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Medical Claims Assessor jobs

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    • Previous experience assessing hospital claims.
    • Assessing health insurance claims accurately and within agreed service levels.
    • View all Avant jobs - Sydney jobs
    • Salary Search: Claims Assessor salaries in Sydney NSW
    • Manage complex and exception claims.
    • Assess and process health insurance claims.
    • As a Claims Processing Consultant, you’ll help our customers and providers…
    • Interpret medical histories, clinical information and supporting documentation.
    • Rather than providing direct patient care, you’ll review clinical information,…
    • Broad knowledge of insurance industry and claims processes.
    • You will oversee the entire claims process, delivering exceptional service, thoroughly evaluating…
    • Manage new claims enquiries and claim lodgements.
    • Support customers through the claims process with empathy and professionalism.
    • An understanding of general insurance as it applies to home building claims is desirable.
    • Ensure accurate and complete updates and diaries are kept on our…
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    • The role provides technical claims advice and support, manages claims end to end with insurers, and negotiates outcomes on complex or contested claims.
    • Assessing remediation and make safe claims and costs.
    • Maintaining a timely delivery of property claims outcomes which meet or exceed the customer expectations…
  • View similar jobs with this employer
    • Assess and triage new claims, providing clear guidance and setting expectations throughout the claims journey.
    • Previous claims experience is highly desirable.
    • Data entry for individual claims portfolios.
    • Customer service experience within a medical or corporate environment.
    • Managing weekly payment of entitlements.
  • View similar jobs with this employer
    • Familiarity with the terminology and procedures associated with claims and building.
    • Manage your daily run sheet of new and active claims—balancing inspections,…
    • In this role you will provide technical claims advice, coordinate claim activity, and help clients navigate the claims process with confidence.
    • The Medical Professional Development Officer is responsible for providing administrative support and ensuring the accurate and timely processing of medical…
    • Monitoring of new claims inboxes and registration queue.
    • Accurate identification of claim types, coding of all new claims and registration of all new claims,…
    • Demonstrate deep practical expertise in managing PIPA claims from start to finish (QLD claims experience is essential), including direct settlement conference…

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Job Post Details

Claims Assessor
Avant
·
3.0
Sydney NSW
Permanent, Full-time
Apply on company site

Job details

Pay information not provided
Health insurance
Permanent, Full-time
Sydney NSW

Full job description

Full-time | Permanent | Sydney | Doctors Health Fund

About the role
We’re looking for an experienced Claims Assessor to join our Doctors Health Fund team.
In this role, you’ll be responsible for accurately and efficiently assessing health insurance claims in line with fund rules, policies, procedures and legislation. You’ll also support our members and providers by handling inbound and outbound enquiries and helping resolve claims-related queries.
This is a great opportunity for someone with a private health insurance (PHI) background, particularly those with experience assessing hospital claims.

What you'll be doing
  • Assessing health insurance claims accurately and within agreed service levels
  • Assessing hospital claims in accordance with fund rules, policies and legislation
  • Adjusting claims where required
  • Handling inbound and outbound calls with members, providers and third parties
  • Conducting peer reviews to ensure claims and processes are accurate
  • Keeping up to date with changes to products, processes and legislation
  • Participating in coaching and training on new products and processes
  • Identifying opportunities to improve processes and delivering practical solutions
  • Supporting other activities relating to the claims and payments process
About you
You’ll be a detail-oriented and customer-focused professional who enjoys working in a fast-paced environment and has a strong understanding of health insurance claims.

You’ll bring:
  • Experience in private health insurance (PHI) – highly desirable
  • Previous experience assessing hospital claims
  • Strong understanding of health insurance claims processes, rules and procedures
  • Knowledge of claim related systems such as HAMBS, ECLIPSE, etc is desirable
  • Extensive hands-on customer service experience
  • Strong data entry skills and a high level of accuracy
  • Excellent verbal and written communication skills
  • The ability to manage competing priorities and meet service level requirements
  • A proactive approach to identifying issues and finding solutions
Equal Opportunity Employer
Avant supports doctors so they can serve Australia's diverse communities. Having diversity in our workforce brings valuable perspectives and strengthens our ability to support healthcare professionals.
We therefore welcome applications from people of all backgrounds, including Aboriginal and Torres Strait Islander peoples, people from culturally diverse communities, LGBTQIA+ individuals, people with disabilities, and those with caring responsibilities.
Our inclusive workplace is somewhere everyone can succeed.
Ready to join us? If you're passionate about supporting Australia's healthcare professionals, we'd love to hear from you. If you require any adjustments during the recruitment process, please don't hesitate to contact us at careers@avant.org.au
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