Take the next step in your career and join the Claims team.About the RoleAs the Hospital Claims Assessor you will be responsible for processing high volumes of hospital claims. This role has a strong customer service focus, and it is essential that accurate information and exceptional service is provided in responding to enquiries raised by internal customers, members, Medicare Australia and providers. A thorough understanding of the funds policies and procedures are required.This is a full time, maximum term contract until October 2028. Hours of operation are Monday to Friday between 8:30am-5:30pm. This role is based in the Sydney CBD with hybrid working available. The responsibilities of the role include but are not limited to the following:• Assess and process all types of hospital claims within SLAs• Review and pay claims in accordance with Fund Rules and policies• Maintain claims quality by ensuring processing accuracy targets are achieved and error rates are below unit KPI’s• Achieve productivity targets as set per unit KPIs• Process rejected, refused, suspended and adjusted claims within standards• Respond to enquiries from providers• Perform claims adjustments and initiate follow up/recovery action as required• Action reports and perform quality review processes as required• Actively assists fellow team members in assessing complicated claims• Provide support to Contact Centre on claims related queries.About YouYou are solutions focused with strong attention to detail and have exceptional customer service skills. You will have experience in a contact centre, ideally within private health insurance claims. You will have:• Previous proven experience of processing claims • Excellent communication both written and verbal• Sound understanding of the Fund’s products and services• ensure unit objectives are met• Accuracy of data input skills• Be an effective team player• Intermediate PC skills in Outlook, Excel, Word and fund m
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