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Cover Genius

Claims Specialist

Posted 2 Days Ago
Be an Early Applicant
Remote or Hybrid
Hiring Remotely in Australia
Mid level
Remote or Hybrid
Hiring Remotely in Australia
Mid level
Assess and settle insurance claims within delegated authority, including complex, high-value, reopened, appealed, and escalated claims. Review documentation, determine coverage, communicate with customers, process payments, monitor quality and KPIs, follow insurance regulations, collaborate with Support and Claims teams, and recommend process improvements. The role also supports SLA and NPS performance and mentors team members toward quality benchmarks.
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About Cover Genius

Cover Genius is the global infrastructure for embedded protection. Active in over 60 countries and all 50 US States, we protect the customers of the world’s largest digital companies, including Klarna, Revolut, Stripe, Priceline, Agoda, Booking.com, Turkish Airlines, Tongcheng Travel, eBay, and Uber, with seamless, end-to-end experiences. Cover Genius has protected more than 73M customers globally across 240M policies with USD $3.2BN in gross written sales. 

Coming off a stellar year with 40% YoY revenue growth and a recent $100M capital raise, putting our valuation at $1.9BN, we are accelerating into our next phase of growth. As part of our team, you’ll help drive our AI-first roadmap, developing hyper-personalization engines, agentic distribution, and automated claims infrastructure, while building the scalable technology powering the fast-growing $70B embedded protection market.

Our people are: Accountable, customer-obsessed, collaborative, driven

Our people are not: Passive, defensive, siloed, hesitant

About the Role

As a Claims Specialist II, Vertical  on our Customer Team, you will own the assessment and settlement of claims within their own settlement authority. 

To drive success in this role, you will have strong attention to detail and great organizational and time management skills. With a bachelor's degree, you will ideally have experience dealing with customers' litigations online. As the Claims Specialist II, Vertical, you will review and assess customers’ claims through our owned XClaim platform, for a fast resolution and prompt payment.  Regular collaboration with the Support team, as well as the Content and Complaints team, will be key in ensuring that agreed SLAs and NPS are achieved.

Key Responsibilities
  • Claims Processing: Manage  day-to-day claims activities for new claims and assist with reopened claims, including claims actions, emails, phone and payments.

  • Own the assessment and approval of new claims within the authority and fraud thresholds.

  • Complex Claims Handling: Handle or triage more complex claims that require deeper analysis, including high-value or multi-policy claims. Including claims appeals and escalations.

  • Customer Communication: Handle customer inquiries regarding claims status, policy coverage and build rapport with customers to speed up claim’s resolution and process claims payments.

  • Documentation: Ensure all necessary documentation is collected and filed accurately in the system. 

  • Quality: Maintain the quality of our work ensuring accuracy to meet business, team and individual KPIs.

  • Collaboration: Own the communication with all relevant stakeholders (Claims, Support) to resolve claims efficiently and ensure the best customer experience. 

  • Compliance: Be aware of current insurance guidelines, policy updates, and regulations. Follow company guidelines and local regulations to ensure claims are handled fairly and ethically.

  • Process Improvement: Identify and recommend process improvements to enhance claims handling efficiency and operations.


SKILLS AND EXPERIENCE
What you will bring
  • 2-4 years of experience in claims handling, preferably in an insurance firm.

  • Fluency in English (verbal & written) is essential for communicating internally and externally. Any other language will be highly regarded for external communications.

  • Strong understanding of insurance products and terminology.

  • Familiarity with legal and regulatory aspects of insurance claims.

  • Bachelor’s or postgraduate degree in a related field or equivalent is desirable

PROFICIENCIES AND ATTRIBUTES
  • Time Management

  • Organisation

  • Attention to Detail

  • Demonstrates resilience

  • Learning orientation

  • Relationship building skills

  • Communication Skills

Key Initiatives

Ensure a +65 NPS 

Work with the team to meet the agreed SLAs

Ensure the team achieves KPIs

Mentor the team to meet QA benchmark

This job description is intended to inform potential candidates of the expected qualifications of candidates of this position. This job description is not intended to include every duty or responsibility of the job nor is it intended to be an all‐inclusive list of the skills and  abilities required to do this job. Covery Genius may, at its discretion, assign or reassign duties and responsibilities to or from this job at any time.


🤔 Why Cover Genius?

At Cover Genius, we create magic by turning the archaic into the extraordinary. We take one of the world’s oldest and most complex industries and reinvent it with world-class technology. Cover Genius doesn’t just disrupt legacy insurance; we make the impossible feel effortless.Our operating principles guide our mission: 

  • Make today matter: We deliver with urgency and excellence. We act decisively, move with intention, and hold a high bar..

  • Act with accountability: We own our commitments  and take pride in delivering results that move us forward.

  • Grow together: We are a collective of curious minds. We learn from wins and setbacks, share knowledge generously, and elevate each other every day.

  • Inspire Each Other: We push each other to think bigger and pull together to go further.

  • Champion Our Customers: We lead with empathy and center the customer, turning complex disruptions into seamless moments of trust.

  • Don't just take our word for it- hear about our culture straight from our people here: story time

Ready to make an impact? If you’re looking for a place where you’ll be challenged, trusted, and empowered, we’d love to meet you.


The Legal & Privacy Stuff

Cover Genius promotes diversity and inclusivity. We don't tolerate discrimination, demeaning treatment of anyone, or harassment due to race, national origin, gender, gender identity, sexual orientation, protected veteran status, disability, age, or any other legally protected status.

By submitting your application, you acknowledge that we may collect, store, and process your personal data for recruitment purposes. To ensure a fair evaluation, we may use AI to assist in sorting applications, but all final decisions are made by our hiring team and no candidate dispositions are automated. We will keep your information on file for three years from the date of your application. For detailed information about how we handle your data and our use of AI, please review our full Privacy Policy.

Cover Genius Sydney, New South Wales, AUS Office

Sydney CBD, Sydney, Australia, 2000

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