Current jobs related to Healthcare Claims Evaluator - Adelaide, South Australia - Dental Corporation
-
Claims Assistant Manager
3 weeks ago
Adelaide, South Australia Avant mutua Full timeAbout the RoleAvant Mutual is seeking a skilled Claims Assistant Manager to join our Adelaide team in a permanent, part-time position (4 days per week). As a Claims Assistant Manager, you will provide support and advice to our members through managing Civil and Professional Conduct claims.This role is perfect for healthcare workers who are looking for better...
-
Senior Claims Manager
4 weeks ago
Adelaide, South Australia Employers Mutual Management Pty Ltd Full timeAbout the RoleEML is a leading provider of workers' compensation and personal injury claims management services. Our mission is to empower individuals to return to work and live fulfilling lives.We are seeking an experienced Senior Claims Manager to lead our team of Claims Specialists in Adelaide. As a key member of our leadership team, you will be...
-
Claims Management Professional
2 weeks ago
Adelaide, South Australia Suncorp Group Full timeClaims Manager Job OverviewSuncorp Group is seeking a Claims Manager to join our team in Adelaide, Australia. As a Claims Manager, you will be responsible for efficiently managing multiple cases, thoroughly reviewing and processing claims, and nurturing meaningful relationships with internal and external stakeholders.Your Responsibilities:Evaluate and...
-
Civil Claims Manager
6 days ago
Adelaide, South Australia Avant mutua Full timeAbout the RoleWe are seeking a skilled Claims Assistant Manager to join our Adelaide team in a permanent, part-time position (4 days per week). As a key member of our claims management team, you will provide support and advice to our members through managing Civil and Professional Conduct claims.This role is perfect for healthcare professionals looking for...
-
Claims Manager
2 weeks ago
Adelaide, South Australia Employers Mutual Management Pty Ltd Full timeEML, a leading Workers Compensation and Personal Injury Claims Management business, is committed to supporting individuals in their return-to-work journey.We're seeking a skilled Claims Manager to lead and manage a team of Claims Specialists, ensuring the effective management of claims and injury aspects for significantly injured workers.This full-time,...
-
Claims Support Specialist
2 weeks ago
Adelaide, South Australia Suncorp Group Full timeAbout the Role:As a Claims Support Specialist within Suncorp Group, you will provide crucial support to the Claims Team and Claims Performance Manager. Your expertise will be pivotal in managing complaints, ensuring quality assurance audits are completed, and facilitating technical referrals. Additionally, you will be responsible for monitoring and reporting...
-
Claims Processing Team Lead
4 weeks ago
Adelaide, South Australia Bupaoptical Full timeAbout the RoleWe are seeking a highly skilled and experienced Team Leader to join our Claims Processing team. As a key member of our leadership team, you will be responsible for leading and developing a high-performing team to deliver exceptional customer experiences.Key ResponsibilitiesLead and manage a team of claims processing professionals to achieve...
-
Insurance Claims Specialist
6 days ago
Adelaide, South Australia Suncorp Group Full timeAbout the Role:As a Claims Technical Support Specialist at Suncorp Group, you will play a crucial role in supporting the Claims Team and Claims Performance Manager in managing complaints, completing quality assurance audits, and providing technical referrals. Your key responsibilities will include monitoring and reporting on Claims Operating Procedures...
-
Insurance Claim Specialist
2 days ago
Adelaide, South Australia Hooker & Heijden Full timeExciting Opportunity at Hooker & HeijdenWe are seeking a highly skilled Solicitor or Associate to join our Insurance & Health team in Adelaide. As an Insurance Claim Specialist, you will play a key role in handling claims across all major classes of insurance and acting for prominent clients in the industry.About the RoleThis is an exciting opportunity to...
-
Clinical Mental Health Specialist
2 weeks ago
Adelaide, South Australia Henderson Healthcare Full timeWe are seeking a skilled Clinical Mental Health Specialist to join our team at Henderson Healthcare. In this role, you will work with the veteran community, providing exceptional mental health support and care.Key responsibilities include:Delivering therapeutic interventions and treatment planningEnsuring best practice and exceptional levels of...
-
Clinical Evaluation Officer
1 month ago
Adelaide, South Australia SA Health Full timeAbout the OpportunityWe are seeking a highly skilled and motivated Clinical Evaluation Officer to join our team at the Women's and Children's Health Network (WCHN). As a key member of our Eating Disorders team, you will play a critical role in planning and implementing an integrated research and evaluation program for eating disorders.Key...
-
Technical Service Advisor
3 weeks ago
Adelaide, South Australia Suncorp Group Full timeAbout the Role:As a Technical Service Advisor, you will provide critical support to the Claims Team and Claims Performance Manager in managing complaints, quality assurance audits, technical referrals, and other key responsibilities.Key Accountabilities:Contribute to team, business, and group priorities with a sense of purpose.Collaborate across and within...
