Claims Officer
Core
Assess private health insurance claims (hospital, medical, ancillary) for Police members, ensuring accuracy and compliance with fund rules and regulations.
Role type
Claims Officer (0.8 FTE)
Builds
Processed health insurance claims and member/provider outcomes
Domain
Private health insurance / Claims administration
Required skills
Claims assessment, Policy interpretation, Regulatory compliance, Member liaison, Provider liaison, Claim adjustments, Data analysis
Preferred skills
Private health insurance knowledge, Regulated environment experience
Technologies
Microsoft Office, Customer systems
Responsibilities
Assess health insurance claims accurately and efficiently, Review hospital, medical and ancillary claims, Manage member and provider claim enquiries, Determine hospital cover eligibility, Process claim adjustments and recoveries, Liaise with Medicare and external providers
Seniority
Individual Contributor