Careers: Complex Medical

2 weeks ago

Sydney, New South Wales, Australia beBeeClaims Full time $90 - $105

Claims Specialist

We're looking for an experienced professional to join our team as a Claims Specialist. In this role, you'll work closely with customers who are facing unexpected situations and provide them with expert guidance and support.

Your primary responsibility will be to manage complex medical and loss of income claims from start to finish. This includes ensuring that claim reserves are set and maintained in line with actuarial principles, policy terms, and regulatory expectations.

You'll also play a key role in managing complaints and escalations, using your conflict resolution skills to de-escalate concerns, restore trust, and ensure a fair and transparent claims experience.

  • Manage end-to-end complex medical and loss of income insurance claims.

  • Set and maintain claim reserves in accordance with actuarial principles, policy terms, and regulatory expectations.

  • Resolve customer complaints and escalations through effective conflict resolution.

  • Support customers with mental health challenges, financial hardship, or language/cultural barriers.

About You:

  • Experience working with mental health, injury, and chronic illness-related claims.

  • Strong understanding of loss of income calculations, including offsets, waiting periods, benefit caps, and pre-disability earnings.

  • Ability to work with vulnerable customers.

  • Proven skill in complaint handling and de-escalation techniques.

  • Confidence in liaising with medical professionals, clients, employers, brokers, and other stakeholders.

Career Growth Opportunities:

  • Award-winning company culture that prioritizes empathy, accountability, inclusion, collaboration, and growth.

  • Ongoing training and development opportunities to enhance your skills and knowledge.

  • Diverse and inclusive workplace where everyone feels valued and respected.

What We Offer:

  • Hybrid working arrangement allowing you to balance work and personal life.

  • Access to over 15,000 courses on demand through Sedgwick Australia University.

  • Competitive remuneration package including superannuation benefits.

  • Diverse range of career pathways across various disciplines.

We value diversity and inclusion in the workplace and recognize that each person brings unique skills, knowledge, and experiences. If you're passionate about delivering exceptional customer service and making a meaningful difference in people's lives, we encourage you to apply for this exciting opportunity.

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