Australian Unity is an Australian healthcare and financial wellbeing company that provides health insurance, aged care, and banking services across Australia.
A Healthcare Claims Officer is responsible for reviewing, processing, and assessing health insurance claims to ensure they are accurate, comply with policy terms, and are paid promptly. The role involves working closely with healthcare providers, members, and internal teams to resolve claim-related issues while maintaining regulatory compliance.
Key Responsibilities:
- Review and process healthcare and medical insurance claims.
- Verify claim information, supporting documents, and member eligibility.
- Assess claims according to policy terms, guidelines, and regulatory requirements.
- Investigate and resolve claim discrepancies or incomplete submissions.
- Communicate with members, healthcare providers, and internal departments regarding claim status.
- Ensure accurate and timely payment of approved claims.
- Maintain detailed and confidential claims records.
- Respond to customer enquiries related to claims processing.
- Identify potential fraudulent or duplicate claims and escalate when necessary.
- Prepare claims reports and assist with process improvement initiatives.
- Ensure compliance with company policies, privacy legislation, and healthcare regulations.
Pay: From $8,500.00 per month
Benefits:
- Childcare assistance
- Dental insurance
- Health insurance
- Life insurance
- Parental leave
- Professional development assistance
- Profit sharing
- Referral program
- Relocation assistance
- Vision insurance
Work Location: In person
