Health Information Manager - Hospital Claims Specialist

Job No: GMHBA488
Location: Geelong or Abbotsford

 
We have an exciting opening for a Health Information/Hospital Claims professional to join our Benefits Management & Audit Team. This is an ongoing role, which can be based in our Geelong or Abbotsford
offices.
 
About us
 
GMHBA is an Australian not for profit health insurance and care company with more than 80 years’ experience. We are Australia's leading regionally based health and care company with more than 230,000 members. Through our personalised approach and exceptional customer service, we put the health and wellbeing of our members and communities first.
 
About the role
 
Your work will be pivotal in helping us to manage benefits by reducing the rate of escalation in benefit outlay and out of pocket costs for members. Working collaboratively with the Claims Team, Benefits Management and providers you’ll be responsible for:
 
  • Assisting the Audit Manager in reducing claims leakage through Hospital claim auditing.
  • Ensure a standard approach to clinical claims coding and audit is followed and communicating with providers regarding claim issues.
  • Providing subject matter expertise related to the audit function and case-mix benefit analysis to team members, senior management and other areas of the business.
  • Undertake the audit function through data analysis and review and report on outcomes and trends
 
You’ll join a team of passionate Health Information professionals and claims specialists who are known as influencers in their field where your work will make a difference. The diverse expertise of our team members leads us to an ongoing journey and commitment to learning and developing our skills every day.
 
This is a great opportunity to use your skills within Benefits Management focusing on ensuring that our Members’ benefits are for the Right Services, at the Right Cost, at the Right Time, in the Right Place.
 
About You
 
As the successful candidate, you’ll hold a relevant qualification and be able to demonstrate experience in health data management working in capacity of Health Information Manager/Clinical Coder, or, professional experience in Australian Health Industry working in hospital billing.
 
You’ll also possess: 
  • The ability to read and understand claims data and medical records to determine where inconsistencies and/or outliers have occurred.
  • An analytical mindset with a proactive approach to problem-solving
  • The ability to communicate ideas in both technical and user-friendly language.
  • Great organisational, planning and time management skills with a commitment to achieving high quality outcomes.
  • Relevant computer technical skills applicable to coding and casemix, or Patient Administration Systems
 
Applicants with the following experience will be favorably considered:
 
  • A Bachelor of Health Information Management, or Diploma of Medical Record Administration or other recognised clinical coding course will be highly regarded.
  • Experience and competency in clinical classification (ICD-10-AM and the Australian Classification of Health Interventions) or demonstrated experience and competency in Hospital/Medical inpatient billing and private patient claims submission.
  • Proven practical experience with reporting tools and relational data concepts
  • Knowledge of private health sector funding models.
 
Let's get started?
 
Submit your application TODAY via the form below. Download the full position description for more information.
 
Have Questions? Contact us at recruitment@gmhba.com.au
 
At GMHBA we celebrate and harness diversity and consider it a competitive advantage. We encourage applicants from all diverse backgrounds.
 
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