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Senior Fraud Analyst

Job Requisition Number:  1557
Date:  06-Sep-2019


We're passionate about nurturing careers.

We support innovation and thinking, and openly collaborate and share new ideas. We're healthy and active in our lives and wellbeing is encouraged at every level.  Our people play an important role in the future of health and healthcare and we believe that working together, we're stronger.


About us

We are Medibank – an integrated healthcare company providing private health insurance and health solutions to 3.7 million Australians. As we work towards our goal of Better Health For Better Lives for all Australians, we value the knowledge and contribution of Aboriginal and Torres Strait Islanders. We are working hard to create an inclusive workplace and we believe in developing Indigenous careers.



The Opportunity

As a Senior Fraud Analyst with Medibank, your key focus will be to limit improper claims made through detection, prevention and investigation of fraud, abuse and error.


In this role, you will work to continuously identify trends and patterns, provide and share insights with the team and stakeholders to improve operations.


Some of the key tasks in this role include the below:

  • Identify, review and assess health service providers, members and staff to ensure compliance with Medibank’s recognition criteria, Fund Rules and industry standards
  • Prioritise activities based on return on investment, quality of care to our members and the member’s experience.
  • Explore new analytics tools and techniques utilising knowledge gained from provider and member behaviour.
  • Identify risks associated with systems, products and claiming errors and share with team and management.
  • Recommend sustainable enterprise wide solutions, ensuring outcomes and activity are aligned with functional and organisational strategy.
  • Coaching and mentoring team members to drive quality performance and output.
  • Undertake root cause analysis and provide recommendations for remediation of systemic issues.


About you

To succeed in this role, you will likely have experience in risk, fraud, compliance or payment integrity.


You will be experienced in running projects and might come from the professional services, health or financial services industry.


You are a subject matter expert in fraud with a strong working knowledge of analytics, data mining and reporting techniques.


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 data driven individual who enjoys resolving challenging issues using a methodical approach.


What we offer

In return for your hard work, we offer a range of great benefits, including subsidised private health insurance, travel insurance and pet insurance.

We take the health and wellbeing of our employees seriously, offering flexible working conditions and encouraging wellbeing at all levels of life.


We’re committed to supporting better accessibility for our customers and our people. You can find out more about Medibank’s Accessibility and Inclusion Plan here. If we call you to discuss the role you’ll also get the opportunity to chat about any adjustments.

A Career at Medibank adds up to more. More achievement. More progress. More passion and more innovation for health.


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


Job Segment: Insurance Fraud, Claims, Data Mining, Insurance, Technology