Claims Specialist (12 months contract)

Job Summary

To examine and investigate increasingly complex disability, life and annuity claims, to develop personal competence and contribute to the timely and equitable settlement of claims and delivery of excellent customer service.

Job Accountabilities - Key Accountabilities

• Analyze and evaluate contestable death, accelerated death benefit and critical illness claims.
• Manage domestic investigations and to interpret medical records and laboratory/autopsy reports.
• Conduct coverage analyses.
• Develop collaborative relationships with the Legal department, Underwriting, Policy Service and the Medical Directors office.
• Maintain appropriate approval authority.
• Engage in correspondence with beneficiaries, agents, medical care providers, and insured's.
• Examine/evaluate individual, group life and waiver of premium claims to determine action.

Business Accountabilities

• Ensure adequate resources are available to meet work requirements.
• Possess a practical understanding of how processes and systems in Life Claims relate to the management of risk and compliance.
• Prepare documents, presentations and other materials to a clear brief.
• Provide feedback and recommendations for improvement of Life Claims processes and systems.
• Respond to and resolve life claims enquiries and problems within authority, to provide an effective service and clear advice to colleagues and customers.
• Oversee life claims processing completed by more junior colleagues to ensure information is recorded in a timely and accurate manner.
• Answer queries from across the business related to Life Claims within authority.

Job Qualifications

• Bachelor's Degree and 3 or more years of experience in the Claims area