Claims Specialist

Infosys Consulting; Melbourne; On-site; AUD 100,000 - 130,000; Full time

Job summary

A leading consulting firm is seeking a Claims SME located in Melbourne. The role involves leading claims operations design and engaging with diverse stakeholders to align on transformation goals. Ideal candidates should possess deep expertise in health insurance and exceptional communication skills. This full-time position offers the opportunity for career development within a diverse and cooperative work environment.

Qualifications

• Proven experience in claims operations, particularly in designing and implementing future-state models.
• Familiarity with Australian health insurance regulations is highly valued.
• Ability to influence and engage stakeholders at all levels.

Responsibilities

• Lead and support the design of the target state for claims operations.
• Engage with stakeholders to ensure alignment on transformation objectives.
• Contribute to the development of executive-level documentation.

Skills

Deep expertise in health insurance

Exceptional communication skills

Strong business acumen

Tools

Pega Smart Claims Engine

Job description

Overview

Role: Claims SME

Location: Melbourne preferred or Sydney

Hiring: Permanent Role

Company: Infosys Consulting is the worldwide management and IT consultancy unit of the Infosys Group (NYSE: INFY). We partner with clients to design and implement customized solutions to address complex business challenges and IT-enabled transformations.

Responsibilities

• Lead and support the design of the target state for claims operations, aligning with business goals and regulatory requirements.
• Engage with stakeholders across all levels—from directors to business analysts—to ensure alignment and clarity on transformation objectives.
• Contribute to the development and communication of executive-level documentation, including roadmaps, priorities, and target state design.
• Provide market-leading insights into industry best practices, emerging trends, and innovative approaches to claims transformation.
• Shape requirements at epic and feature levels, ensuring business value and feasibility are well-articulated.
• Offer strategic input on business value realization and the change effort required for successful implementation.

Qualifications

• Deep expertise in health insurance, with strong business acumen and operational understanding.
• Proven experience in claims operations, particularly in designing and implementing future-state models.
• Exceptional communication skills, with the ability to influence and engage executive and business-facing stakeholders.
• Familiarity with Australian health insurance regulations (highly valued but not mandatory).
• Exposure to Pega Smart Claims Engine or similar platforms (optional but advantageous).

We offer you great opportunities within a dynamically growing consulting organization. You will elaborate and deliver best practice solutions and will be able to further develop your skills. Infosys Consulting provides a global culture that embraces diversity, with a cooperative work environment and training opportunities.

Seniority level

• Mid-Senior level

Employment type

• Full-time

Job function

• Consulting

Industries

• Business Consulting and Services