The Clinical Analyst, Medical supports the Medical Integrity Lead in ensuring Bupa Health Insurance pays no more for services than it is contractually and clinically obligated to pay by identifying, investigating and addressing medical claims leakage and billing inaccuracies. The role is responsible for undertaking complex medical claims audits, including detailed review of itemisation, billing patterns, supporting documentation and clinical notes, to assess whether services billed are substantiated, appropriate and aligned to relevant billing rules and contractual requirements.

This role requires strong working knowledge of Medicare, MBS item numbers and descriptors, billing principles and provider claiming practices, together with the ability to engage directly with specialists, practice staff and provider rooms to clarify billing, documentation and clinical service issues. The role contributes to recoveries, prevention strategies, audit outcomes and broader integrity initiatives through high‑quality clinical review, provider interaction and subject matter expertise.