Leading Industry Superannuation Fund is currently looking for a Technical Group Claims Review Specialist to provide specialised advice in relation to all claim matters and take responsibility for the day-to-day management of high-valued clients to optimize the timely management of claims and contentious disputed claim matters.

More specifically you will:

• Manage the day-to-day relationship with this funds high-valued clients & associations including all policy, claim and other related matters so that enquiries are responded to efficiently, accurately and in a timely manner
• Thoroughly review all aspects of accepted and declined claims to ensure decisions are fair and reasonable, prior to presenting claims to the Trustee’s delegated signatories
• Investigate and respond to enquiries raised by our high-valued clients
• Identify areas where there may be issues or gaps in the insurance cover being provided
• Investigate, review and analyse any disputed matters for high-valued clients and provide recommendations for resolution
• Manage a caseload of high-valued clients, plus attend to day-to-day enquiries and complaints and provide specialised advice so that member’s needs and claims are dealt with appropriately

 You will require:

• ASFA RG146 compliant or equivalent FPA qualification
• Knowledge of commonwealth superannuation requirements & compliance issues
• Insurance claims & underwriting experience and the ability to interpret eligibility & liability
• Ability to interpret policy documents and provide advice to third parties
• Qualitative & quantitative analytical skills and attention to detail, applied to complex policy issues & statistics, and problem solving in areas where change is necessary.
• Written communication skills to prepare concise accurate reports & submissions on technical matters and advise on public communications
• Interpersonal skills that lead to strong relationships with service providers & colleagues