Claims Case Manager | Complex Claims
- Manage a portfolio of 40–50 active claims matters.
- Assess medical and employment evidence to reach outcomes.
- Support customers through complex and sensitive situations.
Claims Case Manager | Complex Claims
01-9-26 Melbourne / Permanent
Looking for a claims role with more substance?
We are partnering with a major Australian organisation as it expands a Specialist claims function, bringing a new permanent cohort of Case Managers into the Melbourne team.
This is not a high-volume transactional claims role.
You will manage a portfolio of approximately 40–50 active matters, working through medical and employment evidence, invalidity, capacity, eligibility and complex customer circumstances before reaching a considered outcome.
What you will actually do:
- Own matters from initial consultation through assessment and outcome
- Review medical, employment and supporting evidence
- Identify gaps and obtain further information
- Assess eligibility against relevant provisions
- Work through complex invalidity and capacity matters
- Manage physical and psychological claims
- Prepare clear, well-reasoned written decisions
- Communicate directly with customers, representatives and families
- Support people through significant changes in health, career and personal circumstances
There is a genuine technical and judgement component to the role, balanced with the human side of supporting people through complex and often sensitive situations.
Coming from another claims environment? That is absolutely fine!
We are interested in people from a range of backgrounds including:
Workers Compensation | DVA | Comcare | Life Claims | Eligibility | Liability | Statutory Claims | Complex Case Management
Alongside your previous claims experience, what matters is that you can demonstrate:
- Genuine ownership of complex claims or cases
- Strong evidence assessment
- Eligibility or liability decision-making
- Clear written communication
- Confidence working with vulnerable customers
- Sound judgement in a regulated environment
- The ability to manage complexity rather than simply follow process
Why this role is worth considering
- Permanent full-time opportunity
- Approx. 40–50 active matters
- Strong working-from-home flexibility
- Structured technical onboarding and development
- Around 6 months targeted to competency
- Support from Senior Case Managers and Team Leaders
- Longer-term pathways across senior, technical and leadership roles
- New starter cohorts planned across October and November
Australian citizenship is mandatory due to security and pre-employment screening requirements.
If you have solid claims or complex case management experience and want something more technical, specialised and genuinely different from your current environment, this is worth a conversation.
Apply now or contact Kurt at Ensure Recruitment for a confidential discussion : k.ringland@ensurerecruitment.com.au
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