BE AT THE HEART OF IT

Helping people live longer, happier, healthier lives and making a better world. That’s what drives us every day. Our people, our customers and our community are all at the heart of Bupa. We’re working hard to shape a brighter future for everyone, but we can’t do it alone.

THE HEART OF THE ROLE

We are looking for Claims Processing Consultants to join our Claims team on a full-time permanent basis. You will be responsible for managing complex customer and provider Health Insurance claim requests for Ancillary, Medical and Hospital Claims. You will be working directly with customers and providers to proactively assess claims and resolve queries while building strong relationships to deliver a seamless claiming experience for our customers and providers.

AS A CLAIMS PROCESSOR YOUR RESPONSIBILITIES WILL INCLUDE:

• End to end claims assessment of Hospital, Medical and Ancillary claims
• Communicate with claimants, policyholders, and third parties to clarify claim details or request additional information
• Gather and analyse evidence to determine the validity and potential impact of claims
• Proactively identify process improvement and self-service opportunities to support customer needs
• Provide best in class service to customers and providers both via phone (inbound and outbound) and written correspondence including account queries.
• Ensure all claims processing activities comply with relevant industry regulations, legal requirements, and company standards
• Keep up to date with changes in regulations, laws, and best practices that affect claims processing

ADDITIONAL INFORMATION ABOUT THE ROLE

• Start Date February 2025
• The role will be based in our Adelaide office for the first 3 months, once you and your team leader agree you have settled well the opportunity to work from home will be an option.