Senior Technical Claims Specialist

Summary
Providing delivery of superior claims service, determining proper policy coverage to conclude,
investigate, evaluate and negotiate assigned cases

Primary Responsibilities

Strategy and Planning
. Identify and implement strategies to minimize Claims Cost and Leakage from the day to day
claims management
. Work with your National Claims Manager, Claims Specialist Team Leader or Technical Claims
Specialist, and Service Providers, to assess, respond and manage complex claims and CAT
events.

Policy, Process and Procedures
. Maintain current knowledge of insurance guidelines and policy changes and modifications
. Compliance with all legislation, industry codes and company policies

Environmental Awareness/Customer Focus
. Maintain good client relationships with the insured, agents, service providers and the general
public
. Provide assistance to claims specialists on matters outside of their individual skill sets
. Effective communication networks established with both internal and external stakeholders
. Respond to client requests in accordance with service standards
. Provide information and feedback on claims activity and developing trends to
NCM/underwriters/risk assessors to enable appropriate actions to be carried out

Technical Performance
. In accordance with Claims Manual and Fair Insurance Code determine policy response, lodge
claims, set reserves and authorise payments within scope of authority and settle claims in the
most cost-effective manner escalating issues as needed.
. Assist Claims Specialists with referrals on more complex matters including interpreting and
actioning legal and expert reports, coaching and training where skills gaps are identified
. Assist Claims Specialists with identification of suspicious or potentially fraudulent claims,
notifying the Claims Specialist Team Leader and guiding Claims Specialist with appointment of
investigator and briefing solicitors if further action is to be taken.

People Management
. Mentor staff as required by the business