Senior Claims Optimisation Consultant

Posted 3 Days Ago
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Sydney, New South Wales
Hybrid
Mid level
Fintech • Information Technology • Insurance • Financial Services • Big Data Analytics
At MetLife, we’re a purpose-driven company that helps our customers build a more confident future.
The Role
The Senior Claims Optimisation Consultant will manage claims capabilities, support operational efficiencies, coach associates, assess complex claims, and lead continuous improvement initiatives. Responsibilities include developing training, maintaining standard operating procedures, and collaborating with stakeholders to enhance claims processes.
Summary Generated by Built In

Description and Requirements
To drive operational efficiencies by managing claims capabilities within the MetLife Claims Customer Experience team and support claims optimisation through continuous improvement initiatives aligning to MetLife's strategy.
Principle Responsibilities:

  • Proactively manage claims capability end to end; including the coaching and mentoring of claim associates through the Claim Accreditation Programme and onboarding
  • Review complex claims as the business requires to recommend and implement claim resolution aligned to IDII and duration management principles; including coaching claim associates, adhering to claims philosophies, SLAs and other core claims metrics
  • Manage and assess MetLife staff claims
  • Adhere to all claim risk management frameworks and requirements e.g. LICOP, Privacy Policies and Financial Services Laws
  • Keep updated with product changes across the business to develop and facilitate product training to claims department
  • Support the preparation and proactively manage tender activity for claims
  • Identify and lead continuous improvement opportunities to create claims efficiencies
  • Support development and implementation of digital initiatives in line with MetLife and Enterprise Transformation priorities, including System Integration Testing (SIT) and On and Off Platform processes and analysis
  • Support the development of training content
  • Develop and deliver communications to the business following digital releases/enhancements
  • Develop and maintain relevant standard operating procedures and claim tools e.g. MIP procedure guides, calculators, eligibility rules engine
  • Recognise and prioritise responsibilities in accordance with business needs and ability to work in an agile environment
  • Work collaboratively with external and internal stakeholders to drive claims optimisation


Knowledge/Skills/Competencies Required:

  • Work with minimal supervision
  • Knowledge of business strategy and claims philosophies, products and regulatory changes
  • Be a committed team player who openly communicates and shares knowledge
  • Excellent time management and ability to prioritise work at all times
  • Can work under pressure in an evolving environment
  • Ability to adapt to and embrace change
  • Strong stakeholder management experience
  • Excellent computing skills and literacy
  • Excellent communication skills, both written and verbal
  • Ability to manage change


Qualifications/Experience Required:

  • Certifications in Lean, Six Sigma, or related continuous improvement methodologies are advantageous.
  • Minimum 3-5 years experience in managing and assessing a claims portfolio and claims technical role (preferred)
  • Experience coaching in claims
  • Desirable knowledge across all product lines e.g. Death, Income Protection, TPD, Trauma and Terminal Illness and lines of business e.g. Retail, Corporate and Group.
  • Demonstrated understanding of process efficiency and capability to develop processes and procedures
  • Strong understanding and working knowledge of applicable regulatory, legislative and Compliance frameworks
  • Understanding key data with the ability to analyse and drive insights
  • Experience and successful achievements in defining, optimising and redesigning business processes
  • Skills and experience working on projects and using agile ways of working


Benefits We Offer
When you join MetLife Australia, you are joining a company that demonstrates holistic care and wellbeing for employees with benefits and programs that address physical, mental, social and financial health. We offer life insurance benefits, generous paid parental leave, market leading menopause and fertility leave, car leasing and more. As well as Employee Assistance Program (EAP), access to 360Health medical support, volunteer leave and study assistance.
About MetLife
Recognised on Fortune magazine's list of the 2024 "World's Most Admired Companies", Fortune World's 25 Best Workplaces™ for 2024, as well as the Diversity Council of Australia Inclusive Employer Award 2023-2024, MetLife , through its subsidiaries and affiliates, is one of the world's leading financial services companies; providing insurance, annuities, employee benefits and asset management to individual and institutional customers. With operations in more than 40 markets, we hold leading positions in the United States, Latin America, Asia, Europe, and the Middle East.
Our purpose is simple - to help our colleagues, customers, communities, and the world at large create a more confident future. United by p urpose and guided by empathy, we're inspired to transform the next century in financial services.
At MetLife, it's #AllTogetherPossible . Join us!
#BI-Hybrid

What the Team is Saying

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The Company
HQ: New York, NY
43,000 Employees
Hybrid Workplace
Year Founded: 1868

What We Do

Named one of Fortune’s “World’s Most Admired Companies,” MetLife is leading the global transformation of an industry we’ve defined for more than 150 years. At MetLife, every innovation and line of code is a lifeline for our customers and their families—from victims of natural disasters to people living with disabilities and beyond.  With operations in more than 40 markets and leading positions across the globe, MetLife’s building a workforce of diverse and empowered voices that all belong.  Join our remarkable journey—one in which you help write the next century of innovation in financial services—because with MetLife, making the world a better place is All Together Possible.

Why Work With Us

At MetLife, you’ll be working for a company whose purpose is to help customers throughout their life’s journey, and often in their most critical time of need. You’ll be a part of developing leading-edge platforms that will have a lasting impact on the lives and well-being of tens of millions of customers.

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