Claims Analyst – Health Information Manager

Defence Health
    March 10, 2020
    Melbourne, Australia
    Job Type
    Application Close Date
    Contact Title
    HR Advisors
    Contact Name
    Alex Lamborn
    Contact Email
    Contact Phone


    About us

    Defence Health provides great value private health insurance to the families of Australian Defence Force (ADF) members and the wider Defence community. As a Members Own Health Fund, we are not-for-profit and all for the benefit of our members. Our members really are just like family, and our team lives and breathes our service culture and corporate values – trust, respect, ownership, excellence and community.

    Here at Defence Health we have a strong focus on staff engagement and supporting a high-performance culture. We recognise that a highly engaged and motivated team not only help us to retain fantastic people but enable us to provide a great member experience. But don’t just take our word for it – Defence Health has been recognised as an Employer of Choice in the 2018 Australian Business Awards.

    Find out more at

    About the role

    We have an exciting opportunity for a Claims Analyst (Health Information Manager – Private Health Insurance) to assist us in protecting our members interests by ensuring benefit payments meet the necessary rule and requirements.

    This role will be responsible for:

    • Analysis of claims and case mix analysis
    • Clinical coding including documentation
    • Investigation of fraud waste and leakage activity
    • Analysis to identify trends in benefit payments
    • Assistance with the development of the annual claims integrity plan.
    • Changes in processes and improvements in the core system to identify and prevent claims payable by third parties, claims errors, and potential fraudulent activities.

    Skills & Experience

    The ideal candidate will:

    • Have demonstrated experience managing clinical audits and case mix analysis
    • Have experience in medical terminology, understanding of MBS and DRG coding
    • The ability to conduct thorough investigations and analysis, and make recommendations
    • Be a proactive problem solver
    • Possess strong attention to detail
    • Have excellent written & verbal communication skills
    • The ability to maintain positive and mutually beneficial relationships with both internal and external stakeholders
    • Be a team player

    Experience in a Private Health Insurance setting is desirable but not essential   Previous experience working with business intelligence software would also be an advantage.


    In return for the above we offer a supportive environment in which you can realise your potential and make a difference to the people around you.

    We focus on internal development and look for ways to help our employees grow. We also have a strong focus on job satisfaction and employee wellbeing which includes; physical, emotional, financial security and social connectedness.

    We are committed to providing you with the knowledge and training to succeed in your role, therefore the first week will be dedicated to induction.

    Our office overlooks the Shrine of Remembrance and Botanical Gardens with public transport aplenty right outside.


    By joining us you will receive competitive remuneration and staff benefits, such as

    • Bi-monthly awards
    • Team days
    • Fresh fruit
    • Flu injections
    • A super active social club
    • Skin checks
    • The list goes on!!

    How to apply

    If this looks like the job for you, please apply now by submitting your resume and a cover letter outlining your suitability!

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