Join the dedicated Hospital Claims team at Parramatta.
About the Role
As a Hospital Claims Assessor you are responsible for assessing member claims associated with hospital admission. This role requires understanding of Fund policies and procedures and providing accurate information to internal and external stakeholders and providers.
To be successful in this role you must display a high degree of accuracy and detailed understanding of HPPA contracts and terms is essential as is the payment of claims within contract terms.Reporting to the Hospital Claims Team Leader you be responsible for Claims Assessment, Member Retention and Administration.
This is a full time, permanent role based at Parramatta. Hours are 8:30am to 5pm from Monday to Friday, with hybrid working available.
These key result areas include:
• Assess and process all types of hospital claims within SLAs
• Assess and review claims in accordance with Fund Rules eliminating overpayments/unnecessary rejections
• Maintain claims quality by ensuring processing accuracy targets are achieved
• Handle any inquiries and resolve problems for members and providers
• Process suspense claims and turnaround within standards.
• Deliver an exceptional customer experience whilst adhering to Fund and SLAs
• Provide support to Provider Services team, Contact Centre and Branch staff
About You
You will have strong customer service skills and previous experience within insurance claims, call centre or administration roles.
To be successful, you will have:
• Strong attention to detail
• Ability to adapt positively to changing work practices and needs.
• Intermediate PC skills with accurate data entry skills
• Ability to adapt positively to changing work practices and needs
• Proficient understanding of WHICS, ECLIPSE, “PreMac” especially in relation to reassessments and claims processing
• Ability to communicate verbally effectively and courteously and in writing to both internal and external customers.
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.