Hospital Claims Specialist
3 weeks ago
Doctors' Health Fund is a leading provider of private health insurance exclusively for the medical community across Australia. As part of the Avant Mutual Group, we proudly support over 70,000 healthcare professionals, students, and their families. Our commitment to members is at the heart of everything we do - driven by our values, mission, and people-first culture.
About the RoleWe are seeking a Hospital Claims Specialist to join our Claims & Business Operations team. In this role, you will be responsible for accurately assessing and processing hospital claims in line with Doctors Health Fund rules, policies and procedures while delivering exceptional service to our members, providers, and third-party organisations. This role involves some inbound and outbound phone contact, providing clear and timely communication, and identifying opportunities to improve processes. You will play a key part in ensuring service expectations are consistently met in a high-volume environment.
Key Accountabilities- Accurately assess claims in accordance with Doctors Health Fund Rules, policies, procedures, and legislative requirements, within service level agreements.
- Handle inbound and outbound calls, ensuring timely, accurate and professional communication with members, providers, and third parties.
- Maintain comprehensive knowledge of systems and products.
- Deliver clear, professional, and respectful written and verbal communication with internal and external stakeholders.
- Work towards individual and team KPIs, take ownership of outcomes, and share knowledge with peers to drive success.
- Ensure adherence to privacy, APRA, PHI Act, and WH&S requirements.
- Support staff development by creating training materials, delivering training sessions and maintaining accurate training records.
- 3+ years experience in same/similar Senior Hospital Claims Assessor role.
- HSC or equivalent preferred.
- Customer service background.
- Insurance or health industry experience.
- Data entry and administrative experience.
- Strong decision-making and problem-solving ability.
- Excellent written and verbal communication.
- High attention to detail with strong organisational skills.
- Proficiency in computer systems and ability to adapt to new technology.
- The ability to work collaboratively and contribute as a strong team player.
- Results-driven mindset.
Avant supports doctors so they can serve Australia\'s diverse communities. Having diversity in our workforce brings valuable perspectives and strengthens our ability to support healthcare professionals. We therefore welcome applications from people of all backgrounds, including Aboriginal and Torres Strait Islander peoples, people from culturally diverse communities, LGBTQIA+ individuals, people with disabilities, and those with caring responsibilities. Our inclusive workplace is somewhere everyone can succeed.
Ready to join us?If you\'re passionate about supporting Australia\'s healthcare professionals, we\'d love to hear from you. If you require any adjustments during the recruitment process, please don\'t hesitate to contact us at careers@avant.org.au
#J-18808-Ljbffr
-
Hospital Claims Specialist
3 weeks ago
Sydney, New South Wales, Australia Avant Mutual Full timeAbout Doctors Health FundDoctors' Health Fund is a leading provider of private health insurance exclusively for the medical community across Australia. As part of the Avant Mutual Group, we proudly support over 70,000 healthcare professionals, students, and their families. Our commitment to members is at the heart of everything we do - driven by our values,...
-
Hospital Claims Specialist
2 weeks ago
Sydney, New South Wales, Australia Avant Mutual Full timeAbout Doctors Health FundDoctors' Health Fund is a leading provider of private health insurance exclusively for the medical community across Australia.As part of the Avant Mutual Group, we proudly support over 70,000 healthcare professionals, students, and their families.Our commitment to members is at the heart of everything we do - driven by our values,...
-
Motor Claims Administration
2 weeks ago
Sydney, New South Wales, Australia Advent Claims Australia PL Full timeAdvent Claims Australia is a trusted **Third Party Authority (TPA)** representing one of the world's leading vehicle fleet organisations. As we enter an exciting growth phase, we are seeking a motivated and experienced **Motor Recovery / Settlements Specialist** to join our friendly, professional team in Sydney's CBD.**What We Offer**- Competitive...
-
Motor Claims Consultant
2 weeks ago
Sydney, New South Wales, Australia Advent Claims Australia PL Full time**About Us**Advent Claims Australia is a trusted **Third Party Authority (TPA)** representing one of the world's leading vehicle fleet organisations. As we enter an exciting growth phase, we are seeking a motivated and experienced **Motor Recovery / Settlements Specialist** to join our friendly, professional team in Sydney's CBD.**What We Offer**-...
-
Motor Claims Consultant
6 days ago
Sydney, New South Wales, Australia Advent Claims Australia PL Full time $537,777 - $8,914,163 per yearAbout UsAdvent Claims Australia is a trusted Third Party Authority (TPA) representing one of the world's leading vehicle fleet organisations. As we enter an exciting growth phase, we are seeking a motivated and experienced Motor Recovery / Settlements Specialist to join our friendly, professional team in Sydney's CBD.What We OfferCompetitive remuneration...
-
Medical Claims Recovery Specialist
2 weeks ago
Sydney, New South Wales, Australia beBeeMedicalClaimsRecovery Full time $90,000 - $120,000**Medical Claims Recovery Specialist Role Overview**">We are seeking a skilled Medical Claims Recovery Specialist to join our team. In this role, you will play a vital part in identifying and recovering lost revenue for healthcare providers through the meticulous review of medical claims.The ideal candidate will possess excellent analytical skills, with the...
-
Medical Claims Specialist
2 weeks ago
Sydney, New South Wales, Australia beBeeClaims Full time $60,000 - $97,000About the RoleThis is an exciting opportunity to join a team dedicated to delivering exceptional service to healthcare professionals and their families. As a Hospital Claims Specialist, you will play a vital role in assessing and processing hospital claims accurately and efficiently.Key Responsibilities:Assess claims in accordance with rules, policies,...
-
Claims Specialist
2 weeks ago
Sydney, New South Wales, Australia beBeeclaims Full time $90,000 - $130,000Claims SpecialistWe're seeking a skilled Claims Specialist to join our team. As a Claims Specialist, you'll be responsible for assessing and managing a portfolio of Retail Income Protection claims.Your primary objective will be to conduct thorough claim assessments, leveraging your understanding of relevant legislations and guidelines. You'll also have the...
-
Claims Specialist
1 week ago
Sydney, New South Wales, Australia beBeeClaims Full time $80,000 - $110,000Job Title: Claims SpecialistWe are seeking an experienced Claims Specialist to join our team in Sydney. As a Claims Specialist, you will use your skills and knowledge to resolve insurance claims and examine reported insurance losses to establish the cause, liability and quantum.Key Responsibilities:Resolve insurance claims and examine reported insurance...
-
Healthcare Claims Professional
2 weeks ago
Sydney, New South Wales, Australia beBeeClaims Full time $110,000 - $140,000About healthcare claims, we support professionals to serve diverse communities. Our commitment is at the heart of everything we do - driven by values, mission, and people-first culture.Role SummaryWe are seeking a Hospital Claims Specialist to join our Claims & Business Operations team. This role involves accurately assessing and processing hospital claims...
