AVP, Asia Pacific Claims Group
Core
Senior technical and operational role managing end-to-end Accident & Health claims in Australia, ensuring high-quality service delivery and operational efficiency.
Role type
Senior IC Claims Manager (Accident & Health)
Builds
High-quality claims services and operational efficiency for Accident & Health portfolio
Domain
Insurance (Accident & Health) in Australia
Deliverable
client delivery
Required skills
Claims management, fraud investigation, internal audits, technical guidance on complex claims, stakeholder management, vendor/TPA management, team leadership, regulatory compliance, legal principles knowledge, claims process improvement
Preferred skills
Professional insurance designation (ANZIIF, ACII), team management experience in Accident & Health, claims litigation experience
Technologies
Claims management systems
Responsibilities
Review, evaluate, negotiate, and resolve claims within authority levels; Conduct investigations into suspicious or fraudulent claims; Perform internal audits of claim files and monitor recoveries; Provide authoritative technical guidance on complex claims matters; Manage customer and intermediary interactions and oversee internal dispute resolution; Coordinate with vendors, suppliers, and legal counsel; Supervise Third Party Claims Administrators (TPAs); Support team management, training, and mentoring; Prepare reports and data analyses; Ensure adherence to legal, regulatory, and internal policy requirements