Primary DetailsTime Type: Full timeWorker Type: EmployeeThis role is responsible for end to end claims management of claims. This includes making decisions on claim outcome, declining claims, customer interaction (inbound and outbound), supplier coordination, raising payments to suppliers and claim finalization. This role is also responsible for keeping portfolios compliant to SLAs measured.
Primary Responsibilities
- Manage claims end-to-end in accordance with the Claims Manual, Delegated Trading Protocols (DTPs), GSSC policies, relevant legislation, and regulatory requirements.
- Ensure compliance with delegated authority limits and all applicable governance standards.
- Maintain effective, professional, and proactive communication with customers throughout the claims lifecycle.
- Coordinate effectively with suppliers, assessors, and other stakeholders to facilitate timely claim resolution.
- Accurately establish claim reserves and ensure timely updates based on assessor reports and claim developments.
- Process payments within delegated authority limits and in accordance with company procedures.
- Interpret policy coverage and determine claim eligibility. Communicate claim acceptance or declinature decisions promptly and escalate issues for appropriate review or endorsement when required.
- Identify and implement the most appropriate settlement strategy to achieve optimal customer and commercial outcomes.
- Detect suspicious or potentially fraudulent claims in line with QBE fraud indicators and refer such cases to the Fraud Investigations Team.
- Identify and pursue recovery opportunities to minimize claim costs and maximize recoveries.
- Provide claims insights, feedback, and trend analysis to Underwriting and Risk teams to support business decision-making and risk management activities.
- Provide feedback to Underwriting regarding policy information, risk considerations, or claim-related insights that should be noted at policy renewal.
- Complete document uploads, claim registrations, and allocation activities to ensure claims and related documentation are routed to the appropriate teams. (Claims Settlements)
- Apply effective settlement strategies and negotiation techniques to achieve KPI targets and deliver optimal commercial outcomes. (Claims Settlements)
- Review claim documentation to identify liability disputes and appropriately triage cases to the relevant Claims Officers. (Claims Settlements)
- Continuously seek opportunities to improve processes, policies, and procedures while remaining current with regulatory, compliance, and business requirements. (Claims Settlements)
Required Education
- Bachelor's Degree or an equivalent combination of education and relevant work experience.
Required Experience
- No specific experience required.
Preferred Competencies And Skills
- Strong customer service orientation.
- Proficiency in Microsoft Office applications and related business tools.
- Strong analytical, problem-solving, and negotiation skills.
- Excellent verbal and written communication skills in English.
- Case management experience or skills preferred.
Preferred Knowledge
- Basic knowledge of insurance principles and claims processes.
- Basic understanding of customer service practices and standards.
QBE Cultural DNA
Everything we do at QBE is underpinned by our Cultural DNA, which reflects the behaviors and values that drive our success. Employees are expected to exemplify and promote the following cultural elements:
- We are customer-focused.
- We are technical experts.
- We are inclusive.
- We are fast-paced.
- We are courageous.
- We are accountable.
- We are a team.
All employees are expected to comply with QBE's Code of Ethics and Conduct and apply sound risk management practices in the performance of their duties.
US Only – Disclaimer
To successfully perform this role, an individual must be able to carry out the essential job responsibilities satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position.
Global Disclaimer
The duties outlined in this job description are not intended to be exhaustive and do not limit the assignment of additional responsibilities. Employees may be required to undertake duties outside their normal responsibilities as business needs arise.
QBE's Code of Ethics and Conduct outlines our responsibilities to our customers, colleagues, suppliers, communities, shareholders, and governments. It provides clear guidance to support ethical decision-making and sound professional judgment.
Skills:
Analytical Thinking, Claims Administration, Claims Resolution, Collaboration Tools, Communication, Critical Thinking, Customer Service, Customer Value Management, Financial Advising, Intentional collaboration, Managing performance, Process Compliance, Process Improvements, Risk Management, Stakeholder Management
How to Apply:
To submit your application, click Apply and follow the step by step process.
Equal Employment Opportunity:
QBE is an equal opportunity employer and is required to comply with equal employment opportunity legislation in each jurisdiction it operates.
