Claims Technical Specialist
Claims Technical Specialist
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Job Description
The Claims Technical Specialist is responsible for providing technical advice guidance and support to the Claims team on technical assessment and case management matters to assist in reaching desired claims durations and outcomes in line with the terms and conditions of the policy.
A key focus of the role is to optimise assessment quality within the Income Protection Life Trauma and TPD portfolios and support Claims Managers to build their capability in line with the TAL claims capability and delegated authority frameworks.
In this role you will:
- Ensure claims handling and service approach reflects industry best practice and TAL processes and policies.
- Act as a subject matter expert responding to Claims Consultant requests and enquiries and to authorise and review claims Provide adverse decision review and sign off on assessment which may require referral to internal Claims review body
- Support Claims Consultants to use effective communication with customers treating health practitioners and other stakeholders Drive the best service experience and appropriate claim outcomes for the customer
- Support Client Managers and Team Managers in their reporting to funds and attendance at fund meetings/case conferences
- Development/ enhancement of claims handling procedures and guidelines as required. Assist with embedment
- Drive processes to support development of technical capability within claims and implement strategies
- Coach Claims Consultants in appropriately executing assessment practices ensuring timely and quality management of claims
- Provide insights into Case Manager technical capabilities for the purpose of performance management
- Support the Team Manager in development planning for individuals to uplift their capability in line with TALs capability framework
- Contribute to the implementation of appropriate governance structures and quality assurance to successfully deliver business solutions
Qualifications :
- Demonstrated experience in a similar role within Life Insurance or extended experience as a Life Insurance Claims Manager or similar
- Experience in coaching and embedding knowledge including an uplift of skills of case managers
- Excellent Knowledge of the Life Insurance Code of Practice Insurance Contracts Act Privacy Principles and other relevant legislative or regulative requirements and their application during claims assessment
- Ability to identify and develop strategies to overcome barriers in claims assessment and management
- Strong written and verbal communication negotiation and influencing
- Demonstrated ability to provide excellent customer service to a wide range of clients and stakeholders
- Relevant tertiary qualifications in Business Commerce Health or Allied Health (desirable)
- Medical vocational or rehabilitation background (desirable)
- Diploma or Cert IV in Life Insurance or equivalent (desirable)
Additional Information :
TAL is one of Australias leading life insurers committed to inclusion and supporting the career growth of our diverse workforce. Were proud to be:
- An Inclusive Employer Recognised as Employer of Choice for Gender Equality by the Workplace Gender Equality Agency and Bronze Tier Status within the Australian Workplace Equality Index
- Diversity Champions Member of Diversity Council Australia Australian Disability Network Pride in Diversity and Champions of Change
- Reconciliation Advocates Read our Innovate Reconciliation Action Plan.
- We welcome applications from people with diverse experiences perspectives and backgrounds including Aboriginal and Torres Strait Islander people caregivers individuals living with disabilities people from culturally diverse backgrounds and the LGBTIQ community.
- Need adjustments during the recruitment process Let our team know by getting in touch with us herewere here to support you.
Yourealwaysaccountable for your actions. You never give up. You strive to find the best outcomes for customers and valueworking together to find the best solutions for problems.
As part of the recruitment process there are several checks which may be conducted to demonstrate your eligibility for a role at TAL including Criminal History Bankruptcy Entitlement to Work Regulatory and Reference Checks.
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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 everyones 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.
Remote Work :
No
Employment Type :
Full-time
Employment Type
Full-time
