Job Claims Technical Specialist

Job Description

Claims Technical Specialist

• Join Australia’s No.1 Life Insurer

• Focus on customer service, achieving better health outcomes and driving thought leadership

• Career progression and excellent employee benefits

About the Opportunity

We’re a continually growing team, one that is dynamic in thinking and solutions oriented with people. Our environment is agile, and we focus on delivering with care and passion for our customers.

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 TAL’s capability framework

• Contribute to the implementation of appropriate governance structures and quality assurance to successfully deliver business solutions.

About You

To be successful in this role you will have,

• 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)

• Diploma or Cert IV in Life Insurance, or equivalent (desirable)

You’re always accountable for your actions. You never give up. You strive to find the best outcomes for customers and partners. And, you value working together to find the best solutions for problems.

Important to us

Every Australian life is different. And we know the value of having different people from all walks of life with varied points of view.

Work is a big part of life, and we work hard to make it one of the best parts. We offer a workplace that’s inclusive and flexible, supporting our people with options that let them make the most of their careers. We don’t just say it; we do it. 

We want to grow with you. Achieve with you. And support you to do your best work. We’re always looking for people who want to go further with us.

Why not see where we can go together?

Doing the right thing

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.