- Contribute towards a culture of process improvement. Along with the Team Manager, ensure that change initiatives are embedded and that best practices are adopted, while ensuring a best practice approach to claims handling
- Contribute to department and company projects as required.
- Maintain current knowledge of life insurance guidelines, processes and policy changes.
- Ensure claims handling and service approach reflects industry best practice and TAL processes and policies.
- Other ad-hoc duties as required
- Act as a subject matter expert, responding to Claims Consultant requests and enquiries and to authorise and review claims (and associated benefits payments)
- 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 to 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 related to technical claim outcomes as required
- Development/ enhancement of claims handling procedures and guidelines as required. Assist with embedment
- Review, advise and sign off (within delegation) on policy T&Cs within internal forums, communicating the outcome of approved policy T&Cs within team to ensure understanding/application
- Drive processes to support development of technical capability within claims and implement strategies lto develop technical skills in line with the TAL claims capability framework resulting in progression of delegated authorities in a timely manner
- Coaching Claims Consultants in appropriately executing assessment practices ensuring the timely and quality management of claims. Including completing 'above delegation' and 'within delegation' reviews of individuals work and recording outcomes and opportunities for development
- Provide insights into Case Manager technical capabilities for the purpose of performance management and support the Team Manager in development planning for individuals to uplift their capability in line with TAL's capability framework.
- Deliver training as required
- Contribute to the implementation of appropriate governance structures and quality assurance to successfully deliver business solutions.
- Ensure compliance with TAL policies, procedures and guidelines procedures, ensuring claims management is in accordance with the TAL claims philosophy
- Adherence to external regulations (eg. Privacy and Life Insurance Code of Practice) and all relevant legislation and industry guidelines
- Ensure all interactions with Customers, Advisers and other internal and external stakeholders adhere to TAL's Customer Service Culture through the provision of high-quality, accurate and compliant work
- At least 2 years' demonstrated experience in a similar role within Life Insurance or 5 years' 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).
We extend this acknowledgment to the many Traditional Lands that we operate across and pay our respects to Elders past, present, and emerging.#LI-HybridEveryone 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.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.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.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.