Senior Claims Manager - Professional Conduct Claims

Colonial Group; Sydney; On-site; AUD 150,000 - 190,000; Full time

Job summary

Avant is Australia’s leading medical defence organisation providing tailored services to healthcare professionals. The Senior Claims Manager will oversee member claims, medico-legal guidance, and related investigations in line with established protocols and ethical standards.

Key duties include supporting information flow across departments, contributing to claims services, and participating in the medico-legal advice hotline while helping to drive improvements and education initiatives for

Qualifications

• Tertiary qualifications in legal, health or business.
• Solicitors with a valid practising certificate will be highly regarded.
• Experience in insurance claims management is essential.
• Strong understanding of current health and insurance legislation.
• Focus on time management and work management.
• Excellent communication and relationship-building skills.

Responsibilities

• Manage member claims and investigations in line with Avant protocols.
• Facilitate information flow to other Avant departments within policy constraints.
• Contribute to Avant’s provision of claims services.
• Participate in the medico-legal advice hotline.
• Support R&G initiatives educating members and staff on medico-legal matters.
• Contribute to national process improvements and change initiatives.

Skills

Claims management

Legal knowledge

Communication

Negotiation

Time management

Education

Tertiary qualifications in legal/health/business

Tools

Electronic document management system

Job description

About Avant

Avant is Australia’s leading medical defence organisation, proudly supporting medical professionals for over 130 years. With more than 90,000 members, including health practitioners and medical students across every state and territory, we provide trusted, market leading products and services tailored to our members’ professional, personal, and practice needs. As a mutual organisation owned by our members, they are at the centre of everything we do. Beyond our core offerings, we advocate for improvements across the healthcare system, promoting quality, safety, and professionalism in medicine through education and research.
About the Role
This role has responsibility for the provision of claims and general medico-legal advice and services to Avant and its members as documented in the claims management protocols and guidelines and in accordance with professional medical, legal and ethical standards. As required, the Senior Claims Manager contributes to special projects and initiatives, written articles, presents and represents Avant and members at medical forums.
The key responsibilities include:

• Manage member claims and investigations in accordance with the relevant Avant claims and investigation protocols and guidelines
• Within legislative and internal policy constraints, facilitate the free flow of information to other Avant departments
• Contribute to Avant’s provision of claims services
• Participate in the medico-legal advice hotline
• Support state Retention & Growth (R&G) initiatives be educating members, staff and internal and external bodies in medico-legal, clinical risk and claims matters
• Positive contribution to national process improvements and change initiatives

To be successful in this role you will have:

• Tertiary qualifications in legal, health or business;
• Solicitors with a valid practising certificate will be highly regarded;
• Previous demonstrated experience in insurance claims management;
• A strong understanding of current health and insurance legislation;
• A strong focus on time management and work management;
• Excellent communication and relationship building skills;
• Proven ability to work in an electronic document management system; and
• Strong relationship building and negotiation skills.

Why work at Avant?

• We value our people by offering an inclusive workplace with flexible work, career development and internal mobility opportunities.
• Our flexible working arrangements are designed to enable genuine work-life balance.
• Your development is our priority and we have a variety of learning and development programs that will support you in your career.
• We offer support to our people via Employee Assistance Program (EAP), Health and wellbeing programs, Tertiary Education Sponsorship and Support.
• We have a diverse and connected work environment where your contribution and ideas will be valued and respected and make a real difference to the lives of others.