Hospital Claims Auditor
9 hours ago
Hospital Claims Auditor - 12-Month Fixed-Term Contract
You'll be responsible for ensuring that claims submitted by Hospital providers on behalf of members comply with internal fund rules and AHSA contract guidelines.
Using HIBIS and other reporting tools, the role will liaise with contacts at Hospitals to validate flagged claim anomalies, and work with internal claims assessors to educate on processing issues leading to benefit leakage.
What we have to offer?
We at Teachers Health have a lot to offer,
- Attractive leave benefits
- Hybrid working model (flex your work/life balance)
- Subsidised private health insurance
- Discounts on our products and services
- Generous employee wellbeing program
- Easily accessible by public transport
Who are we?
Teachers Health was created by teachers for teachers over 70 years ago and is the only health fund exclusively for the education community. As a not-for-profit health fund, we exist for our members covering the lives of over 400,000 teachers, education staff & their families.
What will you do?
- Daily review of alerts in claim auditing tool HIBIS. Work within settlement terms to prevent release of payment for claims flagged with billing anomalies. Complete 'stop payment' processes within the system where appropriate.
- Regular review of HIBIS alerts that have fallen outside of payment settlement terms. Prepare audit batches and liaise with Hospital staff to review anomalies and recover leaked benefits.
- Liaise with the Clinical Coding Auditor to review clinical scenarios and coding issues flagged through various audit activities.
- Completion of regular control processes around payment duplication and quality assurance. Provide feedback and recommendations to stakeholders when issues are identified.
- Complete refund request and payment allocation processes in the system for any recoverable amounts identified across various audit types.
- Provide ongoing education to claims assessors on processing issues that are identified during various audit activities.
- Review, develop and update relevant policies and procedures and assist with identifying areas where processes may be streamlined and improved.
What do you need?
- Experience in claims/benefits assessment within private health insurance, or healthcare billing/revenue assurance roles
- Strong Microsoft Excel skills
- High attention to detail and strong organisational/time management skills
- Excellent written and verbal communication skills
- Stakeholder management experience
- General understanding of the Australian healthcare landscape
- Knowledge of medical terminology
- Experience with HAMBS or similar systems (desirable)
How do I apply?
Click APPLY NOW to submit your updated CV, along with an optional cover letter or a 60-second introduction video sharing why you'd be a great fit for the role.
Teachers Health values diversity and inclusion and encourages applications from people with diverse backgrounds including First Nations people, people with disability, people from diverse cultural and linguistic backgrounds, and people that identify as LGBTQIA+. Applicants can request an adjustment at any stage during the recruitment process by getting in touch with
-
Hospital Claims Specialist
4 weeks ago
Sydney, New South Wales, Australia Avant Mutual Full timeAbout Doctors Health FundDoctors' Health Fund is a leading provider of private health insurance exclusively for the medical community across Australia. As part of the Avant Mutual Group, we proudly support over 70,000 healthcare professionals, students, and their families. Our commitment to members is at the heart of everything we do - driven by our values,...
-
Hospital Claims Specialist
4 weeks ago
Sydney, New South Wales, Australia Avant Mutual Full timeAbout Doctors Health FundDoctors' Health Fund is a leading provider of private health insurance exclusively for the medical community across Australia. As part of the Avant Mutual Group, we proudly support over 70,000 healthcare professionals, students, and their families. Our commitment to members is at the heart of everything we do - driven by our values,...
-
Hospital Claims Specialist
4 days ago
Sydney, New South Wales, Australia Avant Full time $60,000 - $90,000 per yearAbout Doctors Health Fund:Doctors' Health Fund is a leading provider of private health insurance exclusively for the medical community across Australia. As part of the Avant Mutual Group, we proudly support over 70,000 healthcare professionals, students, and their families. Our commitment to members is at the heart of everything we do - driven by our values,...
-
Night Auditor
4 weeks ago
Sydney, New South Wales, Australia Novotel Hotels Part timeNight Auditor (Part-time) - Novotel Sydney City CentreNight Auditor (Part-time) - Novotel Sydney City Centre4 days ago Be among the first 25 applicantsCompany DescriptionAt Accor, we believe that hospitality is a work of heart. We understand the ways in which individual passion for our work and a shared sense of accomplishment create a more rewarding...
-
Night Auditor
4 weeks ago
Sydney, New South Wales, Australia Rydges Hotels Limited Full timeNight Auditor & Guest Service Agent - The Capitol Hotel SydneyAdd expected salary to your profile for insights.Title: Night Auditor & Guest Service AgentTHIS IS A CASUAL ROLEOnly applicants with valid Australian working rights will be considered.We are recruiting candidates who can work both PM shifts (3PM - 11PM) & Night Audit shifts (11PM - 7AM). Options...
-
Night Auditor
4 weeks ago
Sydney, New South Wales, Australia EVT - Entertainment | Ventures | Travel Full timeNight Auditor & Guest Service Agent - The Capitol Hotel SydneyJoin to apply for the Night Auditor & Guest Service Agent - The Capitol Hotel Sydney role at EVT - Entertainment | Ventures | TravelNight Auditor & Guest Service Agent - The Capitol Hotel Sydney3 days ago Be among the first 25 applicantsJoin to apply for the Night Auditor & Guest Service Agent -...
-
Senior Internal Auditor
7 days ago
Sydney, New South Wales, Australia Chubb Insurance Full time $80,000 - $120,000 per yearChubb is a world leader in insurance. With operations in 54 countries and territories, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance and life insurance to a diverse group of clients. As an underwriting company, we assess, assume and manage risk with insight and...
-
Night Auditor
2 days ago
Sydney, New South Wales, Australia IHG Hotels & Resorts Full time $60,000 - $90,000 per yearNight Auditor | Holiday Inn Sydney Potts PointHotel Brand: Holiday InnLocation: Australia, New South Wales, SydneyHotel: Sydney - Potts Point (SYDAS), 203 Victoria Street, Potts Point, 2011Job number: 151097Travel is a journey. We help make it a joy.Starting with a warm, inviting welcome for all guests, whether traveling on business or for fun, enjoying a...
-
Night Auditor/Front Desk Agent Part Time
2 days ago
Sydney, New South Wales, Australia Zara Tower Full time $50,000 - $70,000 per yearAbout the role We are seeking a dedicated Night Auditor/Front Desk Agent to join our dynamic hospitality team at Zara Tower in Sydney, NSW. This is a part-time opportunity with flexible days to suit your lifestyle. As the first point of contact for our guests, you will play a crucial role in ensuring an exceptional experience during their stay.What you'll...
-
Night Auditor
2 days ago
Sydney, New South Wales, Australia Novotel Hotels Full time $45,000 - $60,000 per yearCompany DescriptionAt Accor, we believe that hospitality is a work of heart. We understand the ways in which individual passion for our work and a shared sense of accomplishment create a more rewarding experience for our guests. We foster this culture through a diverse and inclusive workplace that values the contribution of each and every member of our team....
