Senior Claims Examiner

1 day ago

Adelaide, South Australia beBeeHealthcare Full time $90,000 - $110,000
Claims Processing Specialist

Bupa is a workplace that truly cares about wellbeing, and we're not just talking about our customers. We want everyone who works with us to feel supported in living their healthiest and happiest lives.

Job Description:

You'll play a vital role in helping people navigate the complexities of health insurance claims. You'll work directly with customers and providers to assess claims, resolve queries, and build strong relationships that deliver seamless claiming experiences.

Key Responsibilities:

  • End-to-end claims assessment for Hospital, Medical, and Ancillary claims
  • Communicate with claimants, policyholders, and third parties to clarify claim details or request additional information
  • Gather and analyze evidence to determine claim validity and potential impact
  • Identify process improvements and self-service opportunities to support customer needs
  • Provide best-in-class service via phone and written correspondence
  • Ensure compliance with industry regulations, legal requirements, and company standards
  • Stay up-to-date with changes in regulations, laws, and best practices affecting claims processing

Required Skills and Qualifications:

  • Comprehensive training program available for those without prior experience in Health Insurance claims
  • Strong desire to learn and passion for delivering high-quality work required
  • Opportunity to work from home after initial 3-month period

Benefits:

  • Extensive range of health benefits, information, and support for all employees
  • Fully subsidized health insurance products
  • Discounts on travel, car, and home products, as well as services
  • Additional annual leave day for wellbeing focus
  • Annual volunteer day for community involvement

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