Claims Auditor

2 days ago


Melbourne, Victoria, Australia Medibank Private Limited Full time
About the Role

We are seeking a skilled Claims Auditor to join our Ancillary team at Medibank Private Limited. As a Claims Auditor, you will play a critical role in ensuring the integrity of our healthcare claims process.

Key Responsibilities
  1. Claims Review and Analysis: Conduct thorough reviews of healthcare claims to identify irregularities and ensure compliance with Medibank's recognition criteria, Fund Rules, and industry standards.
  2. Intelligence-Led Identification: Utilize data-driven insights to identify patterns and trends in claims activity, and provide recommendations for process improvements.
  3. Root Cause Analysis: Conduct in-depth analysis to identify the root causes of systemic issues and provide recommendations for remediation.
  4. Reporting and Communication: Prepare and present clear, concise reports to stakeholders, highlighting key findings and recommendations.
  5. Case Management: Maintain accurate and comprehensive case management records, adhering to Medibank's policies and procedures.
Requirements
  1. Problem-Solving and Analytical Skills: Possess strong problem-solving and analytical skills, with the ability to detect and interpret patterns and trends in data.
  2. Communication and Interpersonal Skills: Excellent communication and interpersonal skills, with the ability to liaise with stakeholders at all levels.
  3. Attention to Detail: Maintain a high level of attention to detail, with a focus on accuracy and professionalism.
  4. Technical Skills: Proficient in Microsoft Office products, with intermediate-level skills in Excel, including pivot tables and formula manipulation.
  5. Previous Experience: Previous experience in a claim audit role is highly desirable.
About Medibank

At Medibank, we believe in creating a healthier future for our customers, patients, and community. We value diversity of thought and encourage our employees to think big. We offer a range of benefits, including subsidised private health insurance, rewards, and discounts, and health and wellbeing initiatives.



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