Technical Specialist

TALSydney

Location:Sydney
Job Type:Full Time
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Claims Technical Specialist

  • Join Australia’s No.1 Life Insurer
  • Support our Growing Group Claims team

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

Using your strong Life insurance claims knowledge, you will be providing coaching and mentoring of Case Managers, to enable them to provide best-in-class customer experience for clients, in accordance with TAL’s claims philosophy, claims procedures, policy wording and within stated authority limits.

A key focus of this role involves working closely with Case Managers to provide technical advice in relation to the review of claims strategies, as well as the determination of escalated claims above the relevant delegated authority limits of Case Managers. In addition, the Technical Claims Specialist will regularly liaise with Legal, Product and Complaints Management/Disputes Resolution team, in the provision of their technical advice to the Claims Team.

In this role you will be responsible for:

  • Providing ongoing coaching and mentoring to Case Managers (and/or external stakeholders) on the claims management process, enabling them to provide exceptional customer service to clients, including guidance on handling communication with clients relating to the management of their claim and attending to client’s enquiries
  • Being the escalation point for technical advice for Case Managers, undertake duties including:
  • authorising and reviewing claims (and associated benefits payments), including where above delegated authority of Case Managers
  • Interpretation and advice regarding hypothetical claims scenarios
  • undertaking quality assurance reviews of claims files
  • providing advice on the technical interpretation of policies and contract requirements; and
  • taking accountability for the resolution of customer complaints or requests for decision reviews (within authority);
  • Continuously support the Claims Team Manager (or Senior Claims Specialists), including acting as the second-in-charge for the relevant Claims Team, triaging of claims files to Case Managers, providing feedback to the Claims Team Manager on the successes and development opportunities for Case Managers, as required;
  • Liaising with internal and external stakeholders, to ensure the timely and quality management of claims, including participating in case conferences, peer case discussions and working closely with the Claims Technical Training team to identify and develop training package needs;
  • Generation of reports for the Claims Team and Claims Leadership Team (such as Traffic Light reports), to enable the efficient and effective management of the team;
  • Continuously reviewing Claims processes and frameworks to seek out opportunities for improvement in the overall claims experience for customers;
  • Participate in business area and/or Company projects as required.

About You

To be successful in this role you will have:

  • At least 5 years’ experience in a similar role (including life, lump sum, trauma and/or income protection claims assessment) in the Financial Services/Insurance Industry
  • Ability to build rapport and empathy with customers and stakeholders 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.

If you would like to apply or refer a friend please click on the relevant button below and follow the instructions. Alternatively, if you would like further information please contact tania.villiers@tal.com.au

**Claims Technical Specialist**

- Join Australia’s No.1 Life Insurer
- Support our Growing Group Claims team

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**

Using your strong Life insurance claims knowledge, you will be providing coaching and mentoring of Case Managers, to enable them to provide best-in-class customer experience for clients, in accordance with TAL’s claims philosophy, claims procedures, policy wording and within stated authority limits.

A key focus of this role involves working closely with Case Managers to provide technical advice in relation to the review of claims strategies, as well as the determination of escalated claims above the relevant delegated authority limits of Case Managers. In addition, the Technical Claims Specialist will regularly liaise with Legal, Product and Complaints Management/Disputes Resolution team, in the provision of their technical advice to the Claims Team.

In this role you will be responsible for:

- Providing ongoing coaching and mentoring to Case Managers (and/or external stakeholders) on the claims management process, enabling them to provide exceptional customer service to clients, including guidance on handling communication with clients relating to the management of their claim and attending to client’s enquiries
- Being the escalation point for technical advice for Case Managers, undertake duties including:
- authorising and reviewing claims (and associated benefits payments), including where above delegated authority of Case Managers
- Interpretation and advice regarding hypothetical claims scenarios
- undertaking quality assurance reviews of claims files
- providing advice on the technical interpretation of policies and contract requirements; and
- taking accountability for the resolution of customer complaints or requests for decision reviews (within authority);
- Continuously support the Claims Team Manager (or Senior Claims Specialists), including acting as the second-in-charge for the relevant Claims Team, triaging of claims files to Case Managers, providing feedback to the Claims Team Manager on the successes and development opportunities for Case Managers, as required;
- Liaising with internal and external stakeholders, to ensure the timely and quality management of claims, including participating in case conferences, peer case discussions and working closely with the Claims Technical Training team to identify and develop training package needs;
- Generation of reports for the Claims Team and Claims Leadership Team (such as Traffic Light reports), to enable the efficient and effective management of the team;
- Continuously reviewing Claims processes and frameworks to seek out opportunities for improvement in the overall claims experience for customers;
- Participate in business area and/or Company projects as required.

**About You**

To be successful in this role you will have:

- At least 5 years’ experience in a similar role (including life, lump sum, trauma and/or income protection claims assessment) in the Financial Services/Insurance Industry
- Ability to build rapport and empathy with customers and stakeholders 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.

If you would like to apply or refer a friend please click on the relevant button below and follow the instructions. Alternatively, if you would like further information please contact tania.villiers@tal.com.au