Hospital Claims Specialist - Hybrid After Training

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

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.