Claims Gateway Specialist Consultant at Civica

Sydney, New South Wales, Australia -

Full Time

Start Date

Immediate

Expiry Date

02 Jun, 26

Salary

0.0

Posted On

04 Mar, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Health Insurance, Claims Processing, Digital Payment Ecosystems, Product Direction, Business Analysis, Crossfunctional Collaboration, Regulatory Requirements, Digital Payment Requirements, Agile Delivery Methodologies, Discovery Workshops, Analytical Skills, Problem-Solving Skills, UAT Planning, Defect Triage, API-based Integrations, Claims Environments

Industry

Software Development

Description

We’re Civica and we make software that helps deliver critical services for citizens all around the world. From local to state government, to education, to health and care, over 5,000 public bodies across the globe use our software to help provide critical services to over 100 million citizens. Our aspiration is to be a GovTech champion everywhere we work around the globe, supporting the needs of citizens and those that serve them every day. Building on 21 years of continuous growth and success, we're at a pivotal point on our journey to realise that aspiration. As a company, we’re passionate about what we do and the citizens we help to serve. If you too would like to help champion the use of technology in public services, to improve outcomes for citizens and public sector organisations, then Civica is the right place for you. We will help you unlock the best version of yourself, achieve growth in your career whilst making a real difference to people and communities. Why you will love this opportunity as a Claims Gateway Specialist Consultant at Civica This role offers the opportunity to apply deep expertise in health claims and digital payment ecosystems to solutions used across Australia’s health and insurance sectors. It provides the ability to influence product direction through structured discovery, detailed business analysis, and strong crossfunctional collaboration. You will work closely with product, engineering, operations, and customer teams to translate complex regulatory, operational, and digital payment requirements into actionable backlog items. The role provides the platform to shape solutions that improve claims processing efficiency, strengthen compliance, and enhance the digital experience for health funds and their members. Your expertise will directly support Civica’s continued growth in digital health and payment innovation, ensuring the delivery of solutions that help public and private organisations operate more effectively. This role enables meaningful impact by supporting technology that improves outcomes for citizens, health providers, and payers. What you will need to be successful in this role Extensive experience in health insurance, claims processing, or digital health payments Strong knowledge of digital claiming rails, settlement models, and realtime transaction flows Demonstrated capability in gathering, documenting, and validating complex functional and nonfunctional requirements Ability to create solutions related to claiming and digital payments Proven experience structuring Epics, Features, and User Stories with clear acceptance criteria and traceability Strong understanding of Agile delivery methodologies and sprintbased delivery processes Ability to facilitate structured discovery workshops with internal and external stakeholders Strong analytical and problemsolving skills, with the ability to translate ambiguous needs into defined deliverables Experience working with crossfunctional delivery squads, including product managers, engineers, QA, UAT, and operations Knowledge of integration dependencies, digital payment pathways, and optimisation opportunities within claims environments Ability to maintain documentation quality, audit traceability, and scope control across the delivery lifecycle Experience supporting UAT planning, defect triage, and release readiness activities Familiarity with APIbased integrations, health fund ecosystem requirements, or digital health claiming standards (nice to have) Why you'll love working with us. We know that when our people are happy, they will work better and have greater work satisfaction. Here's what you can expect: We're all different - and we love this about us. We provide an inclusive, safe, and welcoming environment to all Civicans - there are heaps of opportunities to enable you to grow and be your best. Giving culture - we encourage you to "give back" with benefits such as our Days of Difference leave where you can volunteer for a charity of your choice. Flexible Work - we have the technology and tools to support you to work from home and come into our offices now and then to catch up and socialise with colleagues. Apply for this job - Become part of something special Do you see yourself in this role? If so, then we would love to hear from you. We are an equal opportunity employer. We do not discriminate based on race, religion, colour, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. In fact, we strongly believe that diversity of experience contributes to a broader collective perspective that will consistently lead to a better company and better outcomes. We are working hard to increase the diversity of our team wherever we can, and we actively encourage everyone to consider becoming a part of it. We are especially keen to receive applications from Aboriginal and Torres Strait Islander peoples of Australia.

Responsibilities

This role involves applying deep expertise in health claims and digital payment ecosystems to influence product direction through structured discovery and detailed business analysis. The specialist will collaborate cross-functionally to translate complex requirements into actionable backlog items, shaping solutions that improve claims processing efficiency and compliance.