Claims Processing Consultant

**Be at the heart of it**

Helping people live longer, happier, healthier lives and making a better world. That’s what drives us every day. Our people, our customers and our community are all at the heart of Bupa. We’re working hard to shape a brighter future for everyone, but we can’t do it alone.

**The heart of the role**

We are looking for Claims Processing Consultants to join our Claims team on a full-time permanent basis. You will be responsible for managing complex customer and provider Health Insurance claim requests for Ancillary, Medical and Hospital Claims. You will be working directly with customers and providers to proactively assess claims and resolve queries while building strong relationships to deliver a seamless claiming experience for our customers and providers.

**As a Claims Processor your responsibilities will include**:

- End to end claims assessment of Hospital, Medical and Ancillary claims
- Communicate with claimants, policyholders, and third parties to clarify claim details or request additional information
- Gather and analyse evidence to determine the validity and potential impact of claims
- Proactively identify process improvement and self-service opportunities to support customer needs
- Provide best in class service to customers and providers both via phone (inbound and outbound) and written correspondence including account queries.
- Ensure all claims processing activities comply with relevant industry regulations, legal requirements, and company standards
- Keep up to date with changes in regulations, laws, and best practices that affect claims processing

**Additional Information about the role**
- Start Date February 2025
- The role will be based in our Adelaide office for the first 3 months, once you and your team leader agree you have settled well the opportunity to work from home will be an option.

**About You**

We offer a comprehensive training program therefore to be successful in this role, you don’t need to have Health Insurance claims experience. But you will have a strong desire to learn and a passion for delivering high-quality and accurate work.

**In addition, you will have**:

- Strong written and verbal communications skills
- Highly proficiency in computer literacy and ability to navigate through multiple systems and processes is essential
- Superior attention to detail and ability to work under pressure and meet timelines
- Be a self-starter with a proactive mindset
- Problem solving attitude with a focus on customer experience
- The ability to work autonomously with great time management skills

**We’ve got your back**

The special thing about Bupa is that care is at our core and will always be a part of how we operate. Extending that, we want our people to feel they are benefiting from Bupa’s purpose: so that everyone is supported to live the healthiest and happiest version of themselves. Simply put, this is what wellbeing means at Bupa.

Our global wellbeing program covers all aspects of our health - from mental and physical, to financial, social and environmental wellbeing. We are providing health benefits, information and support for everyone who works here, no matter their role.

**Our range of benefits include**:

- Fully subsidised health insurance products - How good is that
- Discounts on travel, car and home products, as well as discounts on Bupa services such as Dental and Optical, skin checks and vaccinations
- Discounted products and services via our extensive partner network, like Apple, Endota Spa, New Balance, Garmin, JB Hi Fi,
- An additional annual leave day for you to focus on your wellbeing
- An additional volunteer day each year for you to give back to your community