Claims Assessor Hospital

Ourmob.com.au Chemistry Pty; Sydney; Hybrid; AUD 85,000 - 104,000; Full time

Benefits offered by this job

Attractive leave benefits

Hybrid working model (after training)

Subsidised private health insurance

Fantastic central location in SurryHll

Employee well-being programme

18 weeks paid parental leave

Additional long service leave

Job summary

Teachers Health in Sydney is seeking a detail‑oriented Hospital Claims Assessor to assess and process public and private hospital claims, interpreting policies and contracts to ensure accurate payments. You will engage with internal/external stakeholders and healthcare providers, explaining complex information clearly and concisely.

The role starts with full training in Surry Hills, then moves to a hybrid arrangement with standard hours 8AM–4PM.

Qualifications

• 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.

Responsibilities

• 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.

Job description

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.

• 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

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 [e-mail]