Address Job no: 500074
Work type: Permanent
Location: South Brisbane
Categories: All other
Mater Group is currently seeking an experienced Private Health Insurance (PHI) Audit Coordinator to join our Private Revenue team on a permanent full-time basis.
The PHI Audit Co-Ordinator reviews and coordinates Private Health Fund billing audits. The PHI Audit Co-Ordinator is required to identify practices requiring quality improvement and areas where the delivery of education and process re-engineering would benefit Mater.
Salary range:$42.05-$46.32 per hour plus superannuation and salary packaging
What you’ll be doing
Review all health fund billing audits received by all Mater Private Hospitals
Work closely with the PHI Audit Manager to determine if the recommendation for an audit episode is appropriate, and if not, take relevant steps to work with the health fund to resolve the situation
Liaise and co-ordinate with relevant internal teams including Coding, Revenue Assurance, Billing and Privacy to obtain additional information required to perform the audit
Make recommendations to the PHI Audit Manager and Revenue Operations Analyst where improvements are required based on results from audits
Maintain the audit database so it is up to date and reflects the status of all audits being undertaken or completed
Ensure that responses to the health funds are in accordance with instructions from the PHI Audit Manager
Process audits within Key Performance Targets.
Prepare internal requests on completion of an audit to assist in finalisation of the audit, including liaising with Accounts payable and the Billing Team
Keep up to date with healthcare industry and legislation changes
Keep up to date with renewed HPPA’s, interpretation of contractual obligations and associated billing rules
Perform any other tasks as reasonably required by the Manager PHI Audit
Follow processes and procedures in relation to the Audit Coordinator function
About you
To be successful, you will have demonstrated success in a similar role in a large and complex organisation coupled with the below:
At least 3+ years' experience in a Private Healthcare billing department or experience in PHI contract management
Demonstrated experience in managing and reviewing Health Fund billing queries
Experience in interpreting Health Fund contractual obligations and associated billing rules and demonstrated advanced level of knowledge of the funding models for Private Health care
An understanding of clinical terms, to assist in the review of claims
Strong organisational skills and capable of working on multiple tasks
Possesses a strong attention to detail
Strong skill level in use of Excel spreadsheets
Why join us?
Mater is Queensland’s largest and most innovative not-for-profit healthcare service, providing care for almost 700,000 patients a year across a network of 11 hospitals.
We are a leader in healthcare, education and research — and that’s because we employ exceptional people. #MAKEYOURMATERMOVE
Via salary packaging arrangements, allocate some living expenses directly from your pre-taxable income and ultimately increase your take-home pay
Access to package meal and entertainment expenses via salary packaging
Access to leading education and professional development via Mater Education
Flexible working arrangements, including work from home options where suitable
Access to our Employee Assistance Program and on-site pastoral care teams
Discounts to local and national business/venues for Dining/Retail/Travel & Accommodation/Other
Access to on-site, discounted parking
Discounted food and beverage at various campus cafés and coffee venues
Applications close on Monday 26 February 2024.
Advertised: 19 Feb 2024 E. Australia Standard Time Applications close: 03 Mar 2024 E. Australia Standard Time
