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Medical Auditor

Job Requisition Number:  2066


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

We currently have an opportunity for a Medical Claims Auditor to join our Health Audit team. This is a new role within our growing Health Audit team.

Medibank’s health services complement our private health insurance business and include telehealth services for government and corporate customers, care coordination, allied health care and hospital in the home services. We help customers navigate the health system to get the care they need to better manage their health and wellbeing.

This role will initiate, implement and manage agreed audits that identify irregular medical billing, ensure compliance with industry guidelines and identify benefit leakage of medical claims.

The position will also play a key part in reporting on audit outcomes and driving implementation of requirements across the business to support audit functions.


In this role, you will have the opportunity to:

  • Support the Health Audit Innovation & Support Manager to develop and implement solutions to resolve erroneous claiming and inappropriate benefit outlays specifically relating to medical benefits/claims.
  • Maintain accurate and contemporaneous procedure manuals for allocated audit portfolio.
  • Assist employees across the Medibank Group in understanding key issues surrounding medical claim billing practices and the impact on business outcomes and effectiveness.
  • Assist Hospital Claims Staff to resolve provider related queries and claim issues.
  • Provide advice to clinicians and Medicare to resolve claiming disparities.
  • Support and mentor team members in developing knowledge and skills around medical billing.


In order to be successful in this role, you will have:

  • Knowledge and understanding of the public and private health sectors particularly in relation to the Medicare Benefits Schedule including the application and rules surrounding inpatient medical service item numbers.
  • Experience working in billing or administration of medical services/claims such as accounts payable, or as an assessor in a specialist medical practice, Medicare, private hospital or private health insurer.
  • Demonstrated experience in preparing and analysing data for reporting purposes
  • Demonstrated commercial acumen in the interpretation of data and development of fact-based recommendations.
  • Demonstrated ability to think laterally to identify novel solutions to business problems.
  • A strong understanding of private and public hospital billing models (desirable).
  • Knowledge of medical claims assessing practices in a private health insurer (desirable).


What We Offer

In return for your hard work we offer a range of great benefits. Furthermore, we take the health and wellbeing of our employees seriously, offering flexible working conditions and encouraging wellbeing at all levels of life.

Medibank is an equal opportunity employer committed to providing a working environment that embraces and values diversity and inclusion. If you have any support or access requirements, we encourage you to advise us at the time of application to assist you through the recruitment process.

For a career option that will suit you better, click to apply.

Please note, if this position attracts a large volume of interest, the closing date for applications may be brought forward. With this in mind, we encourage you to submit your application as soon as possible.


A career with us


With flexible working options, our people have choice in how and where they work. We’re also committed to supporting better accessibility for our customers and our people. If we call you to discuss this role, you’ll also get the opportunity to chat about any adjustments.


We offer a range of great benefits such as subsidised private health insurance, rewards and discounts, and health and wellbeing initiatives.


To start small and impact bigger.

Job Segment: Medical, Accounts Payable, Audit, Claims, Medicare, Healthcare, Finance, Insurance