Accident and Injury Case Handler

2 days ago

Sydney, New South Wales, Australia beBeeClaims Full time $90,000 - $150,000
Claims Examiner (Fixed Term)

Job Description:

We are seeking a skilled Claims Examiner to support our team in processing Accident & Health or Combined Insurance claims through effective communication with customers and brokers, and thorough investigation, reserving and adjustment of claims incurred by insureds.

Key Responsibilities:

  1. Manage a portfolio of claims for Accident & Health and/or Combined Insurance claims as allocated, and assist in processing other Retail claims as required.
  2. Assess claims in accordance with quality requirements, determining coverage, reserving within timeframes, making payments, responding to customer queries, providing updates, and requesting additional information as needed to manage a claim.
  3. Communicate effectively by telephone and written correspondence to brokers, claimants and others as required.
  4. Participate in Claim Department and company-wide training as required.
  5. Respond to enquiries and escalations of matters from underwriters, brokers and customers, and work with underwriters, the Compliance Department and other departments as needed.
  6. Review income replacement claims for payment of periodic benefits at lodgement 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.
  7. Participate in claims meetings with internal and external stakeholders as required.
  8. Manage Emergency Assistance cases end to end as allocated.
  9. Facilitate payment of claims costs and service provider fees, including reconciliation and liaison with overseas partners and service providers.
  10. Provide advice, instructions and coaching to overseas partners and outsourced service providers as required on claims within delegated authority limits.
  11. Monitor performance and processes of service providers, making recommendations in respect of process and contract compliance, and escalating breaches to Claims Management as necessary.
  12. Assist in daily payment, audit, and other administrative tasks as required.
  13. Provide general assistance within the Claims Department and adapt to altered business needs and staff changes.

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