Claims Insights Consultant

2 weeks ago

Haymarket, New South Wales, Australia MedHealth Full time
Overview SIS Consultancy is part of the MedHealth Group, a purpose-built collection of industry-leading health, medical, and employment brands. Our unique and diverse capabilities are dedicated to supporting our customers in achieving the best possible health, employment and claim outcomes.
We are looking for a proactive and engaging Insurance and/or Allied Health Professional to provide claims insights and case coordination for cases referred to our Clinical Insights Panel. You will be the face of our service delivery team, liaising and building rapport with our customers and internally with our Medical Advisors to support fair and reasonable case outcomes for public liability cases.
Responsibilities Liaise and build rapport with external customers to better understand referral requirements, case time frames and critical issues.
Screen incoming referrals to ensure all relevant medical documentation is present; summarise key clinical issues and allocate cases to the most appropriate Medical Advisor based on the information available.
Coordinate and schedule case conferences involving Medical Advisors, customers and other stakeholders within agreed timeframes and attend case conferences as required.
Provide comprehensive case coordination; ensuring deliverables are met in accordance with agreed timeframes and regular communication is maintained with internal and external stakeholders.
Build rapport and work closely with Medical Advisors on referral allocation, availability, scheduling and report progress and finalisation to maintain visibility on Medical Advisor caseload and capacity.
Issue finalised reports and invoices via appropriate systems and gather customer feedback to drive continuous service improvement.
Provide weekly status updates to the management team on customer referral trends and Medical Advisor utilisation, availability and work in progress.
Assist in the onboarding of new Medical Advisors including induction on operational processes to ensure consistency in service delivery.
Qualifications Relationship/

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