Eligibility and Compensability Expert

7 days ago

Adelaide, South Australia GB - Global Full time
About the Role

We are seeking a highly skilled and experienced Senior Eligibility Officer to join our team at GB - Global. As a key member of our organization, you will play a critical role in ensuring the effective management of complex claims and providing expert guidance to our customers.

Key Responsibilities
  • Manage a portfolio of complex and scheme-critical claims, ensuring timely and accurate decision-making.
  • Conduct thorough eligibility assessments, reviewing and evaluating complex claims, medical records, legal documents, and supporting documentation to determine eligibility.
  • Develop and maintain expertise in eligibility and compensability, providing subject matter guidance to the team.
  • Collaborate with stakeholders to develop and implement effective claim strategies and interventions.
  • Participate in training and development programs to enhance technical knowledge and skills.
  • Identify opportunities for process improvement and contribute to the evolution of eligibility processes.
Requirements
  • Proven experience in complex claims management or a related field.
  • Strong knowledge of complex claims eligibility criteria and processes.
  • Bachelor's degree in Insurance, Legal Studies, or Healthcare is highly desirable.
  • Demonstrated knowledge of the Return to Work Act and its application is desirable, but not essential.
  • Excellent customer service, communication, and interpersonal skills, with a strong team player attitude.
  • Demonstrated high levels of autonomy and a learning mindset.
  • Experience working in a dynamic, fast-paced environment.
What We Offer
  • A competitive salary and benefits package.
  • Opportunities for career growth and professional development.
  • A dynamic and supportive work environment.
  • Flexible and hybrid working arrangements.
  • A range of staff benefits, discounts, and wellbeing programs.
About GB - Global

GB - Global is a leading organization in the industry, committed to providing exceptional service and support to our customers. We value diversity, inclusion, and equality, and strive to create a workplace that is welcoming and inclusive for all employees.

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