Funding and Claims Specialist
Core
Manage funding and claims operations across Australia and New Zealand for a network of hearing clinics, ensuring compliance and revenue recovery.
Role type
Senior Claims and Funding Specialist
Builds
Accurate claims submissions, compliance frameworks, and revenue recovery processes
Domain
Healthcare / Hearing Aid Industry / Claims Administration
Required skills
Claims administration, Compliance auditing, Revenue management, Data analysis, SOP development, Stakeholder management, Policy interpretation, Process improvement
Preferred skills
Knowledge of HSP/DVA/WorkCover, Audiology services, Healthcare funding models, Compliance investigations
Technologies
Microsoft Excel
Responsibilities
Review, assess and validate claims across all funding streams; Conduct regular compliance reviews and audits; Investigate claim discrepancies and non-compliance issues; Develop and maintain claiming procedures and SOPs; Analyse claims data and operational trends; Provide subject matter expertise on funding eligibility; Deliver training and guidance to clinic teams; Prepare reports and dashboards on claiming performance; Support business initiatives relating to funding systems; Act as escalation point for complex enquiries