Aps5 Compliance Officer

3 weeks ago

Adelaide Region SA, Australia Chandler Macleod Full time

**Applications close by 10am Tuesday 20th of June 2023.**

**Mandatory: Australian Citizenship required to work within Federal Government**

**Our Federal Government client is seeking to engage in multiple**
**APS5 Compliance Officer (Claims and Payments Integrity)**
**for a 12-month fulltime assignment with potential extension in Adelaide CBD.**

**About the Team**

**The Claims and Payments Integrity section comprises of two teams**:
**The Claims and Payments Assurance Team** is responsible for payments assurance control testing for Self-Managed Participant (SMP), Plan Managed Agency (PMA) and Agency Managed Provider (AMP) payments. It is also responsible for engaging with the Analytics, Data and Actuarial (ADA) Division to develop the appropriate statistical sampling methodology for the purpose of generating payment samples to be assessed through assurance activities and to ultimately determine the error rate and estimated leakage of funds. The team is responsible for engaging with providers and participants to request information and supporting evidence to facilitate assurance activities of the sampled payments. It reports on outcomes of assurance activities and assists with remediation. It is also responsible for establishing and maintaining internal and external relationships to improve the payments control environment.

**The Claims and Payments Integrity Team** is responsible for implementing detective and preventative measures that will reduce claims and payments errors and improve compliance through performing a combination of manual validation checks and systematic risk and 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. It reports on outcomes of detective and preventative validation activities and assists with remediation. It is also responsible for establishing and maintaining internal and external relationships to improve the claims and payments control environment.

**About the Role**

**The APS5 Claims and Payments Integrity** is accountable under limited supervision to undertake moderately complex to complex work. Legislation, policies, procedures, standards, methodologies and precedents guide the position.

The position is a team membership position and is accountable for organising their workflow and making independent decisions relating to an area of responsibility. The position will be required to provide policy advice within an area of specialisation with advice based on policies and legislation.

The APS5 Claims and Payments Integrity will have a considerable level of contact with internal and external stakeholders and will be required to communicate with and provide advice on a range of matters to resolve moderately complex to complex enquiries.

**Additional Position Requirements**

**Key skills required for role**
- Excellent attention to detail
- Highly proficient written and verbal communication skills
- Strong business acumen
- Previous experience with project management frameworks and continuous improvement
- Stakeholder engagement, workload management, and team collaboration

**Desirable skills to have for the role**
- Experience in financial services
- Experience with ICT projects

**Responsibilities may include but are not limited to**:

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

(NOTE: the key responsibilities of the role are based on current priorities and may change over time)

It is highly desirable that the successful applicant understand or lived experience in the field of disability.

**What's on Offer?**

**- Position located in Adelaide**

**- APS5 $55.24/ph + super**

**- Temporary contract for 12 months, with possibility to extend**

**- Standard Hours or work - Monday to Friday, 8:30 am till 5:00 pm

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