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GSSC Claims Officer

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QBE Insurance

Jan 31

  • Job
    Full-time
    Entry Level
  • Customer Relations
  • Cebu City
  • Quick Apply

AI generated summary

  • You need a Bachelor’s degree or equivalent experience, strong customer service and communication skills, proficiency in MS tools, and basic knowledge of insurance and case management.
  • You will manage claims end to end, ensure compliance, communicate with customers and suppliers, assess policy coverage, identify fraud, and optimize claims processing and recovery opportunities.

Requirements

  • Required Education
  • • Bachelor's Degree or equivalent combination of education and work experience
  • Required Experience
  • • NA
  • Preferred Competencies/Skills
  • • Customer service skills
  • • Proficiency in MS tools
  • • Analytical and negotiation skills
  • • Excellent verbal and written communication skills (English)
  • • Preferably with Case Management Skills
  • Preferred Knowledge
  • • Preferred Basic Knowledge of Insurance
  • • Basic Knowledge of Customer Service

Responsibilities

  • Manage claims end to end within parameters of claims manual, DTPs, GSSC policies and relevant legislation and regulations.
  • Ensure compliance within delegated authority limits
  • Maintain effective and proactive communication with customers
  • Ensure effective coordination with suppliers
  • Set possible cost of claim and updates on time as reports are sent through by assessors
  • Raises payment within delegations of authority
  • Interpreting policy coverage and determining if coverage's apply to claims submitted. Promptly informing customer of acceptance/ decline of claim and escalating issues or proper endorsement as needed.
  • Decide on the best fulfillment method to settle claim.
  • Identify suspicious or potentially fraudulent claims in accordance with QBE fraud indicators. Refer these claims to the Fraud Investigations team.
  • Identify recovery opportunities on claims
  • Provide information and feedback on claims activity and developing trends to underwriters/risk assessors to enable appropriate actions to be carried out
  • Provide feedback to the underwriting team for details that need to be flagged/ noted in the policy that is relevant upon renewal.
  • Complete uploading and allocation activities to triage documents and claims to the relevant teams (Claims settlements)
  • Utilize appropriate settlement strategies and tactics for the best commercial outcomes by achieving KPI target (Claims settlements)
  • Review claim documents to identify cases where liability is disputed for triage to the appropriate claims officers (Claims settlements)
  • Seeking continuous process, policy and procedure improvement alongside keeping up to date with current and new compliance requirements (Claims settlements)

FAQs

What is the primary responsibility of a GSSC Claims Officer?

The primary responsibility of a GSSC Claims Officer is to manage claims end to end, which includes making decisions on claim outcomes, declining claims, communicating with customers, coordinating with suppliers, raising payments to suppliers, and finalizing claims while ensuring compliance with SLAs and relevant regulations.

What educational qualifications are required for this role?

A Bachelor's Degree or an equivalent combination of education and work experience is required for this role.

Is prior experience in claims management necessary for this position?

No, previous experience is not specifically required for this position.

What skills are preferred for a GSSC Claims Officer?

Preferred skills include customer service skills, proficiency in MS tools, analytical and negotiation skills, and excellent verbal and written communication skills in English.

Are there any specific competencies required for this job?

Yes, candidates should possess skills in analytical thinking, collaboration, critical thinking, process compliance, risk management, and stakeholder management among others.

How does QBE ensure compliance with equal employment opportunity legislation?

QBE is committed to being an equal opportunity employer and adheres to equal employment opportunity legislation in each jurisdiction it operates.

What is QBE's stance on continuous improvement for claims processes?

QBE encourages continuous process, policy, and procedure improvement and expects employees to stay updated with current and new compliance requirements.

Are employees expected to adhere to a code of conduct at QBE?

Yes, all employees are expected to adhere to QBE’s Code of Ethics and Conduct and apply sound risk management practices.

What are the key performance indicators (KPIs) associated with this role?

Employees in this role are expected to achieve KPI targets related to claims settlements and effective claim management.

How can candidates apply for the GSSC Claims Officer position?

Candidates can apply by clicking "Apply" and following the step-by-step process outlined on the application portal.

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QBE Insurance

Finance
Industry
10,001+
Employees
1886
Founded Year

Mission & Purpose

QBE is an international insurer and reinsurer listed on the Australian Securities Exchange and headquartered in Sydney. We employ around 13,000 people in 27 countries. Leveraging our deep expertise and insights, QBE offers commercial, personal and specialty products and risk management solutions to help people and businesses manage risks, build strength and embrace change to their advantage.