Hospital Claims Analyst specialist

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 www.defencehealth.com.au

About the role

We have an exciting opportunity for a Health Services Coordinator to assist us in protecting our members interests by ensuring benefit payments meet the necessary rules and requirements.

This role will:

• Provide administrative support to the team
• Conduct reviews of pre-hospital and post-discharge claims that to ensure the team are aligned with the organisational strategic direction
• Review and process ex-gratia requests which require special consideration
• Identify and authorise member participation in suitable health management programs
• Conduct claim reviews in accordance with Defence Health’s delegation of authority and escalate claims that exceed specified authority
• Respond to member enquiries in accordance with DHL fund rules and policies
• Report and analyse trends in team data

Skills & Experience

The ideal candidate will have:

• Experience in the private health insurance industry and/or healthcare landscape, preferably in claims or member services
• Working knowledge in health literacy including MBS, DRG, ICD, Prosthesesor working towards through recognized learning programs
• Attention to detail with strong written and verbal communication skills
• Ability to work autonomously and take ownership of tasks
• A positive and proactive attitude
• Strong interpersonal and communication skills allowing you to build positive working relationships with both internal and external providers
• Knowledge of MS Office products and ability to conduct analysis.

Culture

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.

Benefits

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!