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Manager, Claims Quality Assurance

External
Tal logoTal · Sydney, Australia
Full-timeRemote2mo ago
ComplianceLeadershipRisk Management
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Benefits

Health insurance

Additional Information

This role is responsible for leading a Claims Quality Assurance team and providing quality assurance in relation to claim assessment in line with the TAL claims quality framework and risk management principles. A key focus of this role is to promote a culture of risk management and continuous improvement by providing risk-based detective controls and insights relating to claim assessment. You may be required to lead the delivery of small to medium scale projects or well-defined tasks on major projects to enable QA remediation or continuous improvement initiatives. In this role you will: Claims Portfolio Ownership : Manage Life Claims with focus on customer service, accurate policy assessment, cost control, and return-to-health outcomes using best-practice strategies. Customer Escalations : Resolve complaints and implement improvements to enhance service quality. Risk & Compliance : Ensure adherence to TAL policies, legislative requirements, industry guidelines, and maintain a strong risk culture. Complex Claims Support : Provide guidance on liability determinations, strategy sign-off, and participate in case conferences for complex claims. Operational Oversight : Allocate daily work, monitor performance, manage resources, and use reporting to ensure service delivery. People Leadership : Recruit, coach, and develop Claims Consultants while driving TAL's risk culture and customer service standards. At least 3-5 years' experience working in claims quality assurance within the Life Insurance or related discipline in Financial Services/Insurance industry (or similar) Demonstrated understanding of life, trauma, Lump Sum (TPD), Disability and Income Protection claims assessment and management requirements. Demonstrated understanding of relevant regulatory and legal obligations impacting Life Insurance claim assessment. Detailed knowledge of Claims processes, regulations and compliance and the ability to translate knowledge and experience into recommendations to add value to the business. TAL is one of Australia's leading life insurers, committed to inclusion, and supporting the career growth of our diverse workforce. We're proud to be: An Inclusive Employer - Recognised as Employer of Choice for Gender Equality by the Workplace Gender Equality Agency and Bronze Tier Status within the Australian Workplace Equality Index Diversity Champions - Member of Diversity Council Australia, Australian Disability Network, Pride in Diversity and Champions of Change Reconciliation Advocates - Read our Innovate Reconciliation Action Plan . We welcome applications from people with diverse experiences, perspectives and backgrounds including Aboriginal and Torres Strait Islander people, caregivers, individuals living with disabilities, people from culturally diverse backgrounds and the LGBTIQ+ community. Need adjustments during the recruitment process? Let our team know by getting in touch with us here -we're here to support you. You're always accountable for your actions. You never give up. You strive to find the best outcomes for customers and partners. And you value working together to find the best solutions for problems. As part of the recruitment process, there are several checks which may be conducted to demonstrate your eligibility for a role at TAL including Criminal History, Bankruptcy, Entitlement to Work, Regulatory and Reference Checks. #LI-Hybrid Everyone at TAL has a responsibility to do the right thing and is accountable for the way they conduct themselves. Our expectations are that you follow the principles set out in our Code of Conduct when you come to work every day. Risk management is everyone's responsibility. If you are already a TAL employee please apply via the SmartRecruiters button in Workday and navigate to the Employee Portal. This is important to ensure that your application is recorded accurately .


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