Insurance Claims Specialist
3 days ago
Assessing and managing retail income protection, trauma, and total & permanent disability claims is a critical aspect of this position. You will be responsible for overseeing the entire claims process, reviewing policies to determine cover type and validity, and managing claim eligibility.
Key Responsibilities:- Claims management including front-end claims management with a focus on retail income protection
- Assessing complex information, interpreting policy terms, and making fair, consistent claim decisions
- Reviewing documents, medical reports, and policy information with a high level of attention to detail to ensure accuracy and compliance
- Applying knowledge of medical terminology or related field training; engaging and instructing external medical, legal, vocational, and forensic vendors as needed
- Developing and implementing continuous improvement initiatives to enhance efficiency
- Supporting and uplifting the capability of claims administrators through knowledge sharing and development support
- Experience in managing all stages of claims with a focus on retail income protection
- Ability to interpret policy terms and make sound, fair decisions
- Strong attention to detail and accuracy in reviewing documents and information
- Knowledge of medical terminology or allied health/medical-related training
- Excellent problem-solving, communication, and stakeholder management skills
- Exceptional organizational and time management abilities; capacity to manage multiple claims and deadlines
- Proactive approach and commitment to continuous improvement
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