Hospital Claims Assessor

Surry Hills | Permanent Full -Time | Hybrid after training | $94,742 incl. super | 8AM – 4PM

We’re looking for a detail-oriented and proactive Hospital Claims Assessor to join our team.

In this role, you’ll assess and process public and private hospital claims, interpreting policies, contracts and legislative requirements to ensure claims are processed accurately and efficiently. Strong communication skills are essential, as you’ll regularly engage with internal and external stakeholders, healthcare providers and members. You’ll need to be confident communicating clearly, particularly when explaining detailed or complex information.

Please note: Full training is provided, with the first three months based in our Surry Hills office. Following the training period, the role moves to a hybrid working arrangement. Standard working hours are 8AM – 4PM.

What we have to offer?
We at Teachers Health have a lot to offer,

Attractive leave benefits
Hybrid working model (after training period) and a 35‑hour full‑time week to support work–life balance
Subsidised private health insurance and discounts on our products and services
Fantastic central location in Surry Hills
Employee well-being programme
18 weeks paid parental leave for eligible employees
Additional long service leave

Who are we?
Teachers Health was created by teachers for teachers over 70 years ago and is the only health fund exclusively for the education community. As a not-for-profit health fund, we exist for our members covering the lives of over 500,000 teachers, education staff & their families.

What will you do? / How will you help
You’ll be responsible for:

Accurately assessing and processing public and private hospital claims within required timeframes
Interpreting policies, hospital contracts and legislative requirements to determine appropriate benefit payments
Reviewing hospital billing and identifying discrepancies or issues
Meeting productivity, quality assurance and KPI standards
Communicating confidently and professionally with internal and external stakeholders, healthcare providers and members
Handling inbound calls and enquiries, clearly explaining information and responding to queries
Identifying problems, using initiative and contributing to solutions
Contributing positively to team performance and continuous improvement

What do you need? /What are we looking for?
While previous claims experience would be advantageous, we’re also interested in candidates who can demonstrate strong transferable skills.

Some of the experience and qualities that would set you apart include:

Experience in hospital claims, medical claims processing or healthcare billing is highly regarded
An understanding of hospital systems, billing practices, private health insurance or the broader healthcare industry
Excellent attention to detail and the ability to interpret complex policies, contracts and information
Strong critical thinking and problem-solving skills
Strong verbal and written communication skills, with the confidence to engage with members and a range of internal and external stakeholders
The ability to understand complex information and communicate it in a clear, concise and easy-to-understand way
Experience working towards KPIs and quality standards
The ability to manage detailed or repetitive work efficiently without compromising accuracy
A proactive approach, with the initiative to identify issues and contribute to solutions
A genuine interest in ongoing learning and developing technical knowledge
A collaborative, positive approach to working within a team
Applicants must be Australian Citizens or Permanent Residents

How do I apply?
Click APPLY NOW and send in your updated CV. Please note, as part of our recruitment process candidates may be required to complete video screening and online assessments, and applications will be reviewed and progressed on an ongoing basis, so we encourage you to apply as soon as possible!

Due to the high number of applicants, only shortlisted candidates will be contacted.

Teachers Health values diversity and inclusion and encourages applications from people with diverse backgrounds including First Nations people, people with disability, people from diverse cultural and linguistic backgrounds, and people that identify as LGBTQIA+. Applicants can request an adjustment at any stage during the recruitment process by getting in touch with jobs@teachershealth.com.au

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