Job Description 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. A key focus of the role is to optimise assessment quality within the Income Protection, Life, Trauma and TPD portfolios and support Claims Managers to build their capability in line with the TAL claims capability and delegated authority frameworks. In this role you will: Ensure claims handling and service approach reflects industry best practice and TAL processes and policies. Act as a subject matter expert, responding to Claims Consultant requests and enquiries and to authorise and review claims 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 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 Development/ enhancement of claims handling procedures and guidelines as required. Assist with embedment Drive processes to support development of technical capability within claims and implement strategies Coach Claims Consultants in appropriately executing assessment practices ensuring timely and quality management of claims Provide insights into Case Manager technical capabilities for the purpose of performance management Support the Team Manager in development planning for individuals to uplift their capability in line with TAL’s capability framework Contribute to the implementation of appropriate governance structures and quality assurance to successfully deliver business solutions
