GSSC Claims Officer-1

Primary DetailsTime Type: Full timeWorker Type: EmployeeThis role is responsible for the end-to-end management of claims, including assessing and determining claim outcomes, declining claims where appropriate, managing customer interactions (both inbound and outbound), coordinating with suppliers, processing payments, and finalizing claims. The role is also accountable for maintaining portfolio compliance and ensuring service level agreements (SLAs) and performance targets are consistently met.Primary Responsibilities

• Manage claims end to end within parameters of claims manual, DTPs, GSSC policies, and relevant legislation and regulations.
• Ensure compliance within delegated authority limits.
• Maintain effective and proactive communication with customers.
• Ensure effective coordination with suppliers.
• Set possible cost of claim and update reserves on time as reports are sent through by assessors.
• Raise payments within delegations of authority.
• Interpret policy coverage and determine if coverages apply to claims submitted. Promptly inform customers of the acceptance or decline of claims and escalate issues for proper endorsement as needed.
• Decide on the best fulfillment method to settle claims.
• Identify suspicious or potentially fraudulent claims in accordance with QBE fraud indicators and refer these claims to the Fraud Investigations Team.
• Identify recovery opportunities on claims.
• Provide information and feedback on claims activity and developing trends to underwriters/risk assessors to enable appropriate actions to be carried out.
• Provide feedback to the underwriting team for details that need to be flagged/noted in the policy and are relevant upon renewal.
• Complete uploading and allocation activities to triage documents and claims to the relevant teams (Claims Settlements).
• Utilize appropriate settlement strategies and tactics for the best commercial outcomes by achieving KPI targets (Claims Settlements).
• Review claim documents to identify cases where liability is disputed for triage to the appropriate claims officers (Claims Settlements).
• Seek continuous process, policy, and procedure improvement while keeping up to date with current and new compliance requirements (Claims Settlements).
  
  

Required Education

• Bachelor's Degree or equivalent combination of education and work experience.
  
  

Required Experience

• NA
  
  

Preferred Competencies/Skills

• Customer service skills.
• Proficiency in MS tools.
• Analytical and negotiation skills.
• Excellent verbal and written communication skills (English).
• Preferably with Case Management Skills.
  
  

Preferred Knowledge

• Preferred Basic Knowledge of Insurance.
• Basic Knowledge of Customer Service.
  
  

QBE Cultural DNA

• Everything we do at QBE is underpinned by our DNA (which interlinks seven cultural elements). We know it's not just what we do that matters, but how we do it that makes the difference. We expect all employees to role model and inspire the right behaviours that link to our cultural elements: We are customer-focused. We are technical experts. We are inclusive. We are fast-paced. We are courageous. We are accountable. We are a team.
• All employees are expected to adhere to QBE’s Code of Ethics and Conduct and apply sound risk management practices.
  
  

US Only - Disclaimer

• To successfully perform this job, the individual must be able to perform each essential job responsibility satisfactorily.
• Reasonable accommodations may be made to enable an individual with disabilities to perform the essential job responsibilities.
  
  

Global Disclaimer

• The duties listed in this job description do not limit the assignment of work. They are not to be construed as a complete list of the duties normally performed in the position or those occasionally assigned outside an employee’s normal duties.
• Our Group Code of Ethics and Conduct addresses the responsibilities we all have at QBE to our company, to each other, and to our customers, suppliers, communities, and governments. It provides clear guidance to help us make sound judgment calls.
  
  

Skills:

Analytical Thinking, Claims Administration, Claims Processing, Claims Resolution, Communication, Critical Thinking, Customer Service, Customer Value Management, Financial Advising, Intentional collaboration, Managing performance, Process Compliance, Process Improvements, Risk Management, Stakeholder Management

How to Apply:

To submit your application, click "Apply" and follow the step by step process.

Equal Employment Opportunity:

QBE is an equal opportunity employer and is required to comply with equal employment opportunity legislation in each jurisdiction it operates.

---