Member Claims Specialist

Hcf Australia; Sydney; Hybrid; AUD 65,000 - 90,000; Full time

Benefits offered by this job

Flexible working arrangements

50% subsidy on health cover

Family-friendly policies

18 weeks parental leave

Mental health programs

Discounts on products

Job summary

HCF Australia is recruiting a Member Claims Specialist in Parramatta, NSW. The role focuses on first call resolutions, assessing and processing health insurance claims to ensure timely payments, and supporting the Contact Centre and Branch teams with complex queries.

This is a 12-month maximum term contract. The position is based in Parramatta with full-time hours, 9:00 am to 5:15 pm, and hybrid work after training. In-office presence is required at least two days per week.

Qualifications

• Knowledge of private health insurance products and Ancillary claims procedures.
• Familiarity with Claims Portal, Elmo, New Health and GV.

Responsibilities

• Respond to member queries over the phone and assess/ review claims.
• Lead with empathy and provide exceptional customer care.
• Handle all claims enquiries adhering to quality standards.
• Identify opportunities to improve customer service standards.
• Provide support to Contact Centre and Branch teams with complex queries.
• Respond to dissatisfied members and resolve complaints over the phone.

Skills

Customer service

Communication

Typing & data entry

Adaptability

Work under pressure

Continuous learning

Tools

Claims Portal

Elmo

New Health

GV

Job description

Member Claims Specialist HCF Australia Parramatta, NSW, AU

Job Description

About The Role

The Member Claims Specialist will focus on first call resolutions for our members over the phone, assess and process health insurance claims to ensure timely payments for our members. You will also provide support to the Contact Centre and Branch teams with complex claims queries.

Join the HCF Claims team at Parramatta.

About The Role

The Member Claims Specialist will focus on first call resolutions for our members over the phone, assess and process health insurance claims to ensure timely payments for our members. You will also provide support to the Contact Centre and Branch teams with complex claims queries. This is a maximum term contract for 12 months. This role is based at Parramatta and you will work full time hours, Monday to Friday from 9 am to 5:15 pm. Hybrid working is available, after the training period. You will be required to work in the office a minimum two days a week.

As The Member Claims Specialist, You Will

• Respond to all member queries over the phone, and assess and review claims
• Lead by example by displaying soft skills of empathy, patience and providing uncommon care
• Handle all member claims related enquiries adhering to agreed call and claims processing quality standards
• Identify opportunities to improve customer service standards and provide outstanding customer service
• Provide support to Contact Centre and Branch team members with complex claims queries
• Respond to dissatisfied members and handle all complaints and provide resolutions over the phone.

About You

You will have a comprehensive knowledge of private health insurance products and Ancillary claims procedures. You will have strong understanding of Claims Portal, Elmo, New Health and GV.

To Be Successful In This Role, You Will Demonstrate

• The ability to work under pressure
• A strong commitment to providing exceptional customer service
• A positive attitude and willingness to embrace change
• Strong written and verbal communication skillsAccurate typing and data entry skills
• The desire to improve and develop skills and knowledge.

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.

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.