Claims Adjuster handling commercial claims for an innovative insurance startup utilizing real - time data. Collaborating with a global team and driving successful claims outcomes in a high - growth environment.
About the role
- Claims Specialist providing exceptional service managing complex medical stop loss claims at QBE. Collaborating with stakeholders and maintaining client relationships while ensuring compliance and strategy implementation.
Responsibilities
- Provide exceptional claims service to customers by managing complex medical stop loss claims effectively.
- Assess policy coverage, investigate, evaluate, and negotiate claims.
- Collaborate with suppliers and stakeholders while offering technical support.
- Support the implementation of the Claims strategy to enable the delivery of overall business targets.
- Maintain current knowledge of insurance guidelines, policy changes, and modifications.
- Maintain good client relationships with insured individuals, agents, service providers, and the general public.
- Identify and implement strategies to minimise Claims Costs and Leakage.
- Assist with the negotiation of claims settlements.
- Participate in relevant meetings to share and develop strategy, knowledge, and best practices.
- Identify and resolve issues or anomalies non-compliant with policies and procedures.
- Assist with the daily review of reports and ad hoc reporting.
- Mentor and coach junior staff as required.
Requirements
- Moderate relevant experience
- Experience in an Accident & Health claims department or the insurance industry (preferred)
- Experience handling Medical Stop Loss claims (preferred)
- Tertiary Degree or equivalent combination of education and work experience (necessary)
- Relevant insurance qualifications (necessary)
Benefits
- Hybrid Working – a mix of working from home and in the office
- 22 weeks of paid leave for family growth, with 12 weeks available to all parents on a gender-equal basis
- Competitive 401(k) program with company match up to 8%
- Well-being program including holistic wellbeing coaching, gym membership, confidential counselling, financial and legal advice
- Tuition Reimbursement for professional certifications, and continuing education
- Employee Network and Community – QBE actively supports six Employee Networks, and many ways to give back to your community
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