Disputes Resolution Specialist – Insurance Complaints

Disputes Resolution Specialist – Insurance Complaints At ClaimsCo , we are a purpose-driven claims advocacy firm dedicated to standing up for everyday policyholders. We help individuals navigate complex insurance processes and challenge unfair claim decisions—ensuring that insurers remain accountable and outcomes are fair, transparent, and consistent with policy terms and industry standards. As we continue to grow, we are looking for a Disputes Resolution Specialist to join our Claims Advocate Management Team and help shape the way disputes are approached and resolved across IDR and EDR channels. For any offers accepted in the month of December/January we are offering a one time $1000 sign on bonus The Opportunity As our Dispute Strategy Lead , you will play a pivotal role in reviewing and advising on complex, declined, or escalated claims that progress through Internal Dispute Resolution (IDR) and External Dispute Resolution (EDR). Your expertise will help guide our advocacy team, refine our resolution strategies, and ensure that our clients are equipped with strong, well-evidenced, and fair representations. This is an opportunity to apply your understanding of dispute resolution, policy interpretation, and regulatory frameworks to make a real impact on both clients and the broader insurance industry. Key Responsibilities Independently assess and oversee complex or disputed claims, with a focus on fairness and strategic resolution. Guide claims advocates in structuring submissions and engagement strategies for IDR and EDR processes. Prepare persuasive and well-reasoned written responses to insurers and dispute bodies. Identify systemic issues and provide feedback that helps inform ClaimsCo’s broader claims strategy. Interpret and apply policy wordings, case precedents, and codes of practice to support our advocacy positions. Ensure all dispute processes meet relevant regulatory and compliance standards. Monitor industry developments and contribute to thought leadership on claim conduct and resolution. What You Bring A deep understanding of insurance dispute resolution, complaint handling, or claims decision review. 2+ years' experience in dispute management, claims, legal, or regulatory roles ideally with exposure to AFCA or IDR/EDR frameworks. Strong working knowledge of the General Insurance Code of Practice, Corporations Act obligations, and regulatory guidance (e.g., RG 271). Excellent critical thinking, case analysis, and decision-making skills. Outstanding written and verbal communication skills, particularly in submissions and stakeholder liaison. A strong sense of ethics, customer fairness, and professional judgment. Legal qualifications or experience in dispute resolution including external complaint bodies would be an advantage. What We Offer Competitive Compensation – Your experience is valued and rewarded. Remote Flexibility – Work from anywhere in Australia. Impact-Driven Mission – Help shape better insurance outcomes for real people. Innovative, Agile Culture – Join a dynamic, growing team challenging the status quo. Growth Opportunities – Expand your influence and leadership within a high-impact organisation. New employee benefits program coming in early 2026 to help with cost of living. Make an ImpactIf you’re ready to shift from neutral observer to active advocate, this is your opportunity to lead dispute strategy in a company that’s redefining fairness in insurance claims. All applications require a cover letter to be considered. All applications are strictly confidential. #J-18808-Ljbffr