Aps5 Claims

**About the Organization**:
This leading Federal government agency supports Australian’s in achieving their goals and helps them to live a better life. Their work has an impact on a significant area in the social sector, and you can contribute to the difference that they make in this role. This agency is known for having a great culture across different teams and have excellent office location in Richmond.

**About the Team and Role**:
**The Claims and Payments Integrity section comprises of two teams**:
**The Claims and Payments Assurance Team** is responsible for payments assurance control testing for the Provider Payment Correctness (PPC) and Self-Managed Participant Payments (SMP) Programs. It is also responsible for engaging with the Scheme Actuary Group to request the payments sample (Primary Program) and generate a statistical sample in SES (Secondary Program) to be assessed to return the outcome of the assurance activities for the purpose of determining the error rate, and to complete relevant surveys. The team is responsible for engaging with providers and participants to request information and supporting evidence to facilitate assurance activities of the sampled payments. I

**The Claims and Payments Integrity Team **is responsible for implementing detective and preventative measures that will reduce claims and payments error and improve compliance through performing a combination of manual validation checks and systematic risk & behavioural analytics. The team is responsible for engaging with providers, plan managers and participants to increase the testing and validation of claims and to also design and implement control measures that are preventative.

**The APS5 Claims & Payments Integrity Officer** is responsible for supporting the Agency in its participation at all levels of government. The work will be varied, fast-paced, and highly valued. You will be responsible for managing complex works under the supervision of the manager.

Responsibilities may include but are not limited to:

- Undertake control and conformance testing and providing administrative support for the PPC and SMP Programs
- Provide input to appropriate assurance and compliance reports to articulate outcomes of reviews and actions required including delivering compliance decisions to participants and providers
- Modify test documentation (Test Guides and Test Forms) to ensure assurance program relevancy.
- Undertake reviews of targeted claims through engagement with providers, plan managers and participants.
- Contribute to the design of new detective and preventative controls using a combination of manual validation check and systematic analytics
- Work with various teams to investigate, report on and escalate claims and payments anomalies

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**MANDATORY**
- Experience working in a similar role under Australian rules and regulations
- Excellent written and oral communication skills, and proficiency in the use of IT systems including Microsoft Office
- Demonstrated commitment to ongoing professional development
- Current Police Check, o ability to obtain one

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**What you will bring to the role**:

- Strong communication and interpersonal skills.
- Experience in building relationships both with internal and external stakeholders.
- Ability to work within and across teams, the ability to adapt quickly to a changing environment
- Ability to manage confidential and sensitive information.
- Ability to prioritise and allocate tasks in an efficient manner while also maintaining high work standards and accuracy.

**How to apply**:
**Mandatory: Australian Citizenship required to work within Federal Government.**

**Applications close 15.00 PM AEST, 15th March 2023