Case Specialist
Core
Manage end-to-end premium administration and remediation cases for health fund members and providers, ensuring accurate calculations and fair outcomes.
Role type
Case Specialist (Premium Administration)
Builds
Remediation payments, case assessments, and record rectifications for health fund members
Domain
Health Insurance / Financial Administration
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
policy administration, remediation case management, financial calculation validation, customer enquiry resolution, risk identification and escalation, quality assurance checks, case management tools proficiency
Preferred skills
strong numerical skills, experience in regulated environments, dispute resolution
Technologies
spreadsheets, case management tools
Responsibilities
Calculate and validate remediation payments, investigate payment discrepancies, maintain accurate audit trails, act as primary contact for cases, perform quality assurance checks, support and coach coordinators
Seniority
Mid-level, hands-on IC