Are you passionate about upholding legal and ethical standards in healthcare, and ensuring affordable private health insurance for all Australians? HCF is seeking a dedicated Benefit Integrity Officer to join our Benefit Integrity team, based in the heart of Sydney CBD.
The objective of the Benefit Integrity team is to ensure that HCF acts with integrity when fulfilling our legal and ethical obligations to members and providers. Our team is committed to implementing effective payment approaches that control unnecessary and inappropriate costs, helping to maintain affordable private health insurance and healthcare for our members.
Please note this role is a contract position until the end of June 2027
Role Overview:
The Benefit Integrity Officer will support the Policy and Audit Manager in achieving the team's goals and will be responsible for:
Supporting the identification, mitigation, elimination and management of benefits inaccuracy and leakage
Contributing to audit and recoveries activities undertaken by the team
Corresponding with providers and members regarding claims and audits
Maintaining accurate reports and records
Key Focus Areas
Assist with the broader identification, mitigation, and elimination of benefits inaccuracy and leakage
Identify system improvements to enhance identification, audit and recovery efficiency
Support recovery of monies from providers on behalf of HCF where possible
Record progress on departmental activities and recovery processes
Report monthly on savings and recoveries
Liaise with providers and members on all matters concerning audited/recoverable claims
Manage correspondence and enquiries related to known or potential recoveries and related claims
Ensure records and files are accurate, up to date, and accessible
Support sensitive claims reviews and investigations
Comply with HCF’s Risk Management Framework, Strategy, Manual, and risk/compliance procedures
Perform other duties as required to support the effective and efficient operation of the Benefit Integrity unit and Member Health team
Skills, Experience, and Qualifications:
Essential
Proven capacity in a similar role, with minimum 1-year experience liaising with providers and members
Minimum of 1-year clinical experience
Innate curiosity, ability and desire to learn
Strong English written and verbal communication skills
Fully conversant in MS Word, with basic MS Excel skills
Excellent attention to detail
Ability to work unsupervised in a team environment
Methodical, organised, and committed to continuous improvement
Tact, diplomacy, and ability to maintain complete confidentiality
Excellent customer service skills (internal and external)
Desirable
About HCF
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 2 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 Strategy. Living our values in action we step forward, walk in their shoes, stay human, make it better and get there together.
Culture & Benefits
Purpose-driven passion
We’re united by a common purpose: to make healthcare affordable, understandable, high quality and member-focused.
Wellness and work-life balance
We’ll empower you with the necessary skills and tools to support your personal wellbeing journey, ensuring you perform at your best. Our offerings include:
Flexible working arrangements
50% subsidy on HCF hospital and/or extras cover
Family-friendly certified employer
18 weeks of parental leave for all new parents
Mental health and wellbeing programs, including workshops, fitness classes, flu vaccinations, skin checks and more
Discounts on HCF’s products, including life, pet and travel Insurance, as well as discounts at Fitness First gyms and on our eyecare products.
Collaboration and inclusivity
We embrace diversity as our strength and are committed to maintaining an inclusive and collaborative work environment. Our workplace is welcoming and safe for all our employees, irrespective of their unique characteristics including age, ethnicity, cultural or spiritual background, gender identity, disability, education and socio-economic status.
Continuous learning and growth
We believe in lifelong learning. HCF provides opportunities for personal and professional development. From workshops to mentorship programs, we encourage your growth and curiosity.
Next steps
If you require any adjustments to assist you in making your application or during the recruitment or onboarding process, please reach out to Talent Acquisition – [email protected] to discuss.
We encourage applicants to submit their applications at their earliest convenience, as at HCF, we review applications as they are submitted, and may have filled the role prior to the job closing date.
