Claims Case Manager
vor 1 Monat
Summary of Responsibilities
To proactively manage and assess a portfolio of TPD claims and Income Protection (IP) claims against the relevant policy/plan design and definitions, MetLife's claim philosophy whilst ensuring service level agreements are met.
Principal Responsibilities:
- Proactively manage a portfolio of high complexity disability claims in line with the MetLife claims Philosophy
- Provide proactive customer support by keeping people making a claim updated on the progress of the claim assessment. Manage all stakeholders expectations to support a seamless customer experience
- Build rapport with people on claim over the phone, establishing disability level (and for IP: return to work motivation and return to work plan) and achieve appropriate NPS customer engagement score
- Assess claims against policy contracts and explain complex decision in writing over the phone with logical and clear rationale and description of why evidence has been weighted over other evidence
- Instruct third parties to provide claim assessment support as appropriate to the claim situation and use claim providers in line with an appropriate cost benefit analysis
- Manage incoming work items in line with service level agreements, department objectives and practices
- Manage claims within appropriate risk and governance frameworks such as the Life Insurance Code of Practice and act appropriately as MetLife's First Line of Defense for risk issues
- Ability to recognize, categorize and prioritize work requiring minimal intervention
- Ensure all written communication is timely, accurate and professional
- Request appropriate evidence of income to calculate usual earnings for employed and self-employed people. Calculate benefit payable against the policy calculation method.
- Create and release claim payments in line with delegated authority & calculate any CPI increases
- Contribute to the team through special projects when required
- Ability to adopt and embrace change and best of class: philosophy and championing change within the Claims and wider Operations team Work in a positive, optimistic and balanced way and support the team to complete the daily team workload.
- Support a positive culture in line with MetLife's cultural values.
- Promotion of MetLife's insurance operations internally and externally
Skills, Competencies & Experience Required:
- Minimum of 6 months of relevant experience in claims assessment, within the Life Insurance Industry
- Ability to efficiently manage a portfolio of claims holistically to achieve sustainable, timely outcomes and within SLAs and financial services law claims handling provisions and Life Code of Practice
- Excellent proven ability in using the telephone professionally to speak to customers on a regular basis, using a range of motivational questioning and express empathy and build rapport
- Preparing all customer communication, including complex information and adverse decision advice
- Ability to review and complete complex financial calculations
- Ability to deliver outstanding service levels on a daily basis
- Ability to work supportively within a team and assist team members with work as needed. To be a committed team player who openly communicates and shares knowledge
- A high level of attention to detail
- Excellent time management and ability to prioritise work at all times delivering quick outcomes with high accuracy
- Proven ability to work under pressure in an evolving environment
- Understand and weigh up motivation to return to work and biopsychosocial factors that affect disability
- An understanding of life insurance policy conditions and contracts
- Excellent computing skills and literacy and excellent file note keeping and data capture experience
- Clear and concise communication skills. Strong listening skills essential and counselling skills preferred but not essential
Qualification Required:
- ANZIIF (or equivalent) or Tertiary qualifications highly desirable.
- Strong understanding and working knowledge of applicable regulatory, legislative and Compliance framework applicable such as the Life Insurance Code of Practice.
Personal Attributes:
Positive, optimistic, warm, compassionate, confident, patient, calm, fair, honest, respectful of others, has integrity, open, resilient, strong talker and listener, hardworking, team player, leads by example, encourager, self-motivated, supports change in a positive way, owns their culture. Takes ownership and where needed, leadership What's in it for you? Great central location in brand new offices Flexible work arrangements Fantastic employee benefits including - health & wellbeing allowance, access to corporate discounts through Perks at Work, additional purchased annual leave, super matching. Access to ongoing professional development, including study support and career progression within a leading global organisation.
What's in it for you?
- Flexible & hybrid work arrangements
- Fantastic employee benefits including - health & wellbeing allowance, access to corporate discounts through Perks at Work, additional purchased annual leave, super matching and insurances
- Access to ongoing professional development, including study support and career progression within a leading global organisation.
To apply, please send your resume to aucareers@metlife.com
MetLife is proud to be an equal opportunity/affirmative action employer. We are committed to attracting, retaining and maximizing the performance of a diverse and inclusive workforce. It is the policy of MetLife to ensure equal employment opportunity without discrimination or harassment on the basis of race, color, creed, religion, national origin, alienage or citizenship status, age, sex, sexual orientation, gender identity, or expression, marital or domestic/civil partnership status, disability, veteran status, genetic information or any other basis protected by law.
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