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Private Health Insurance Audit Coordinator
2 weeks ago
About the Opportunity
Mater Misericordiae Ltd is currently seeking a skilled Private Health Insurance Audit Coordinator - Revenue Specialist to join our team on a permanent full-time basis.
The successful candidate will play a crucial role in reviewing and coordinating Private Health Fund billing audits, identifying areas for quality improvement, and ensuring compliance with contractual obligations.
Key Responsibilities
- Review all health fund billing audits received by Mater Private Hospitals and work closely with the PHI Audit Manager to determine the appropriateness of audit episodes.
- Liaise and coordinate with internal teams, including Coding, Revenue Assurance, Billing, and Privacy, to obtain additional information required to perform audits.
- Analyze results from audits and make recommendations to the PHI Audit Manager and Revenue Operations Analyst to improve processes and procedures.
- Maintain the audit database, ensuring it remains up-to-date and accurately reflects the status of all audits being undertaken or completed.
- Prepare responses to health funds in accordance with instructions from the PHI Audit Manager and ensure that audits are processed within Key Performance Targets.
- Perform other tasks as reasonably required by the Manager PHI Audit and adhere to established processes and procedures.
About You
To be successful, you should possess:
- A strong understanding of clinical terms to assist in the review of claims.
- Excellent organisational skills and the ability to work on multiple tasks simultaneously.
- A high level of attention to detail and accuracy.
- Proficiency in using Excel spreadsheets and experience in private healthcare billing or contract management.
- The ability to interpret Health Fund contractual obligations, associated billing rules, and funding models for private healthcare.
About Us
Mater Misericordiae Ltd is a leading not-for-profit healthcare service provider, dedicated to delivering exceptional care to patients across Queensland. As a key member of our team, you will have access to a range of benefits, including salary packaging, education and professional development opportunities, and a comprehensive employee assistance program.
We offer a supportive and inclusive work environment, with a focus on staff wellbeing and flexible working arrangements. If you are a motivated and detail-oriented individual looking to contribute to a dynamic team, please consider applying for this exciting opportunity.
Salary Range: $85,878 - $94,618 per annum plus 11.5% superannuation
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South Brisbane, Queensland, Australia Mater Misericordiae Ltd Full timeJob SummaryMater Misericordiae Ltd is seeking a dedicated Private Health Insurance Audit and Compliance Specialist to join our team on a permanent full-time basis.About the RoleThe successful candidate will be responsible for reviewing and coordinating private health fund billing audits, identifying areas for quality improvement, and implementing process...
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