Claims Case Manager

• Posting Location: Sydney, New South Wales

• Posting Location: Melbourne, Victoria

• Posting Location: Brisbane Adelaide Street, Queensland

We’re looking for experienced and motivated Case Managers to join us at a pivotal time in our digital transformation journey. In this role, you’ll manage a portfolio of complex life insurance claims – primarily across Group but Retail experience is also highly valued. You’ll be empowered to use your technical skills to assess claims in line with policy intent, while supporting customers through critical life moments with empathy and professionalism. This is a great opportunity to be a part of a team that’s modernising the way we deliver claims, placing customer outcomes, efficiency and integrity at the centre of everything we do.

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  Technical expertise: Proactively manage and assess a portfolio of claims end to end, develop, recommend and implement case management strategies to drive sustainable outcomes and consumer expectations adhering to the policy definitions, philosophies, risk management meeting SLAs and other core claims metrics (includes claims handling requirements around claim strategy, financial, medical and eligibility assessments). With a strong digital focus, you’ll use our claims platform and tools to support high-quality, efficient assessments.
• Customer experience and communication: Proven ability to communicate professionally claims decisions and updates written and verbal (include strong telephony standards). Deliver a consistently high standard of service by communicating with empathy, clarity, and professionalism. You’ll provide timely updates, transparent decisions, and personalised support, ensuring members feel informed and cared for throughout their claims journey. Your communication style will support our customer-first values while meeting both compliance and service expectations.
• Delegation of Authority (DA): Currently holds a DA with consistent pass QA outcomes in their portfolio
• Risk management: drives and adheres to all claims related regulatory and compliance requirements eg LICOP timeframes and set MetLife SLA decision timeframes. Recognise, categorise and prioritise claims in accordance with business needs and Fund partner expectations
• Collaboration/culture: Work collaboratively with all stakeholders (internal and external) to establish and maintain relationships with Claimants, Financial Advisers, Distribution as applicable as well as drive an inclusive workplace culture (strong team player)
  • Time management: proven time management skills with demonstrated ability to prioritise work in a changing environment
  • Continuous improvement: Identify opportunities to improve how we assess and manage claims, whether through streamlining processes, clarifying communications, or leveraging system capabilities. You’ll work with your leader to share these ideas, contributing to our broader goal of enhancing both the customer and case manager experience.

• Experience managing life insurance claims, ideally with 3+ years’ experience within a Group Insurance environment (TPD, IP, Death).
• Work with minimal supervision and currently holds a DA across all Group product lines (can prove current DA held).
• Sound understanding of relevant legislation, policy definitions, and the claims assessment process.
• Proven ability to interpret complex information and make evidence-based, defensible decisions.
• Strong communication skills, with the ability to explain outcomes clearly and support customers with empathy.
• Comfortable working with digital systems and open to adapting to new technology and ways of working.
• A collaborative team player who contributes positively to team culture and supports shared goals
• Demonstrated resilience and adaptability when managing complex cases, competing priorities , and change.
• Tertiary qualifications in a relevant field (e.g., allied health, legal, business, insurance) are desirable but not essential.

• End to end management of life insurance claims (TPD, IP and Death), ensuring assessments align with policy terms, claims philosophy and risk frameworks.
• Completion of MetLife Claims Accreditation Program to attain DA within 3 months of employment commencement with MetLife.
• Quality decisions supported by sound analysis of medical, vocational, and financial information.
• Customer-first outcomes by balancing empathy, compliance, and commercial considerations.
• Strong adherence to service level agreements (SLAs), quality standards, and customer satisfaction (CSAT) measures.
• Effective written and verbal communication that clearly outlines the decision rationale and next steps.
• Positive engagement with internal and external stakeholders, including medical providers, trustees, and reinsurers.
Active contribution to a team environment that values professionalism, accountability, and continuous improvement.