
Claims And Payments Integrity Specialist
3 days ago
We are seeking an experienced APS5 Claims and Payments Integrity Officer to join our team in Adelaide. The successful candidate will play a critical role in implementing detective and preventative measures to reduce claims and payments errors, improve compliance, and enhance the overall claims and payments control environment.
This is a key position within a Federal Government Agency responsible for delivering high-quality services to stakeholders. As an APS5 level officer, you will be working closely with various teams to investigate, report on, and escalate claims and payments anomalies.
The ideal candidate will possess excellent analytical skills, strong communication abilities, and the ability to work independently. You will also have experience in assurance and compliance reporting, as well as the development and modification of test documentation.
A relevant qualification in a field such as accounting, finance, or business is highly desirable. Additionally, proficiency in manual validation checks and systematic analytics is essential for this role.
Please note that applicants must be Australian Citizens to be considered for this position.
Key Responsibilities:
- Undertake control and conformance testing for PPC and SMP Programs.
- Contribute to assurance and compliance reports.
- Develop and modify test documentation.
- Conduct targeted claims reviews through engagement with providers, plan managers, and participants.
- Collaborate in designing new detective and preventative controls using manual validation checks and systematic analytics.
- Work with various teams to investigate, report on, and escalate claims and payments anomalies.
- Communicate clearly and concisely with stakeholders.
Benefits:
- $55.24 per hour + 11% superannuation.
- A casually loaded rate of pay.
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