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About the Role
We're looking for an experienced Advanced Case Management Consultant to join a specialist team responsible for managing complex, high-risk and sensitive claims. This role offers the opportunity to work across a diverse portfolio of cases, applying investigative thinking, sound judgment and strong technical expertise to achieve fair and balanced claim outcomes.
Responsibilities
- Manage an end-to-end portfolio of complex and high-risk claims, applying fraud and moral hazard indicators and assessment frameworks.
- Analyse claim information, identify inconsistencies and assess behavioural indicators and potential risks.
- Execute investigative activities and evidence-gathering strategies as directed.
- Liaise with Legal and other specialists on claims requiring formal investigation or technical guidance per approved frameworks.
- Build strong relationships with customers, advisers and key stakeholders.
- Prepare comprehensive, accurate and legally defensible case documentation and detailed case notes.
- Identify emerging risks and complex matters requiring escalation to senior technical expertise.
- Execute the adverse decision process diligently for appropriate claims.
- Deliver fair, professional and customer-focused claim outcomes.
- Contribute to continuous improvement initiatives and team learning activities.
Requirements
- Experience managing insurance claims, ideally within complex and high-risk claims environments.
- Strong end-to-end case management capability.
- Experience working with customers, advisers and key stakeholders in a professional manner.
- The ability to analyse information, identify risks and make informed recommendations.
- Excellent written and verbal communication skills, with the ability to document complex matters clearly.
- Strong organisation and documentation skills, with meticulous attention to detail.
- A commitment to quality, consistency, compliance and customer outcomes.
- Resilience, professionalism and a collaborative team approach.
- The ability to manage competing priorities in a fast-paced, regulated environment.
- Background checks (including Federal Police Checks, Employment checks, ASIC banned and disqualified persons and Bankruptcy checks) will be completed prior to the candidate's employment being confirmed.
Skills
- Investigative thinking
- Sound judgment
- Strong technical expertise
- Fraud and moral hazard indicators
- Behavioural indicators assessment
- Evidence-gathering strategies
- Risk management
- Decision-making
- Compliance
Experience Level
- Experienced
About the Company
- At Acenda Group, everything we do is driven by a clear purpose: to help our customers and their families live, save and retire with confidence.
- We bring together some of Australia and New Zealand’s most trusted life insurance brands. With over 176 years of combined heritage and deep expertise across our local markets, our Group includes Acenda Life, Resolution Life Australasia, and Asteron Life New Zealand.
- Backed by the global strength of Nippon Life, we are one of the largest life insurance businesses across Australia and New Zealand. More than two million customers rely on us for life insurance, wealth protection and retirement solutions that support their confidence at every stage of life.
- We’re building an inclusive, dynamic and future focused business. Joining us means stepping into a period of integration and growth, where your work will help shape our future.
- If you’re energised by change and motivated by purpose, this is your moment to make an impact.
Equal Opportunity
- We celebrate the diversity of our customers and community, and we embed diversity, equity, inclusion, and belonging into how we do business. We encourage applications from people of all backgrounds, cultures, experiences, and identities.