Claims Specialist – Accident & Health
QBE Insurance
full-time
Posted on:
Location Type: Hybrid
Location: Marblehead • Massachusetts • United States
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Salary
💰 $76,000 - $125,500 per year
Job Level
About the role
- Provide exceptional claims service to customers by managing complex medical stop loss claims effectively
- Assess policy coverage, investigate, evaluate, and negotiate claims
- Collaborate with suppliers and stakeholders while offering technical support
- 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
Requirements
- Moderate relevant experience
- Experience in an Accident & Health claims department or the insurance industry preferred
- Experience handling Medical Stop Loss claims preferred
- Tertiary Degree or equivalent combination of education and work experience necessary
- Relevant insurance qualifications necessary
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
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
claims managementpolicy assessmentclaims negotiationclaims evaluationmedical stop loss claimsreportingstrategy implementationcost minimizationissue resolution
Soft Skills
customer servicecollaborationcommunicationmentoringcoachingrelationship management
Certifications
insurance qualificationstertiary degree