Claims Specialist - Accident & Health

QBE Insurance Group • Atlanta, GA

5d • $76,000 - $125,500 • Hybrid

About The Position

The purpose of this role is to provide exceptional claims service to customers by managing complex medical stop loss claims effectively. This includes assessing policy coverage, investigating, evaluating, and negotiating claims, as well as collaborating with suppliers and stakeholders while offering technical support.

Requirements

• Moderate relevant experience.
• Tertiary Degree or equivalent combination of education and work experience.
• Relevant insurance qualifications

Nice To Haves

• Experience in an Accident & Health claims department or the insurance industry.
• Experience handling Medical Stop Loss claims.

Responsibilities

• Support the implementation of the Claims strategy to enable the delivery of overall business targets.
• Maintain current knowledge of insurance guidelines, policy changes, and modifications.
• Maintain good client relationships with insured individuals, agents, service providers, and the general public.
• Provide claim management for various types of insurance claims.
• Identify and implement strategies to minimise Claims Costs and Leakage.
• Respond to client requests following service standards.
• Assist with the negotiation of claims settlements.
• Participate in relevant meetings to share and develop strategy, knowledge, and best practices.
• Identify and resolve issues or anomalies non-compliant with policies and procedures.
• Assist with the daily review of reports and ad hoc reporting.
• Mentor and coach junior staff as required.

Benefits

• Hybrid Working – a mix of working from home and in the office
• 22 weeks of paid leave for family growth, with 12 weeks available to all parents on a gender-equal basis
• Competitive 401(k) program with company match up to 8%
• Well-being program including holistic wellbeing coaching, gym membership, confidential counselling, financial and legal advice
• Tuition Reimbursement for professional certifications, and continuing education
• Employee Network and Community – QBE actively supports six Employee Networks, and many ways to give back to your community

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level