Quality & Compliance Consultant

Location:Melbourne
Job Type:Full Time

Quality & Compliance Consultant - AustralianSuper

12 month contract

Welcome to This Australian Life.

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.

TAL needs people who represent our diverse Australian community. People who embrace our spirit and inspire confidence in their colleagues, customers and community. People who are passionate about making the most of the choices and options we provide. People who do what’s right, aim high, and work smart.

About the Opportunity

This role is accountable for ensuring claims are being accurately assessed to ensure quality health and claim outcomes.

A key focus of this role involves undertaking coaching and development of Case Managers on claims strategy, including the provision of technical advice on the interpretation of policy terms and TAL Claims procedures. This role is also responsible for actively participating in the facilitation of internal and external Claims audits, as well as quality and compliance reporting for internal stakeholders.

In this role you will be responsible for:

  • Provide ongoing coaching and mentoring to Case Managers on the claims management process, enabling them to provide exceptional customer service to clients;
  • Being the escalation point for technical advice for Case Managers, undertake duties including the provision of advice on the technical interpretation of policies and contract requirements;
  • Providing regular feedback and guidance to Claims Team Managers on the performance of Case Managers, including advice regarding development opportunities for individuals;
  • Undertake individual claims file reviews with and for Case Managers, including but not limited to comprehensive file reviews, conducting matrix and duration management reviews, and development of appropriate claims strategies for ensuring quality health and claim outcomes;
  • Assist with the management of audits, both internal and external, on the Claims function. This includes:
    • Preparation for audits;
    • Liaison with and assistance to auditors throughout the process; and
    • Response to and management of recommendations / findings;
  • Complete quality and compliance reporting, including preparation of monthly operational reports and providing data on a regular and ad hoc basis to relevant stakeholders; including Financial, Actuarial and Reinsurance;
  • Develop and deliver training for the TAL Claims team regarding technical claims strategies as required, including the development of education material and publications;
  • Participate in business area and/or Company projects as required.

About You

To be successful in this role you will have:

  • Experience in a similar role (involving life, lump sum, trauma and income protection claims assessment) in the Financial Services/Insurance Industry (Desirable)
  • The ability to build rapport and empathy with customers during difficult times
  • Meticulous attention to detail
  • Medical, vocational or rehabilitation background (Desirable)

Work is a big part of this Australian life, and we work hard to make it one of the best parts. We want our employees to work in ways that suits their life and the nature of their role, so they feel able to meet their work life commitments and support their wellbeing. Everyone’s welcome to work for us – regardless of their age, ethnicity, religion, sexual orientation, gender identity, intersex status or any disabilities they might be living with.

We know it’s the people we work with and experiences we share that make work meaningful and fulfilling, and we’d love for you to be part of it.

You don’t have to be an artist, adventurer, doer or dreamer, but it really helps.