Job Summary
This senior technical and operational role is responsible for the end‐to‐end management of Accident & Health claims in Australia. The incumbent will ensure the delivery of high‐quality claims services, maintain operational efficiency and support the Vice President in strategic oversight of the claims function, including management of Third‐Party Claims Administrators (TPAs).
Job Duties and Responsibilities
Claims Management
Review, evaluate, negotiate and resolve claims within designated authority levels, in accordance with established standards, procedures and regulatory requirements.
Conduct thorough investigations into suspicious or potentially fraudulent claims, implementing appropriate actions and maintaining timely communication with stakeholders.
Perform periodic internal audits of claim files and actively monitor outstanding recoveries to ensure financial accuracy and accountability.
Technical Leadership
Provide authoritative technical guidance on complex claims matters to internal teams and external stakeholders.
Demonstrate sound judgment and independent decision‐making on high‐complexity, legally sensitive cases.
Support continuous improvement initiatives within the claims process to enhance efficiency and service quality.
Stakeholder & Relationship Management
Manage all customer and intermediary interactions with professionalism and efficiency, ensuring a consistently high standard of customer satisfaction.
Handle complaints and oversee the internal dispute resolution process in compliance with the Corporations Act, ASIC Regulatory Guide 271, the General Insurance Code of Practice and other applicable regulatory requirements.
Engage proactively with internal and external stakeholders to support delivery of broader business strategies and objectives.




Promote claims services and contribute to business development through client and intermediary meetings.
Vendor & Third‐Party Management
Coordinate with approved suppliers, vendors and legal counsel to ensure the timely and appropriate delivery of services to customers.
Supervise and manage supplier, vendor and legal counsel expenditure, as well as the performance of Third‐Party Claims Administrators (TPAs).
Demonstrate proven capability in selecting, engaging, and evaluating legal counsel and independent experts.
Support the Vice President in day‐to‐day team management, including training, mentoring and professional development of team members.
Foster a collaborative, high‐performance team culture aligned with the company's values and service standards.
Reporting & Compliance
Prepare reports, data analyses and management information as required.
Ensure strict adherence to all applicable legal, regulatory and internal policy requirements.
Undertake additional duties and responsibilities as reasonably required by the business.
Knowledge, Skills & Qualifications
Qualifications & Experience
Relevant tertiary qualifications in insurance, law, business or a related discipline.
7–10 years of progressive claims experience, with demonstrated team management experience in Accident & Health or a related line of business preferred.
Professional insurance designation (ANZIIF, ACII or equivalent)



preferred or actively in progress.
Demonstrate knowledge and experience in adhering to local licensing, regulatory and complaints‐handling requirements.
Proven ability to independently manage complex and legally sensitive claims with strong analytical, negotiation and decision‐making skills.
Sound knowledge of legal principles and claims litigation processes.
Experience in claims process improvement and operational efficiency initiatives.
Proficiency in relevant PC applications and claims management systems.
Interpersonal & Leadership Skills
Strong leadership, communication and organizational capabilities.
Effective collaborator with the ability to engage confidently with senior management, clients and external partners.
Customer‐centric mindset with a commitment to service excellence.
Self‐motivated and capable of managing a diverse and demanding claims portfolio independently.
Strong professional communication skills, both written and verbal, are essential.
Benefits
Instant membership in the Allied World, a global network of colleagues who will support your career journey
A manager who will help you build your career through a structured coaching program
Access to a full suite of learning and development tools and resources
Allied World is an equal prospect employer. Subject to applicable law, all qualified applicants will be considered for employment without regard to race, color, religion or belief, gender, age, disability, military service, marital or civil partnership status, family status, sexual orientation, ethnic or national origin, genetic information or any other characteristic protected by applicable law or regulation in the relevant jurisdiction where we operate.
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📌 Avp, Asia Pacific Claims Group (Sydney)
🏢 @
📍 Sydney