Claims Management Leader

We are seeking a talented individual to join our Operations and Risk team at Mercer Super. This role can be based in Sydney, Melbourne, Adelaide or Brisbane. This is a hybrid role that has a requirement of working at least three days a week in the office.

Claims Management Leader

Reporting to the Mercer Super Chief Operations Officer (COO), this position is responsible for leading the management and operation of the Mercer Super Claims Delegate team. The Claims Delegates make determinations on death claim distributions and review declined claim decisions from the insurers, to ensure the decisions are fair and reasonable, and challenge those decisions where considered necessary, in line with legislation.

Due to the importance of a robust insurance governance regulatory framework and regulatory and community expectations, the role requires an experienced senior manager to liaise with a number of high level internal and external stakeholders

We will count on you to:

Ensure adherence with the claims governance regulatory framework across Mercer Super
Report to the Trustee Office on governance related matters, including oversight of service providers
Be accountable for liaising with Line 1 and Line 2 Risk Compliance, internal audit and external auditors on claims matters as they relate to MSAL’s trustee obligations, ensuring that all queries are fully and adequately addressed. This includes monitoring and reporting on agreed controls.
Analysis and review comprehensive disability claims, including challenges to insurer decisions based on medical and policy interpretation matters where required, and ensuring correct application of ICA remedies by insurers and distribution of death benefits;
Identify any gaps or inconsistencies in insurer’s decisions and challenge insurer’s decisions where it is considered in the best financial interests of members;
Provide oversight of claims administration performance and member outcomes as it relates to claims.
Lead the quarterly reviews of all insurance manager reporting, considering matters such as compliance attestations, due diligence reviews and service level performance against metrics set out in the Insurance Service Agreements (ISA). Escalate any issues of concern to the Trustee Office and other stakeholders as relevant.
Act as people leader, mentor and/or coach to Claims Officers and Claims Delegates and relevant staff within Mercer Super (as agreed with the COO), monitoring workflow and quality of output, to deliver a high standard of work through on-the-job training and development.
What you need to have:

Minimum of 10 years’ relevant superannuation industry experience, including at least 5 years relevant experience in a financial services role with a group insurance focus.
Understanding and experience with claims management from a superannuation trustee perspective.
Understanding of Retail insurance products within a superannuation environment.
Excellent working knowledge of a trustee’s role and responsibilities, and the superannuation regulatory framework.
Excellent understanding of ASIC and community expectations in regard to claims handling
Detailed knowledge of claims management and assessment and understanding of superannuation and insurance legislation and current issues.
Highly organised, with the ability to manage a role involved in multiple projects and conflicting deadlines successfully, and with a particular emphasis on being able to apply project management techniques to do so.
Strong stakeholder management and negotiation skills.
Strong communication and influencing skills, with an ability to communicate both verbally and in writing, in a clear, effective and
Ability to build and maintain strong working relationships with external and internal stakeholders.
What makes you stand out:

Experience working within the Life Insurance industry
Why join our team:

We help you be your best through professional development opportunities, interesting work and supportive leaders
We foster a vibrant and inclusive culture where you can work with talented colleagues to create new solutions and have impact for colleagues, clients and communities
Our scale enables us to provide a range of career opportunities, as well as benefits and rewards to enhance your well-being

Mercer, a business of Marsh McLennan (NYSE: MMC), is a global leader in helping clients realize their investment objectives, shape the future of work and enhance health and retirement outcomes for their people. Marsh McLennan is a global leader in risk, strategy and people, advising clients in 130 countries across four businesses: Marsh, Guy Carpenter, Mercer and Oliver Wyman. With annual revenue of $24 billion and more than 90,000 colleagues, Marsh McLennan helps build the confidence to thrive through the power of perspective. For more information, visit mercer.com, or follow on LinkedIn and X.

Marsh McLennan is committed to creating a diverse, inclusive and flexible work environment. We aim to attract and retain the best people and embrace diversity of age, background, disability, ethnic origin, family duties, gender orientation or expression, marital status, nationality, parental status, personal or social status, political affiliation, race, religion and beliefs, sex/gender, sexual orientation or expression, skin color, or any other characteristic protected by applicable law.

Marsh McLennan is committed to hybrid work, which includes the flexibility of working remotely and the collaboration, connections and professional development benefits of working together in the office. All Marsh McLennan colleagues are expected to be in their local office or working onsite with clients at least three days per week. Office-based teams will identify at least one “anchor day” per week on which their full team will be together in person. Read more