Claims Assessor Hospital

Teachers Health Group; Sydney; Hybrid; AUD 85,000 - 104,000; Full time

Benefits offered by this job

Hybrid after training

35-hour full-time week

Subsidised private health insurance

Central location in Surry Hills

Employee well-being programme

18 weeks paid parental leave

Long service leave

Job summary

Teachers Health Group is seeking a detail-oriented Hospital Claims Assessor in Sydney. The role offers a permanent full-time position with hybrid work after training and standard hours 8AM–4PM. Training is in the Surry Hills office, with ongoing support and competitive benefits.

The successful candidate will process public and private hospital claims, interpret policies and contracts, and collaborate with stakeholders to ensure accurate payments while meeting KPIs and quality standards.

Qualifications

• Experience in hospital claims, medical claims processing or healthcare billing is highly regarded.
• 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.

Skills

Attention to detail

Verbal & written communication

Critical thinking

Problem solving

Team collaboration

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.

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

• 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?

• 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?

• 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]