- Provide ongoing coaching and mentoring to Case Managers (and/or external stakeholders) on the claims management process, enabling them to provide exceptional customer service to clients, including guidance on handling communication with clients relating to the management of their claim and attending to client’s enquiries;
- Being the escalation point for technical advice for Case Managers, undertake duties including:
- Authorise and review claims (and associated benefits payments), including where above delegated authority of Case Managers;
- Interpretation and advice regarding hypothetical claims scenarios;
- undertake quality assurance reviews of claims files;
- provide advice on the technical interpretation of policies and contract requirements; and
- take accountability for the resolution of customer complaints or requests for decision reviews (within authority);
- Continuously support the Claims Team Manager (or Senior Claims Specialists), including acting as the second-in-charge for the relevant Claims Team, triaging of claims files to Case Managers, providing feedback to the Claims Team Manager on the successes and development opportunities for Case Managers, as required;
- Liaising with internal and external stakeholders, to ensure the timely and quality management of claims, including participating in case conferences, peer case discussions and working closely with the Claims Technical Training team to identify and develop training package needs;
- Generation of reports for the Claims Team and Claims Leadership Team (such as Traffic Light reports), to enable the efficient and effective management of the team;
- Continuously reviewing Claims processes and frameworks to seek out opportunities for improvement in the overall claims experience for customers;
- Participate in business area and/or Company projects as required
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