Senior Health Insurance Claims Specialist

4 days ago


Melbourne, Victoria, Australia beBeeHealthInsurance Full time $75,000 - $95,000
Health Insurance Claims Processor

This role involves the processing and management of health insurance claims, ensuring compliance with regulatory standards. The ideal candidate will have a strong understanding of the health insurance framework and possess excellent communication skills to effectively interact with customers, members, beneficiaries, and healthcare providers.

Responsibilities:
  • Verify policyholder eligibility and coverage details before claim adjudication
  • Communicate effectively with customers to resolve inquiries and coordinate treatment and billing information
  • Identify potential fraud or abuse cases and escalate them to the compliance team
  • Maintain confidentiality and data privacy when handling sensitive health information
Requirements:
  • Bachelor's degree in Insurance, Healthcare Administration, or related field
  • Minimum 1-3 years of experience in health insurance claims processing
  • Strong understanding of the health insurance regulatory framework
  • Proficiency in claims processing systems and MS Office tools
  • Fluency in Mandarin, Cantonese, and English (speak, read, write)

We are seeking a skilled professional who can work efficiently in a fast-paced environment, maintaining accuracy and attention to detail while providing exceptional customer service.



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