Claims Case Manager

 Summary of Responsibilities:

To proactively manage and assess a portfolio of Retail and Group TPD and Salary Continuance (CSI) claims in line with MetLife's claim philosophy/policy terms and conditions whilst ensuring service level agreements and regulatory requirements are met.

Principal Responsibilities:

• Ownership of portfolio and workflow associated with portfolio with the aim of ensuring we’re meeting customer requirements.
• Proactively manage claims end to end in line with the MetLife claims Philosophy
• Build rapport with customers over the phone by maintaining regular contact, identifying appropriate added support services and liaising with the Strategy & Recovery Team to support customers achieve their goals and return to health
• Manage all stakeholders expectations to support a seamless customer experience 
• Assess claims against policy terms and explain complex decisions with logical and clear rationale and description of why evidence has been weighted over other evidence
• Instruct third parties to provide claim assessment support as appropriate to the claim situation and use claim providers in line with an appropriate cost benefit analysis
• Manage incoming work items in line with service level agreements, department objectives and practices
• Manage claims within appropriate risk and governance frameworks such as the Life Insurance Code of Practice and act appropriately as MetLife's First Line of Defense for risk issues
• Ability to recognize, categorize and prioritize work requiring minimal intervention
• Ensure all written communication is timely, accurate and professional
• Create and release claim payments in line with delegated authority & calculate any CPI increases
• Contribute to the team through special projects when required
• Ability to adopt and embrace change and best of class: philosophy and championing change within the Claims and wider Operations team
• Work in a positive, optimistic and balanced way and support the team to complete the daily team workload. Support a positive culture in line with MetLife's cultural values.

Skills, Competencies & Experience Required:

• Proven ability using the telephone professionally to speak to customers on a regular basis, using a range of questioning and summarizing skills, express empathy and build rapport 
• Previous life claims experience 
• Preferred experience in person centred communication and motivational interviewing  
• Ability to deliver outstanding service levels on a daily basis
• Ability to work supportively within a team and assist team members with work as needed. To be a committed team player who openly communicates and shares knowledge
• Embraces change with a view to delivering excellent results
• A high level of attention to detail
• Weighing up multiple pieces of information and making a sound judgment.
• Excellent time management and ability to prioritise work at all times delivering quick outcomes with high accuracy
• Proven ability to work under pressure in an evolving environment
• Understand and weigh up motivation to return to work and biopsychosocial factors that affect disability
• Excellent computing skills and literacy and excellent file note keeping and data capture experience
• Strong financial calculation skills preferred
• Medical literacy preferred
• Passion for helping people and making a difference 
• A caring approach and high personal integrity and honest
• Clear and concise communication skills. Strong listening skills essential and counselling skills preferred but not essential

Qualifications/Experience Required:

• Minimum 2-3 years’ experience in managing and assessing a claims portfolio end to end; including both Income Protection and TPD claims 
• ANZIIF (or equivalent) or Tertiary qualifications highly desirable.
• Strong understanding and working knowledge of applicable regulatory, legislative and Compliance framework applicable such as the Life Insurance Code of Practice.

Personal Attributes:

Positive, optimistic, warm, compassionate, confident, patient, calm, fair, honest, respectful of others, has integrity, open, resilient, strong talker and listener, hardworking, team player, leads by example, encourager, self-motivated, supports change in a positive way, owns their culture. Takes ownership and where needed, leadership.

What's in it for you? 

Great central location in brand new offices

Flexible & hybrid work arrangements

Fantastic employee benefits including - health & wellbeing allowance, access to corporate discounts through Perks at Work, additional purchased annual leave, super matching and insurances

Access to ongoing professional development, including study support and career progression within a leading global organisation. 

To apply, please send your resume to *********@metlife.com

Applications close Monday 29 January 2024

MetLife is proud to be an equal opportunity/affirmative action employer. We are committed to attracting, retaining and maximizing the performance of a diverse and inclusive workforce. It is the policy of MetLife to ensure equal employment opportunity without discrimination or harassment on the basis of race, color, creed, religion, national origin, alienage or citizenship status, age, sex, sexual orientation, gender identity, or expression, marital or domestic/civil partnership status, disability, veteran status, genetic information or any other basis protected by law.

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