-
Senior Claims Manager
3 weeks ago
Adelaide, South Australia Employers Mutual Management Pty Ltd Full timeEML is a leading Workers Compensation and Personal Injury Claims Management business. Our goal is to help people get their lives back through ongoing support during their return-to-work journey. We continue to experience ongoing growth and now have over 4,000 dedicated employees. We foster a learning culture that allows for us to continually invest in our...
-
Senior Healthcare Manager
3 weeks ago
Adelaide, South Australia Central Adelaide Local Health Network Full timeAbout the RoleThe Central Adelaide Local Health Network is seeking a skilled and experienced Senior Healthcare Manager to lead the integrated multi-disciplinary team of inpatient rehabilitation staff. As a key position, you will be responsible for establishing the direction and functioning of the team, managing service demand and workload allocation, and...
-
Senior Claims Operations Manager
1 week ago
Adelaide, South Australia Employers Mutual Management Pty Ltd Full timeEML, a pioneering Workers Compensation and Personal Injury Claims Management business, is dedicated to helping individuals regain their lives through ongoing support during their return-to-work journey. With a strong focus on employee development and career growth, we continue to thrive, boasting over 4,000 dedicated employees.The OpportunityThis role offers...
-
Senior Claims Management Lead
3 weeks ago
Adelaide, South Australia Employers Mutual Management Pty Ltd Full timeEML is a leading Workers Compensation and Personal Injury Claims Management business. Our goal is to provide ongoing support to individuals during their return-to-work journey. We foster a culture that allows for continuous investment in our employees, ensuring a long-term career at EML.The OpportunityAs part of our diverse team in Adelaide, you will...
-
Senior Claims Management Leader
2 weeks ago
Adelaide, South Australia Employers Mutual Management Pty Ltd Full timeEML is a leading Workers Compensation and Personal Injury Claims Management business. Our goal is to help people get their lives back through ongoing support during their return-to-work journey. We continue to experience ongoing growth and now have over 4,000 dedicated employees. We foster a learning culture that allows for us to continually invest in our...
-
Senior Claims Management Team Lead
3 weeks ago
Adelaide, South Australia Employers Mutual Management Pty Ltd Full timeEML is a leading Workers Compensation and Personal Injury Claims Management business. Our goal is to help people get their lives back through ongoing support during their return-to-work journey. We continue to experience ongoing growth and now have over 4,000 dedicated employees. We foster a learning culture that allows for us to continually invest in our...
-
Senior Healthcare Operations Manager
3 days ago
Adelaide, South Australia Central Adelaide Local Health Network Full timeJob OverviewThe Central Adelaide Local Health Network is seeking an experienced Senior Healthcare Operations Manager to lead our integrated multi-disciplinary team in providing safe, efficient, and effective service delivery to consumers and carers.About the RoleThe successful candidate will be responsible for establishing the direction and functioning of...
-
Healthcare Records Specialist
3 days ago
Adelaide, South Australia Women's and Children's Health Network Full timeAs a Medical Records Coordinator at the Women's and Children's Health Network, you will play a vital role in providing a comprehensive, efficient, and confidential medical record service to the organisation.The successful candidate will be responsible for coordinating and contributing to the provision of a high-quality medical record service,...
Healthcare Claims Evaluator
2 months ago
As a Clinical Claims Specialist, you will become a vital part of our assessment team, specializing in compliance and eligibility evaluations within the health insurance sector. Your primary responsibility will be to ensure that our members receive the appropriate benefits for their claims while identifying instances where claims may not qualify under existing regulations or company policies.
Key Responsibilities:
- Conduct thorough and timely clinical evaluations of all assigned claims.
- Engage with customers empathetically, respecting their health and financial challenges, while maintaining professionalism in communications with healthcare providers and other stakeholders.
- Identify and propose enhancements to processes and functions that facilitate effective claim reviews.
In addition to a competitive salary, we offer a comprehensive range of benefits, including flexible working arrangements. You will be encouraged to innovate and collaborate with colleagues dedicated to delivering exceptional service. We value diversity and believe that your unique perspective will contribute to our success.
Other perks include discounts on health insurance, travel, automotive, home, and pet insurance products, as well as access to wellness programs that provide health coaching, annual health checks, and resources for mental and physical well-being.
Qualifications:
This role is ideal for individuals with a background or interest in claims investigation and policy compliance. Candidates should possess:
- A solution-oriented mindset to ensure fair assessments of claims based on policy guidelines.
- The ability to quickly learn and retain new information and skills.
- Self-motivation and comfort in navigating complex legislation.
- Excellent written and verbal communication skills for professional interactions.
- Familiarity with Customer Relationship Management systems is a plus.
- Proficiency in MS Office with strong data entry capabilities.
- Experience in the insurance or healthcare sectors is advantageous but not mandatory.
We are a leading healthcare organization committed to enhancing the lives of our customers through personalized care and innovative solutions. Our operations span multiple regions, supporting millions of customers with a diverse array of health and care services.
