Share this Job

Claims Compliance Specialist

Job Requisition Number:  5416
Date:  04-Oct-2021


Will you actively create a healthier future for tomorrow?


At Medibank we’re encouraged to think big. We have a clear purpose to impact better health outcomes for our customers, patients and our community.


We celebrate diversity of thought because we want to make better decisions for our customers. As we work towards our goal of better health for better lives, we value the knowledge and contribution of Aboriginal and Torres Strait Islanders. We are working hard to create an inclusive workplace and develop Indigenous careers.


The Opportunity

Enjoy looking for patterns and trends in large data sets?

Experienced in the allied health sector?

Passionate about building smarter solutions for the future?

Interested in healthcare and making an impact on your community?


If it’s yes to nearly all the above, we may be the right place for you!


Your key focus as a member of the Payment Integrity team will be to look for opportunities to limit improper claims, through prevention and investigation of fraud, waste, abuse and error. It is through this work, that we ensure premiums remain affordable for members in these uncertain times.


To be successful in this role, you will need:

  • A keen eye for detail, adept at looking through large claim sets and picking out claims which indicate inappropriate claiming behaviour.
  • The ability to multi-task and prioritise the high case volumes yet maintain quality standards and continue to meet financial targets.
  • Be a proficient communicator, both spoken and written as you will be engaging with providers, members and various stakeholders within the business.
  • Be self-driven with a great attitude, to be able to work autonomously and be driven to deliver results but still like to have fun and maintain the strong co-working culture which Medibank is so well known for.
  • Always looking out for ways to improve the way of working and challenging the status quo, because that’s how we continue to achieve high quality outcomes for our members!


About you


You are experienced in claims investigation, audit, fraud, risk or practice management with working interest or knowledge in healthcare. You’re meticulous and organised, thriving on change and disruption, continuously looking to improve processes.


You are a critical thinker with the ability to interrogate systems to identify issues and propose sustainable solutions. As you will need work with large sets of data in this role, you will be an analytical and structured in your approach and enjoys resolving challenging issues using a methodical approach.



A career with us

At Medibank, we believe work is something we do, not somewhere we go. Our modes of working – Collaboration, Connection and Concentration – help inform how your day is structured and where you choose to work will vary, depending on your role and requirements.


The wellbeing of our employees is our priority. We encourage you to talk to us about any adjustments or additional support you may require during the recruitment process, as well as how this role can be flexible for you. Virtual interviews are always on offer and will not adversely impact your application.


We offer a range of great benefits such as subsidised private health insurance, rewards and discounts, and health and wellbeing initiatives. To find out more, click here.


To start small and impact bigger.

Job Segment: Claims, Compliance, Insurance, Legal