Claims Assessment Officer

**About HCF**

HCF is devoted to member care and to being a customer centric in everything we do. Our company is Australia's largest not for profit private health insurer. With over 80 years of heritage in Australia, we remain faithful to our not for profit charter and continue to deliver more benefits to our members. Our mission is to satisfy the needs of Australians for access to affordable, high quality health care when and where they need it, personal protection and peace of mind.

**About the role**

This is an exciting opportunity to be part of a newly created team. As a Claims Assessment Officer you are responsible for reviewing, approving and processing high volume HCF member Private Health Insurance claims. To be successful in this role you will hold high attention to detail, be outcome driven and display a strong desire to being pro-active to support your team.

**Key responsibilities include**
- Ensure all medical claims are processed in a timely, effective and efficient manner
- Review, capture and source claims information accurately ensuring completion is achieved
- Take ownership of claims processing, ensuring the delivery of timely, quality and aligned outcomes
- Call quality, handling and customer enquiries managed efficiently through to resolution
- All exceptions based handling of claims related services managed in timely, effective and efficient manner raising improvement needs where required
- Consult with others and share relevant information to ensure claims assessment functions are managed to deliver high level of service
- Offer ideas and solutions to support team objectives
- Identify and raise opportunities for business process improvements within team and across the wider Claims Operations division
- Provide recommendations and actively pursue solutions to issues for our members
- Pro-actively identify and work through business process improvement

**About you**
- Ability to effectively process claims and/or related processing functions
- Excellent interpersonal skills and strong creative customer service
- Ability to adapt positively to changing work practices and needs
- Ability to work autonomously and set own priorities to ensure unit objectives are met
- Ability to make effective decisions by ensuring the issues are fully understood and the most appropriate course of action is taken
- Sound problem solving and analytical capability
- Ability to acquire knowledge of changing organisational policy and procedural documents
- Ability to make a customers and their needs a primary focus of ones actions; developing and sustaining effective customer relationships; providing responsive service and follow up
- Responsible for identifying changes to their business area and communicating these to management and compliance
- Ability to handle stress and continue to deal with difficult situations in a professional and positive manner
- Demonstrated experience in problem solving and analysis

**Culture**

Working in the health insurance industry, we know how important it is to prioritise the wellbeing of our own people. We want to provide you with the skills and tools you need to support your own wellbeing journey, so that you can be at your best.

We’re all about creating a fantastic people experience, guided by our values, so that we can in turn better deliver for our members. We work with our people to create a work experience that is inclusive, supportive, safe and respectful so we can do the best for our members.

**Benefits**
- Up to 50 % discount on health cover, pet and travel insurance
- Organisational wide Recognition & Rewards program
- Generous Parental Leave Scheme
- Health and Wellbeing Initiatives
- Additional time off in the form of a "Family & Friends day"