Senior Claims Consultant

TAL Australia; Sydney; On-site; AUD 120,000 - 150,000; Full time

Job summary

TAL Australia in Sydney seeks a Senior Claims Consultant to lead a portfolio of Group Life Insurance claims, applying TAL's claims philosophy and regulatory requirements. You will engage with customers, advisers and healthcare partners to ensure timely, quality outcomes.

You will interpret policy terms, analyse medical and financial information, develop Return to Work plans, and mentor junior staff while contributing to technical leadership within the Group Claims team.

Qualifications

• 4–6 years' experience in Group Life Insurance claims.
• Experience with TPD and Income Protection claims.
• Analytical and problem-solving skills with attention to detail.
• Advanced time management and prioritisation.

Responsibilities

• Manage a portfolio of complex Group Life Insurance claims.
• Communicate with customers, advisers, and treating practitioners.
• Interpret policy terms, underwriting decisions and non-disclosure matters.
• Analyse complex financial and medical information for decisions.
• Develop and monitor Return to Work plans with customers and providers.
• Lead case conferences and gather information on conditions and work capacity.
• Collaborate with underwriters, rehab consultants, legal and medical officers, and reinsurers.
• Mentor junior staff and contribute to technical leadership.

Skills

Customer communication

Analytical thinking

Time management

Empathy

Education

Diploma or Cert IV in Life Insurance

Tertiary qualifications in Business/Commerce/Health

Tools

Fineos

Genesis

OneNote

Excel

Job description

Job Description As a Senior Claims Consultant, you'll play a critical role in our Group Claims team, guiding customers through life insurance claims with care, expertise, and efficiency. You will be responsible for the proactive management of a portfolio of Life Insurance Claims in accordance with TAL's claims philosophy, claims handling procedures, policy terms & conditions and in accordance with the Life Insurance Code of Practice and other legislative and regulatory requirements. A key focus of this role involves providing a best-in-class customer and client (e.g. advisers, trustees, fund administrators) experience, including regular communication in relation to the status of claims and managing expectations, to deliver on quality health and claim outcomes.

In this role you will:

• Manage a portfolio of complex Group Life Insurance claims, balancing customer needs with policy and business requirements.
• Communicate effectively with customers, advisers, and treating practitioners via telephone and written correspondence.
• Interpret policy terms, underwriting decisions, and non-disclosure matters to determine claim eligibility.
• Analyse complex financial and medical information to make sound, evidence-based claims decisions.
• Develop and monitor Return to Work (RTW) plans in collaboration with customers and healthcare providers.
• Lead case conferences and employ strategies to gather critical information on customer conditions and work capacity.
• Collaborate with internal and external stakeholders, including underwriters, rehab consultants, legal and medical officers, and reinsurers.
• Mentor junior staff and contribute to technical leadership across the claims team.

Qualifications

• At least 4-6 years' experience in Claims across Group Life Insurance claims with experience in TPD and Income Protection Claims Ability to build rapport and empathy with customers during difficult times and a commitment to delivering proactive, high quality customer service.
• Comfortable navigating claims systems (Fineos, Genesis, OneNote, and Excel) Diploma or Cert IV in Life Insurance, or equivalent (desirable).
• Relevant tertiary qualifications in Business, Commerce, Health or Allied Health (desirable).
• Demonstrated analytical and problem-solving skills and attention to detail.
• Advanced time management and prioritisation skills.