days ago

Perth, Western Australia beBeeClaims Full time $76,000 - $84,000

Accident and Health Claims Professionals drive the success of our organization by delivering exceptional customer experiences. Their role is multifaceted, involving prompt and professional interactions with clients and brokers, as well as thorough investigations, reserving, and adjustments of claims.

The ideal candidate will possess strong analytical skills, excellent communication abilities, and a deep understanding of insurance contracts and legal requirements.

  • Manage a portfolio of Accident & Health and /or Combined Insurance claims as allocated and assist processing other Retail claims as required.
  • Assess claims in accordance with service level and quality requirements and the General Insurance Code of Practice. This includes determining coverage, reserving within timeframes, making payments, responding to customer queries, providing updates, and requesting additional information as needed to manage a claim.
  • Effective communication through telephone and written correspondence with brokers, claimants, and others as necessary.
  • Participate in Claim Department and companywide training as required.
  • Respond to inquiries and escalations of matters from underwriters, brokers, and customers, and collaborate with underwriters, the Compliance Department, and other departments as necessary.
  • Proactively apply claims policies and procedures including fraud, salvage, cost containment, and complaints.
  • Review income replacement claims for payment of periodic benefits at lodgment stage and at key points in the claim cycle, and develop strategies for claim management and successful return to work of the claimant where possible.
  • Facilitate payment of claims costs and service provider fees, including reconciliation and liaison with overseas and service providers.
  • Provide guidance, instructions, and coaching to overseas and outsourced service providers as required on claims within delegated authority limit.
  • Monitor performance and processes of service providers to make recommendations regarding process and contract compliance, escalating breaches to Claims Management.
  • Support daily payment, audit, and other administrative tasks as necessary.
  • General assistance within the Claims Department and adaptation to altered business needs and staff changes.

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