AVP - Claims
Core
Review, evaluate, negotiate, and resolve complex claims; provide technical leadership; identify and investigate fraudulent claims; manage team members and external stakeholders.
Role type
Senior Individual Contributor (Claims) with team management responsibilities
Builds
Resolved claims and managed recovery processes for Accident & Health, Commercial Packages, and Personal Packages
Domain
Insurance / Claims Management
Required skills
Claims adjudication, fraud investigation, team management, stakeholder negotiation, legal case handling, claims process improvement, vendor management, report preparation, regulatory compliance
Preferred skills
Professional insurance qualification (ANZIIF, ACII), legal knowledge, claims process improvement expertise
Technologies
PC applications
Responsibilities
Review and resolve claims within designated authority; Provide technical leadership on claims matters; Identify and investigate suspicious or fraudulent claims; Support Line Manager in team management and mentoring; Manage customer and intermediary interactions; Coordinate with suppliers, vendors, and legal counsel; Supervise Third Party Claims Administrators; Engage with stakeholders to support business strategy; Conduct internal reviews of claim files and monitor recoveries; Prepare reports and analyses; Ensure compliance with legal and regulatory requirements
Seniority
Senior, hands-on IC with team management