Claims Officer - Hospital
Job no: 501028
Work type: Fixed Term Full Time, Secondment
Location: Sydney CBD
At HCF, our purpose is to bring our human touch to healthcare. Since 1932 we’ve been putting our members and their health first. As Australia’s largest not-for-profit health fund, we cover over 1.7 million members with health, life, travel and pet insurance and our vision is to make healthcare understandable, affordable, high quality and member centric.
We want to be true health partners to our members, easily guiding the healthcare choices that are right for them. At HCF, our values are the way we do things and create the necessary culture to help us realise our purpose and deliver our 2025 Strategy. Living our values in action we step forward, walk in their shoes, stay human, make it better and get there together.
About the role
As a Claims Assessor you are responsible for assessing member claims related to hospital admissions, understanding of Fund policies and procedures and providing accurate information to internal and external stakeholders and providers.
Please note this is a 6 month full time contract position.
- Assess and process all types of hospital claims in accordance with fund rules
- Maintain claims quality
- Handle any inquiries and resolve problems
- Respond to enquiries from providers.
- Liaise with HMUR on clinical issues and/or unusual billing practices identified in assessing.
- Deliver an exceptional customer experience whilst adhering to Fund and SLA’s.
- Ensure members comply with membership claiming requirements.
- Actively assist fellow team members in assessing complicated claims.
- Provide support to Provider Services team, Call Centre and branch staff.
To be successful in this role, you will demonstrate the following qualifications, experience and skills:
- A background in Claims and Insurance
- Strong attention to detail
- Excellent communication both written and verbal
- Ability to adapt positively to changing work practices and needs
- Ability to work autonomously and set own priorities to ensure unit objectives are met
- Be an effective team player
Working in the health insurance industry, we know how important it is to prioritise the wellbeing of our own people. We want to provide you with the skills and tools you need to support your wellbeing journey, so that you can be at your best.
We’re all about creating a fantastic people experience, guided by our values, so that we can in turn better deliver for our members. We work with our people to create a work experience that is inclusive, supportive, safe and respectful so we can do the best for our members.
Come and join our HCF team!
- Up to 50% discount on health cover, pet & travel insurance
- Family & Friends day
- Organisational wide Recognition & Rewards program
- Generous Parental Leave Scheme
- Health & Wellbeing Initiatives
- Linkedin Learning Access
- Flexible working environment
HCF is committed to creating a diverse and inclusive workplace. All suitably qualified applicants will receive equal and fair consideration for employment. Applicants who identify as Aboriginal and/or Torres Strait Islander are actively encouraged to apply.
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