Business-minded professional with exemplary skills in customer service, time management and effective decision making. Bringing a together years of related experience combined with superior stakeholder relation and client relationship management abilities. Currently pursuing a change of career into an industry that can utilize current skillsets and experience to aid in achieving team goals.
Work History
Group Claims Assessor
2 Years 4 Months
AIA | 12.2021 - 04.2024
IP,TPD, MI & Death Claims Assessment - Portfolio of 50-70 Claims
Relationship management between Fund Managers, Trustee and internal governance, quality and legal teams
Outcome focused claims assessment
Return to Work Assessment, Plans and Outcomes
Independent Medical Requests
RTW Program Referral's
Effective written communication inclusive of Final Decision documents, Medical Report requests from treater, employers and third party stakeholders
Extensive knowledge of the Life Insurance Code of Practice & effective management of claims in accordance to the code
Transparent and empathetic stakeholder communication
Effective claims strategy in accordance to individual policy
Project involvement outside of BAU for digital platform improvement for claims
Consultation with end users for adequate feedback
Project OSS considerations - process improvement focus project.
Streamlined the claims assessment process for increased efficiency through the development of standardized templates and checklists.
Examined claims forms and other records to determine insurance coverage.
Escalated complex claims to senior management for further review, ensuring a collaborative approach to decision-making and fair outcomes.
Retail IP Claims Case Manager
1 Year 4 Months
AMP/Resolution Life | 08.2020 - 12.2021
Complex End to End Income Protection, Death & TPD Claims Assessment
Return to work focus outcomes
Engagement with Rehabilitation services
Stakeholder engagement (external & internal), relationship with claimant advisors/brokers.
Contract Role
4 Months
TAL | 04.2020 - 08.2020
Assisting both Claims Case Manager Team & Claims Service Consultants
Floating across 2 teams
Claims Management, End to end assessment of claims, approval of small benefit claims
Inbound and Outbound Claims related queries.
Self Employer/Partner
7 Years
Day N Nite Pty Ltd | 03.2013 - 03.2020
Proved successful working within tight deadlines and a fast-paced environment.
Demonstrated strong organizational and time management skills while managing multiple projects.
Assisted with day-to-day operations, working efficiently and productively with all team members.
Small Festival Operations
Staffing/Workforce Planning
Payroll
Project Co-Ordination from Initiation, Planning to Execution
Event budgeting
Brand Partnership relations
Venue prospecting
Social Media Adverts/Ticketing
Claims Case Manager (Direct)
3 Years 3 Months
TAL | 08.2015 - 11.2018
Achieving team KPI's & meeting timeframes for assessments, follow up and ongoing assessments for claims
Initial Claims Assessment using CAP plan structure
Data Integrity within CRM (Fineos)
Direct Life Insurance - Death, Income Protection, Permanent Disability
Understanding underwriting
In depth knowledge of insurance products and versions
Phone contact with Claimant (Life, IP, PD)
Managing Claimant Expectations
Financial Assessments for Income Protection Claims
Understanding of Life Insurance Code of Conduct and timeframes
Working with other stakeholders to achieve claim decision in appropriate timeframes
Writing all ongoing correspondence, Acceptance & Decline Letters
Engaging internal and external medical providers, document providers and rehabilitation specialists when needed.
Claims Officer
1 Year 3 Months
TAL | 05.2014 - 08.2015
First Point of contact for insurance claimants for funeral insurance, income protection, life insurance, involuntary un-employment and permanent disability claims
Initial Triage of claimants
Initial Assessment of basic claim requirements
Handling of inbound claims enquires for claimants, potential claimants and internal stakeholders wishing to know more re: policy documents
Understanding of policy documents, including different brands rules and regulatory requirements
Delivery of both positive and negative outcomes to claimants at initial point of contact
Assisting with Decline letters for IU Claims
Understanding of grief cycle and making speech adjustments to manage the phone call
Fineos Project Involvement (CRM) system
Change Champion during the migration into Fineos System
Team SME/Training.
Insurance Sales
1 Year 8 Months
TAL DIRECT (InsuranceLine) | 09.2012 - 05.2014
Trained in all underwritten products (IPP2 & LIP)
Trained in GA products (FP3 & ADP)
Outbound calls
Warm leads team
KPI's for both talk time, commission and lead usage.
Director/Partner
11 Months
Results Marketing Group Pty Ltd | 10.2011 - 09.2012
Seminar sales (B2B / small business & Corporate Sales)
Present Social Media Seminar for small business.
Skills
Research and due diligence
Collaboration and Teamwork
Relationship Building
Empathetic goal orientated Return to Work outcomes
Decision-making capabilities
Time Management
Stakeholder communications
Collaborative mindset
Statement
I aim to share with my new employer a strong skillset in stakeholder communication and management, outcome driven problem solving and critical decision making.
Whilst my experience is mainly in the Life Insurance industry I believe that the skillsets learnt with years of being mentored, vision for process improvement and being able to adapt, be agile to the shifting demands of governance, risk and ultimately constantly changing circumstances be translated into effective project and relationship based roles within a broad range of industries.
My aim is to join an employer who can not only hone in on my current skillset but also work with me in developing alternate skills that will allow me to adapt, grow and set up a long term working relationship with my team and brand.
I'm of the belief that long term partnerships, trust in the process and willingness to make small changes for process improving can ultimately lead to long term growth and meeting forever changing business needs.
Certification
Cert IV in Work Health & Safety - Chisholm Institute - Enrolled to commence 5/05/2024 (online completion 6 months)
RG146 Compliance - Completed at Kaplan Institute via TAL (Employer) 2013
Currently completing Certificate IV Life Insurance ANZIFF
Sr. Vice President – CMAX Claims Technology and CMAX Claims Group at A360incSr. Vice President – CMAX Claims Technology and CMAX Claims Group at A360inc