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Medical Claims Examiner

3 weeks ago

Brisbane, Queensland, Australia beBeeClaimsQuality Full time $90,000 - $110,000
Key Responsibilities of the Claims Quality and Support Officer

The main focus of the Claims Quality and Support Officer is to guarantee the precision and excellence of operational claim processes and adjudication. This role involves scrutinizing claims to apply quality standards, generating clear and accurate audit findings and recommendations, and identifying error trends and training opportunities.


Responsibilities Include:
  • Reviewing and inspecting claims for accuracy and adherence to established quality standards.
  • Creating clear and concise audit findings and recommendations to improve claim processing efficiency.
  • Identifying and addressing error trends and developing training programs to enhance staff knowledge and skills.

Required Skills and Qualifications

To excel in this position, candidates should possess a Bachelor's degree in a medical field or a related discipline, along with 3-5 years of experience in a customer-focused environment. Key skills include proficiency in MS Office, general internet navigation, and research skills, as well as being detail-oriented and able to work independently.


Benefits and Requirements

The ideal candidate will have strong analytical and problem-solving skills, excellent communication abilities, and a passion for delivering exceptional results. They should also be proficient in navigating complex data systems and possess a high level of emotional intelligence.


Why This Role Matters

This role plays a vital part in ensuring the accuracy and quality of operational claim processes and adjudication. It requires a unique blend of technical expertise, business acumen, and interpersonal skills, making it an exciting and challenging opportunity for professionals seeking a dynamic and rewarding career.