Claims Management Consultant

Australian Unity Limited; Sydney; On-site; AUD 95,000 - 125,000; Full time

Benefits offered by this job

Competitive salary

Bonus program

Parental leave 14 weeks

Well-being leave

Employee referral program

Employee assistance program

Discounts on Australian Unity services

LinkedIn Learning access

Job summary

Australian Unity is seeking a Claims Management Consultant to lead a portfolio of complex workers' compensation claims under NSW legislation and SIRA guidelines, delivering timely, accurate, and cost-effective management with a focus on sustainable return-to-work outcomes. You will coach internal stakeholders, manage escalated claims, assess liability, calculate weekly benefits, and support continuous improvement.

A RTW certification and self-insurance experience are desirable.

Qualifications

• Minimum 5 years' experience in end-to-end workers' compensation claims management.
• Strong knowledge of NSW Workers Compensation legislation, frameworks, timeframes, and SIRA requirements.
• Ability to interpret medical reports and legal documentation accurately.
• Excellent communication, negotiation and stakeholder management skills.

Responsibilities

• Manage portfolio of physical and psychological injury claims in line with NSW workers compensation legislation and SIRA guidelines.
• Conduct liability assessments, determine entitlements, calculate PIAWE and process weekly benefit payments.
• Develop and monitor injury management plans with employees, leaders, and healthcare providers to support safe return-to-work.
• Manage complex claims including Legal WPI assessments, Common Law WID processes and XOL reviews.
• Build relationships with injured employees and internal teams, providing clear updates and case conferences.
• Provide accurate claims estimates and reporting insights to inform decision-making.
• Coach internal stakeholders on workers compensation and best-practice claims management.
• Identify legislative changes and contribute to continuous improvement in claims governance.

Skills

Workers' compensation

Stakeholder management

NSW legislation knowledge

Claims negotiation

Analytical skills

Communication skills

RTW coordination

Injury management

Education

Tertiary qualification in insurance/related field

Certificate IV in Personal Injury Management

SIRA Accredited RTW Coordinator Certification

Tools

SolvInjury

Donesafe

Microsoft Office

Job description

Established in 1840, we are Australia's first wellbeing company, delivering health, wealth and care services for our members and the community.

As a social enterprise, we're motivated by our purpose to positively impact the wellbeing of millions. We reinvest profits to deliver products and services sustainably that matter most to our members, customers and the Australian community.

For us, Real Wellbeing encompasses the whole experience of life. It's about feeling supported in your health, connected with your community and empowered to live life on your terms.

The Opportunity

The Claims Management Consultant is responsible for leading and managing a portfolio of complex workers' compensation claims in accordance with NSW Workers Compensation legislation and SIRA guidelines. This role ensures timely, accurate, and cost-effective claims management and drives early and sustainable return-to-work outcomes, along with increased engagement of employees and managers. The role requires the ability to provide support to injured employees and offer coaching and technical support to internal stakeholders and managers.

Key Responsibilities Include:

• Manage a portfolio of physical and psychological injury claims, ensuring decisions are timely, accurate and aligned with NSW workers compensation legislation, SIRA guidelines and self-insurance requirements.
• Conduct liability assessments, determine entitlements, calculate PIAWE and process weekly benefit payments within required timeframes and with a strong focus on compliance.
• Develop, implement and monitor tailored injury management plans in partnership with employees, people leaders, medical practitioners and rehabilitation providers to support safe and sustainable return-to-work outcomes.
• Manage complex and escalated claims, including Legal WPI assessments, Common Law WID processes and XOL reviews, applying sound technical judgement and legislative interpretation.
• Build trusted relationships with injured employees, people leaders, medical professionals, legal representatives and internal teams, providing clear communication through case conferences, claims reviews and regular updates.
• Provide accurate claims estimates, reporting insights and regular claim strategy updates to support informed decision-making throughout the claim lifecycle.
• Coach and support internal stakeholders on workers compensation, injury management and best-practice claims management to build capability and improve outcomes.
• Identify legislative or process changes, contribute to continuous improvement initiatives and promote consistent, high-quality claims governance.

You will bring:

• Minimum 5 years' experience in end-to-end workers' compensation claims management (self-insurance experience desirable), including exposure to complex, legal, and psychological injury claims.
• Strong knowledge of NSW Workers Compensation legislation, frameworks, timeframes, and SIRA requirements.
• Exceptional communication, negotiation, and stakeholder management skills, with a proven ability to influence and deliver results through collaboration.
• Strong technical expertise in interpreting Legal WPI assessments, managing Common Law WID processes, and an understanding of XOL reviews, ensuring compliance with legislative requirements and best practice standards.
• Expert knowledge of PIAWE legislation, regulations, and standards of practice, with proficiency in processing Workers Compensation Weekly Benefits.
• Proven ability to interpret medical reports and legal documentation accurately.
• Ability to provide specialist advice and guidance to employees, managers, supervisors, and People and Culture business units in relation to claims management.
• High attention to detail and strong analytical skills.
• Demonstrated passion for employee wellbeing and safety objectives.
• Ability to manage conflicting priorities and stakeholder expectations effectively.
• Capability to implement strategies that achieve key outcomes.
• Proactive, engaged, collaborative, and professional approach to work.
• Strong teamwork skills with a constructive and solution-focused mindset.
• Proficient computer skills, including Microsoft Office; experience with SolvInjury and Donesafe is desirable.
• Current SIRA Accredited Return to Work (RTW) Coordinator Certification.

Desirable Qualifications & Core Competencies:

• Tertiary qualification in insurance, law, health science, or related field.
• Certificate IV in Personal Injury Management or equivalent.
• Customer-centric approach with empathy and resilience.
• Strategic thinking and problem-solving ability.
• Ability to work under pressure and manage competing priorities.

Why Join Us?

You will enjoy a range of great employee benefits and rewards including:

• Competitive salary + bonus program
• Enjoy additional yearly Well-Being and Community leave days
• 14-week paid parental leave, with equal benefit for both parents
• Employee Referral Program
• Employee Assistance Program - support and assistance for you and your partner at those times in life when you need it most
• Flare/Maxxia Rewards - a great range of discounts and benefits at selected retail outlets, department stores, attractions, travel, cinemas, restaurants.
• Discounts across the Australian Unity business including Private Health Insurance, General Insurance + more!
• Available access to LinkedIn Learning courses through our great Learning platform

For further benefits visit: https://www.australianunity.com.au/careers/culture

Australian Unity is an Equal Opportunity employer and we encourage applications from all members of the community, including people of Aboriginal and Torres strait Islander descent, culturally and linguistically diverse backgrounds and, mature aged people.