Claims Assessor Hospital in Sydney

We’re looking for a detail-oriented and proactive Hospital Claims Assessor to join our team. In this role, you’ll assess and process public and private hospital claims, interpreting policies, contracts and legislative requirements to ensure claims are processed accurately and efficiently. Strong communication skills are essential, as you’ll regularly engage with internal and external stakeholders, healthcare providers and members. You’ll need to be confident communicating clearly, particularly when explaining detailed or complex information.

Please note: Full training is provided, with the first three months based in our Surry Hills office. Following the training period, the role moves to a hybrid working arrangement. Standard working hours are 8AM - 4PM.

What we have to offer?

• Attractive leave benefits
• Hybrid working model (after training period) and a 35-hour full-time week to support work-life balance
• Subsidised private health insurance and discounts on our products and services
• Fantastic central location in Surry Hills
• Employee well-being programme
• 18 weeks paid parental leave for eligible employees
• Additional long service leave

What will you do? / How will you help

You’ll Be Responsible For:

• Accurately assessing and processing public and private hospital claims within required timeframes
• Interpreting policies, hospital contracts and legislative requirements to determine appropriate benefit payments
• Reviewing hospital billing and identifying discrepancies or issues
• Meeting productivity, quality assurance and KPI standards
• Communicating confidently and professionally with internal and external stakeholders, healthcare providers and members
• Handling inbound calls and enquiries, clearly explaining information and responding to queries
• Identifying problems, using initiative and contributing to solutions
• Contributing positively to team performance and continuous improvement

What do you need? / What are we looking for?

• While previous claims experience would be advantageous, we’re also interested in candidates who can demonstrate strong transferable skills.
• Experience in hospital claims, medical claims processing or healthcare billing is highly regarded
• An understanding of hospital systems, billing practices, private health insurance or the broader healthcare industry
• Excellent attention to detail and the ability to interpret complex policies, contracts and information
• Strong critical thinking and problem-solving skills
• Strong verbal and written communication skills, with the confidence to engage with members and a range of internal and external stakeholders
• The ability to understand complex information and communicate it in a clear, concise and easy-to-understand way
• Experience working towards KPIs and quality standards
• The ability to manage detailed or repetitive work efficiently without compromising accuracy
• A proactive approach, with the initiative to identify issues and contribute to solutions
• A genuine interest in ongoing learning and developing technical knowledge
• A collaborative, positive approach to working within a team

Applicants must be Australian Citizens or Permanent Residents. Teachers Health values diversity and inclusion and encourages applications from people with diverse backgrounds including First Nations people, people with disability, people from diverse cultural and linguistic backgrounds, and people that identify as LGBTQIA+. Applicants can request an adjustment at any stage during the recruitment process.