Claims Assessor | Complex Claims

If you enjoy the assessment side of claims more than simply moving a file through a process, keep reading..
Ensure Recruitment is partnering with a major Australian organisation as it expands a specialist claims function and builds a new permanent team in Canberra.

For Canberra claims professionals, there is strong crossover from statutory claims, government compensation, Workers Compensation, eligibility, liability and other complex claims environments.
The legislation and framework may be different. The thinking behind the work will feel familiar.

The work You will manage a portfolio of complex claims with a strong focus on invalidity, medical evidence, capacity and eligibility.

A typical matter may require you to understand the customer’s circumstances, assess medical and employment evidence, identify what information is missing, investigate further, interpret relevant provisions, form a view and clearly explain the outcome.

The job:

• Manage complex claims from assessment through to outcome
• Review medical, employment and supporting evidence
• Assess capacity, invalidity and eligibility issues
• Identify gaps and obtain further information
• Interpret relevant legislation, policy or scheme provisions
• Prepare clear, well-reasoned written decisions
• Communicate directly with customers and representatives
• Manage sensitive physical and psychological claims
• Work across complex customer circumstances, including death and financial hardship matters

This is not purely back-office assessment. You will maintain direct ownership of your matters and communicate with customers and their representatives throughout the claims journey.

Who could be a strong fit? We are interested in people from backgrounds including:
Statutory Claims | Government Compensation | Workers Compensation | Eligibility | Liability | Claims Assessment |Complex Case Management

What translates particularly well is:

• Complex case ownership
• Medical and supporting evidence assessment
• Eligibility or liability decision-making
• Legislation, policy or scheme interpretation
• Written determinations
• Strong judgement
• Difficult or sensitive customer conversations

If you enjoy evidence, legislation, judgement and decision writing but want a fresh technical environment, there is strong crossover into this role.

The Team
This is expansion hiring, rather than simply replacing 1 departing employee.
You will join a growing case management function supported by experienced Team Leaders and Senior Case Managers.

What is on offer?

• Permanent full-time employment
• Salary up to $100K
• Approx. 40–50 active matters
• 100% WFH flexibility
• Canberra office access if preferred
• Structured learning and technical development
• Senior Case Manager and Team Leader support
• Internal progression opportunities
• New starter cohorts planned across October and November

Australian citizenship is mandatory due to security and pre-employment screening requirements.

If you have built your career around complex claims, evidence assessment or eligibility decisions and want a fresh technical challenge, this is well worth a conversation.

Apply today or contact Kurt at Ensure for a confidential discussion: [email protected]