Claims Assistant

2 weeks ago

Sydney, Australia Tal Services Limited Full time

Company Description

From the millions of Australians we protect, to those that make it happen every day at TAL, people really are what we’re all about. We want to grow with you. Achieve with you. And support you to do your best work. That's why we're focused on developing leadership, promoting diversity, rewarding excellence, and retaining great talent.

We're always looking for people who want to go further with us. People who do what’s right, aim high, and work smart.  Why not discover where we can go?

Job Description

This role is accountable for handling the process aspects of claims assessing required by Claims Consultants to assess claims. The Claims Assistant will also assess low complexity claims as well as assessing and initiating appropriate support options tailored to the customer’s needs where appropriate.

This role is integral to meeting the quality and service standards which ensure the functions are meeting TAL’s Customer and Claims requirements.

  • Ensure compliance with TAL policies, procedures and guidelines procedures, ensuring claims management is in accordance with the TAL claims philosophy
  • Adhere to external regulations (e.g., Privacy and Life Insurance Code of Practice) and all relevant legislation and industry guidelines
  • Ensure all interactions with Customers, Advisers and other internal and external stakeholders adhere to TAL’s
  • Customer Service Culture through the provision of high-quality, accurate and compliant work
  • Liaise closely across the TAL Claims and other relevant internal departments to provide support in project work (including system and user acceptance testing and procedural reviews)
  • Contribute towards a culture of process improvement
  • Contribute to department and company projects as required 
  • Other ad-hoc duties as required.

Undertake customer service and administration in support of the Claims function, including but not limited to:

  • Preparing initial claims for assessment
  • Labelling Documents in claims systems
  • Monitoring team workflows and taking actions to ensure workflow prioritisation and portfolio management
  • Co-ordinating referrals including Medebridge, CDAP, Health Team, Reinsurance
  • Scheduling and co-ordinating appointments
  • Data entry
  • Oversight of claims closures
  • Placing LTC checklists into claims
  • Oversight of invoicing
  • Summarising information from customers e.g., medical reports, clinical notes, rehab updates and progress claim forms
  • Answering simple queries from customers e.g., Request for Payment Summaries or payment due dates
  • Logging Complaints and Incidents on behalf of consultants
  • Holiday/ leave and coverage
  • Management of Low Complexity Claims portfolio
  • New consultant process coaching
  • Draft simple letters to customers – e.g., 5.5 /Payment letters Minimum 1-2 years in a customer service-based role
  • Excellent problem-solving skills
  • Ability to build rapport over the phone and demonstrate empathy with customers during difficult times
  • Outstanding relationship management and negotiation skills
  • Meticulous attention to detail
  • Understanding of medical terminology (desirable)

Qualifications

  • Minimum 1-2 years in a customer service-based role
  • Excellent problem-solving skills
  • Ability to build rapport over the phone and demonstrate empathy with customers during difficult times
  • Outstanding relationship management and negotiation skills
  • Meticulous attention to detail
  • Understanding of medical terminology (desirable)

Additional Information

At TAL we value diversity in all its forms and are committed to fostering an inclusive and equitable culture for all our people. We encourage Aboriginal and Torres Strait Islander people, individuals from all backgrounds, including those with caring responsibilities, people living with disability, and individuals from the CALD and LGBTQI+ communities to apply. Even if you don’t check every box in the criteria above, we encourage you to apply today or get in touch with us here. 

To provide you with the best experience, we can accommodate you at any stage of the recruitment process. Simply inform our Recruitment team at any time.

TAL is recognised by the Workplace Gender Equality Agency as an Employer of Choice.  We are proud to be a member of Diversity Council Australia and the Australian Network on Disability. For information on our reconciliation journey, take a look at our Innovate Reconciliation Action Plan.

Everyone at TAL has a responsibility to do the right thing and is accountable for the way they conduct themselves. Our expectations are that you follow the principles set out in our Code of Conduct when you come to work every day. Risk management is everyone’s responsibility.

If you are already a TAL employee please apply via the SmartRecruiters button in Workday and navigate to the Employee Portal. This is important to ensure that your application is recorded accurately.

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