Clinical Claims Analyst

What Makes Us, Us
We want to be the most trusted wellbeing company in Australia, and this means our focus on wellbeing starts with our people. We support our employees Real Wellbeing so that they can better support our members' and customers' wellbeing journey.
At Australian Unity We're for real wellbeing. For us, real wellbeing means so much more than physical health. It's about your standard of living, your personal relationships and being connected to your community. It's about what you want to achieve in life, while having the security to get out and do what makes you happy.
We're bold, warm and honest. We make a real difference to people's wellbeing.
What's on Offer:
You will enjoy a range of great employee benefits and rewards including:

• Competitive salary + bonus program
• Enjoy additional yearly Well-Being and Community leave days
• 14-week paid parental leave, with equal benefit for both parents PLUS our Bump to Baby
• Employee Referral Program
• Employee Assistance Program - support and assistance for you and your partner at those times in life when you need it most
• Maxxia Rewards - a great range of discounts and benefits at selected retail outlets, department stores, attractions, travel, cinemas, restaurants.
• Discounts across the Australian Unity business including Private Health Insurance, General Insurance + more!
• Available access to LinkedIn Learning courses through our great Learning platform

For further benefits visit:
Your New Role Looks Like This:
Are you an experienced senior nurse looking for a change of scenery? Would you welcome the opportunity to use your acute skills in a different setting, with no shift work and no direct patient contact? Why not consider joining our team of experienced industry professionals, as a subject-matter expert to ensure that private health insurance claims are paid appropriately.
Your daily responsibilities will require you to use your practical experiences to assess clinical documentation supporting hospital/medical claims to ensure appropriate payment, as part of a team of nurses and other health professionals. The team also manages review of clinical ex-gratia requests, Provider compliance monitoring through on-site/desktop audits, as well as providing technical advice to internal stakeholders.
About You:
You are an experienced Critical Care Nurse with recent senior employment in Theatre, ICU, ED, or hospital management; and have good analytical and numerical skills
Other desirable skills/knowledge include:

• Knowledge of MBS, DRGs, Government legislation and regulations relating to Private Health Insurance
• Understanding of prostheses arrangements
• Coding experience with ICD-10-AM/ACHI
• Experience working in the Private Health Insurance Industry
• Confidence with computer systems; Microsoft Office, Salesforce

Australian Unity is an Equal Opportunity employer and we encourage applications from all members of the community, including people of Aboriginal and Torres strait Islander descent, culturally and linguistically diverse backgrounds and, mature aged people.