Claims Processing Consultant

Assess and process complex Health Insurance claims in accordance with Bupa, policies, procedures, and fund rules

End to end claims assessment of Hospital, Medical and Ancillary claim types

Exception management of complex claims

Eclipse assessment

Daily management of Medicare reporting

Ensure high level quality customer and provider outcomes through both accurate and efficient claims assessment

Provide best in class service to customers and providers both via phone (inbound and outbound) and written correspondence including account queries

Achieve or exceed performance targets including but not limited to AHT, Quality, Risk and Compliance

Proactively identify process improvement and self-service opportunities to support customer needs

Ability to perform autonomously and demonstrate time management skills

Display empathy and superior customer service interaction skills, adhering to Case Management best practice and follow up procedures.

We support our people to be the healthiest and happiest versions of themselves.

If this sounds exciting, we’d love to hear from you. Let’s shape the future of healthcare, together.

At Bupa your wellbeing, identity, and personal story are respected and valued. We are continuing to build teams that reflect the diversity of the communities we serve. Bupa is committed to providing equal opportunities and fostering a workplace and environment that is free of discrimination, bullying and harassment.

We actively encourage applicants from all backgrounds and experiences, including Aboriginal and Torres Strait Islander peoples, veterans, people with disabilities, and LGBTQIA+ applicants.

We are dedicated to removing barriers to participation. If you need any reasonable adjustments during the recruitment process, or if you’d like to discuss how this role can be flexible for you, please let us know so we can support your participation on an equitable basis.