Claims Specialist - Pooling

DBOS is hiring for Claims Specialist with the following background for our Australian Account!

• Claims Specialist with Settlement experience with 3rd party insurers
• Claims Specialist (End to End Process preferably with experience in Recovery)
• Claims Specialist for Pet Insurance (preferably with healthcare or pet experience)
• Motor Claims Consultants

Ensures claims are processed in an accurate and timely manner, mitigating claims costs in accordance with policy guidelines, delegated authorities industry laws and regulations. A customer-facing role, this position embraces our Soft Landings philosophy in ensuring a high level of customer service from lodgement to claim closure.

What are the duties and responsibilities?

• Receive inbound and outbound calls from existing customers and third parties
• Provide, reliable and accurate information to customers and third parties in a timely manner
• Apply the Policy Disclosure Statement (PDS)and underwriting guidelines to determine coverage for claims
• Identify and report potentially fraudulent activity
• Liaise with third-party suppliers and service providers
• Obtain documentation from customers to facilitate claims handling in line with organizational Policies and Procedures.
• Accept or decline claims in accordance with Underwriting guidelines, and as instructed by Manager
• Maintain an appropriate level of compliance and adhere to regulatory requirements
• Report incidents, breaches or complaints in a timely manner and in accordance with relevant Policies and Procedures
• Negotiate claims costs and engage in negotiations regarding quantum
• You will be required to carry out other duties that are within the limits of your skills, competence, training, and/or experience as directed by your Manager

The essentials you'll need:

• Minimum Year 5-10 yrs or equivalent
• An understanding of the role and importance of insurance
• Intermediate level computer skills, including Microsoft Office
• Prior experience in customer service
• Sound written and verbal communication skills
• Can work ONSITE

Other valuable skills you may have:

• Previous experience handling insurance claims, or working in a financial services institution
• Skills in negotiation, persuasion, and investigation with customers and service providers
• Sound interpersonal skills, building rapport with customers and service providers
• Skilled in asking probing questions and gaining detailed information to support claims handling