Claims Technical Specialist

Welcome to TAL. As a leading life insurer, we’ve been protecting Australians for over 150 years. Backed by Daiichi Life, we're driven by big ambitions and empower to create better products and services. 

Together with our Partners, we’re helping millions of Australians live a life filled with choices, options, and freedoms. See the direct impact you make delivering support and financial security with care and expertise. Grow beyond expectations with diverse roles, global connections, and exclusive learning opportunities. 

Work with passionate, bright and capable colleagues. Feel inspired by supportive leaders. Collaborate with heart, where flexibility, wellbeing and inclusivity is valued. Together, we're reimagining insurance. 

So, bring a curious mind and an ambition to help us become the progressive, digitally enabled leading insurer. 

The Claims Technical Specialist is responsible for providing technical advice, guidance and support to the Claims team on technical assessment and case management matters, to assist in reaching desired claims durations and outcomes in line with the terms and conditions of the policy. 

Technical Support 

• Act as a subject matter expert, responding to Claims Consultant requests and enquiries and to authorise and review claims (and associated benefits payments) 

• Provide adverse decision review and sign off on assessment, which may require referral to internal Claims review body 

• Support Claims Consultants to use effective communication with customers, treating health practitioners and other stakeholders to drive the best service experience and appropriate claim outcomes for the customer 

• Support Client Managers and Team Managers in their reporting to funds and attendance at fund meetings/case conferences related to technical claim outcomes as required 

Team Capability 

• Drive processes to support development of technical capability within claims and implement strategies lto develop technical skills in line with the TAL claims capability framework resulting in progression of delegated authorities in a timely manner 

• Coaching Claims Consultants in appropriately executing assessment practices ensuring the timely and quality management of claims. Including completing ‘above delegation’ and ‘within delegation’ reviews of individuals work and recording outcomes and opportunities for development  

Compliance 

• Contribute to the implementation of appropriate governance structures and quality assurance to successfully deliver business solutions. 

• Adherence to external regulations (eg. Privacy and Life Insurance Code of Practice) and all relevant legislation and industry guidelines 

• At least 2 years’ demonstrated experience in a similar role within Life Insurance or 5 years’ experience as a Life Insurance Claims Manager or similar. 

• Experience in coaching and embedding knowledge, including an uplift of skills of case managers. 

• Excellent Knowledge of the Life Insurance Code of Practice, Insurance Contracts Act, Privacy Principles and other relevant legislative or regulative requirements and their application during claims assessment. 

• Ability to identify and develop strategies to overcome barriers in claims  

• Relevant tertiary qualifications in Business, Commerce, Health or Allied Health (desirable not essential). 

• Diploma or Cert IV in Life Insurance, or equivalent (desirable not essential). 

Additional information 

TAL is one of Australia’s leading life insurers, committed to inclusion, and supporting the career growth of our diverse workforce. We’re proud to be:  

• An Inclusive Employer – Recognised as Employer of Choice for Gender Equality by the Workplace Gender Equality Agency and Bronze Tier Status within the Australian Workplace Equality Index  

• Diversity Champions – Member of Diversity Council Australia, Australian Disability Network, Pride in Diversity and Champions of Change  

• Reconciliation Advocates – Read our Innovate Reconciliation Action Plan. 

• We welcome applications from people with diverse experiences, perspectives and backgrounds including Aboriginal and Torres Strait Islander people, caregivers, individuals living with disabilities, people from culturally diverse backgrounds and the LGBTIQ+ community.  

• Need adjustments during the recruitment process? Let our team know by getting in touch with us here.—we’re here to support you. 

You’re always accountable for your actions. You never give up. You strive to find the best outcomes for customers and partners. And you value working together to find the best solutions for problems.   

As part of the recruitment process, there are several checks which may be conducted to demonstrate your eligibility for a role at TAL including Criminal History, Bankruptcy, Entitlement to Work, Regulatory and Reference Checks.  
#LI-Hybrid   

Everyone at TAL has a responsibility to do the right thing and is accountable for the way they conduct themselves. Our expectations are that you follow the principles set out in our Code of Conduct when you come to work every day. Risk management is everyone’s responsibility. 

Everyone at TAL has a responsibility to do the right thing and is accountable for the way they conduct themselves. Our expectations are that you follow the principles set out in our Code of Conduct when you come to work every day. Risk management is everyone’s responsibility.

If you are already a TAL employee please apply via the SmartRecruiters button in Workday and navigate to the Employee Portal. This is important to ensure that your application is recorded accurately.