Clinical Claims Specialist

100 Stirling Street Perth, Perth, Australia
Job Type
Application Close Date
Contact Title
Talent Acquisition Lead
Contact Name
Helen McKenzie
Contact Email
Contact Phone
08 9227 4238


  • Permanent full-time opportunity
  • Great inclusive culture and employee benefits

We’re the Health Insurance Fund of Australia, but our friends call us HIF and we're looking for an experienced health professional to join our Member Benefits Team as a Clinical Claims Specialist.

About the role

This is a newly created role in a great supportive team, with the primary responsibility for ensuring hospital, medical, prostheses and ancillary cost savings are achieved leading to improved payment integrity as a result of;

  • The development, implementation and maintenance of claims leakage strategies and activities to minimise opportunities for loss
  • Proactive clinical and business rules development
  • Desk-top and onsite targeted coding audits
  • Benchmarking activities
  • Claims review and provider compliance activities
  • Third party debt management
  • Financial recoveries

What we're looking for in you

There are some essential things we are looking for

  •  Relevant tertiary qualification in Clinical, Health Informatics or Nursing
  •  Extensive Health Insurance industry experience
  •  Strong analytical and numerical skills
  •  Experience interpreting clinical information from a variety of sources
  • Strong Report writing ability
  • Track record of achieving outcomes and deadlines in a pressured environment
  • Capacity to balance cost constraint (claims leakage), provider partnering, member acquisition/retention and product value proposition

Previous experience with the following would be highly advantageous

  • Audit/claims experience in a health insurance environment would be well regarded

About HIF

HIF is a multi award winning health insurer with a passion for helping our Members live healthy lives. Though we have a huge national brand, we are a tight-knit team of 115 Member focused people based in our Perth office. Being a smaller member health fund helps us maintain an inclusive culture and ensures we excel at being there as a community and for the community. As our HIF mascot Hif says, we create a Hiference for our Members!

What you’ll get

In addition to the opportunity to make your mark within our buzzing team, you’ll enjoy a great package including 10.5% super, subsidised health insurance cover, discounted pet and travel insurance, an Employee Assistance Program that supports you, free flu shots, study support and heaps of great social events with our fun-hungry Social Club. What’s more, you’ll get it all in our bright, modern Community focused Hub, with excellent public transport links, just a stone’s throw from Perth city centre.

Visit to find out more about who we are and what we stand for.


To find out more about us, who we are and what we stand for or to apply for this opportunity please visit

For additional enquiries, please contact Helen McKenzie,

Aboriginal and Torres Strait Islander peoples are encouraged to apply for this opportunity.

HIF encourages cultural diversity and is an equal opportunity workplace. We are committed to creating an inclusive culture for all employees.


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