Medical Claims Specialist

2 weeks ago

Sydney, New South Wales, Australia beBeeClaims Full time $60,000 - $97,000
About the Role

This 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, procedures, and legislative requirements within service level agreements.
  • Provide timely, accurate, and professional communication with members, providers, and third parties through inbound and outbound calls.
  • Maintain comprehensive knowledge of systems and products.
  • Deliver clear, concise, and respectful written and verbal communication with internal and external stakeholders.
  • Work towards individual and team Key Performance Indicators (KPIs), take ownership of outcomes, and share knowledge with peers to drive success.
  • Ensure adherence to privacy, APRA, PHI Act, and WH&S requirements.
Requirements:
  • Minimum 3 years of experience in a similar Senior Hospital Claims Assessor role.
  • HSC or equivalent qualification preferred.
  • Proven 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 skills.
  • High attention to detail with strong organisational skills.
  • Proficiency in computer systems and ability to adapt to new technology.
  • Ability to work collaboratively and contribute as a strong team player.
  • Results-driven mindset.
Benefits:

We offer a supportive work environment, opportunities for growth and development, and a chance to make a real difference in the lives of healthcare professionals and their families.

Equal Opportunity Employer:

We are committed to creating a diverse and inclusive workplace where everyone can succeed.

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