Hospital Claims Analyst specialist

Defence Health
    February 18, 2020
    Melbourne, Australia
    Job Type
    Application Close Date
    Contact Title
    HR Advisor
    Contact Name
    Alex Lamborn
    Contact Email
    Contact Phone
    8679 1138


    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 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.


    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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