Claims Officer

Primary Details

Time Type: Full time

Worker Type: Employee

Providing delivery of superior claims service, determining proper policy coverage to conclude, investigate, evaluate and negotiate assigned cases

Primary Responsibilities
- Strategy and Planning
- Nil
- Policy, Process and Procedures
- Maintain current knowledge of insurance guidelines and policy changes and modifications
- Identify any issues and/or anomalies that are non-compliant with regards to policy and procedures and resolve and/or escalate where required
- Sharing and disseminating information with relevant stakeholders taking into consideration confidentiality/policy guidelines
- Compliance requirements and individual accreditation levels are maintained and adhered to
- Non-compliant issues/any discrepancies resolved and/or escalated within agreed timeframes
- Environmental Awareness/Customer Focus
- Maintain good client relationships with all relevant stakeholder
- Respond to client requests in accordance with service standards
- Provide information and feedback on claims activity and developing trends to underwriters/risk assessors to enable appropriate actions to be carried out
- Clear and timely communication with all stakeholders
- Enquiries responded to within agreed timeframes
- Technical Performance
- Receiving, recording and processing all incoming insurance claims for assigned area
- If appropriate, interpreting basic policy coverage and escalating issues as needed
- Setting reserves and authorising payment within scope of authority
- Identifying suspicious or potentially fraudulent claims and notifying line manager if further action is to be taken
- Satisfactory peer review, internal audit and regulator audit findings
- Accuracy and timeliness of payments
- Adherence to policies and procedures
- People Management
- Successful transfer of knowledge

Preferred Competencies/Skills
- Customer service
- Organizational and communication skills
- Analytical and negotiation skills

Preferred Education Specifics
- Relevant tertiary or equivalent

Preferred Experience
- 1+ years’ experience in insurance

Preferred Knowledge
- Basic knowledge of insurance industry and claims processes

QBE Cultural DNA
- Everything we do at QBE is underpinned by our DNA (which interlinks seven cultural elements) - because we know it's not just what we do that matters, it's how we do it that makes the difference. We expect all employees to role model and inspire the right behaviours that link to our cultural elements:

- We are customer-focused
- We are technical experts
- We are inclusive
- We are fast-paced
- We are courageous
- We are accountable
- We are a team

US Only - Disclaimer
- To successfully perform this job, the individual must be able to perform each essential job responsibility satisfactorily. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential job responsibilities.

Global Disclaimer
- The duties listed in this job description do not limit the assignment of work. They are not to be construed as a complete list of the duties normally to be performed in the position or those occasionally assigned outside an employee’s normal duties. Our Group Code of Ethics and Conduct addresses the responsibilities we all have at QBE to our company, to each other and to our customers, suppliers, communities and governments. It provides clear guidance to help us to make good judgement calls.

Skills:
Case Management, Claims Settlement, Collaboration Tools, Communication, Critical Thinking, Customer Service, Data Privacy, Detail-Oriented, Insurance Policies, Intentional collaboration, Managing performance, Prioritization, Problem Solving, Risk Assessments, Standards Compliance

Application Close Date: 26/06/2025 11:59 PM

How to Apply:
Equal Employment Opportunity:
QBE is an equal opportunity employer and is required to comply with equal employment opportunity legislation in each jurisdiction it operates.