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 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 hospital and medical claims and case mix analysis
• Reviewing clinical coding and supporting documentation
• Identify claims that don’t meet contractual standards, across EPM and Per Diem funding models.
• Seek and manage recovery of inappropriate benefit payments
• Provide recommendations to mitigate inappropriate benefit payments and highlight areas of exposure/opportunity

Skills & Experience

The ideal candidate will have:

• Bachelor of Health Information Management, Nursing or Allied Health
• Excellent written and verbal communication skills
• Proven record of collating and analysing complex information
• Ability to conduct thorough investigations and analysis, and make recommendations
• Ability to maintain good working relationships with both internal and external providers
• Demonstrated ability to prioritise work and work to deadlines

Experience in a Private Health Insurance setting and/or Private Hospital is desirable but not essential.

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.

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!