Payment Integrity Specialist

2 weeks ago

Brisbane, Australia HBF Health Full time

**Job no**: 494236
**Work type**: Permanent full time
**Location**: Brisbane, Townsville
**Categories**: Health Services

**HBF Employee Benefits**
- Flexibility with hours and work-from-home options
- Fully Subsidised Corporate Gold Health Cover for you and your family
- 13 days personal leave per year
- Access to corporate discounts across a range of retail, restaurants, and hotels

Are you passionate about protecting the interests of the HBF Group and ensuring the sustainability of the See-U? As the Payment Integrity Specialist, you will play a crucial role in preventing, identifying, and recovering claims leakage by investigating inappropriate claiming (provider or member).

**About the role**
- Conduct investigations into claims leakage, fraud, or inappropriate behaviour to reduce potential loss to the organisation.
- Identify areas where rules can be introduced, enhanced, or changed to improve the identification of claims leakage.
- Seek recovery of outstanding debts to the HBF Group.
- Liaise with internal and external stakeholders, including providers and members, to gather and document evidence.
- Prepare and submit reports to the Executive and provide fraud awareness training to management and team members.
- Continuously review and make recommendations on current HBF policies and rules to reduce the risk of claims leakage.
- Develop and maintain effective working relationships with key stakeholders and share outcomes and learnings from investigative experiences.

**About you**
- Minimum 2 years of experience in conducting investigations and/or audits, or 3 years of health insurance claims experience.
- Strong verbal and written communication skills, with demonstrated high-level report writing ability.
- High level of interpersonal skills, including the ability to build strong relationships and influence others.
- Demonstrated analytical skills, including knowledge of Microsoft Office suite products.
- Proven ability to develop and deliver presentations for effective dissemination of fraud awareness information.
- Certificate III in Investigations or eligibility to attain an Investigators Licence is desirable.
- Experience in preparing briefs of evidence for police and/or regulatory bodies is a plus.

**Next Steps**

If you are looking for an exciting opportunity and are passionate about protecting the interests of the HBF Group, we’d love to hear from you.

Our recruitment process includes reference checks, National Police Clearance, and verification of working rights in Australia.

**Advertised**: 10 Jan 2025 E. Australia Standard Time
**Applications close**:

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