Benefit Integrity Officer

The objective of the Benefit Integrity team is to ensure that HCF acts with integrity when fulfilling our legal and ethical obligations to members and providers. Our team is committed to implementing effective payment approaches that control unnecessary and inappropriate costs, helping to maintain affordable private health insurance and healthcare for our members. Please note this role is a full time contract position until the end of June 2027 This role also offers a flexible work arrangement with 2 days onsite at our Sydney CBD head office and 3 days working from home each week. Role Overview The Benefit Integrity Officer will support the Policy and Audit Manager in achieving the team's goals and will be responsible for: Supporting the identification, mitigation, elimination and management of benefits inaccuracy and leakage Contributing to audit and recoveries activities undertaken by the team Corresponding with providers and members regarding claims and audits Maintaining accurate reports and records Key Focus Areas Assist with the broader identification, mitigation, and elimination of benefits inaccuracy and leakage Identify system improvements to enhance identification, audit and recovery efficiency Support recovery of monies from providers on behalf of HCF where possible Record progress on departmental activities and recovery processes Report monthly on savings and recoveries Liaise with providers and members on all matters concerning audited/recoverable claims Manage correspondence and enquiries related to known or potential recoveries and related claims Ensure records and files are accurate, up to date, and accessible Support sensitive claims reviews and investigations Comply with HCF's Risk Management Framework, Strategy, Manual, and risk/compliance procedures Perform other duties as required to support the effective and efficient operation of the Benefit Integrity unit and Member Health team Skills, Experience, and Qualifications Proven capacity in a similar role, with minimum 1-year experience liaising with providers and members Minimum of 1-year clinical experience Innate curiosity, ability and desire to learn Strong English written and verbal communication skills Fully conversant in MS Word, with basic MS Excel skills Excellent attention to detail Ability to work unsupervised in a team environment Methodical, organised, and committed to continuous improvement Tact, diplomacy, and ability to maintain complete confidentiality Excellent customer service skills (internal and external) Tertiary qualification in a relevant area Minimum of 1-year private health insurance experience About HCF At HCF, our purpose is to bring our human touch to healthcare. Since 1932 we've been putting our members and their health first. As Australia's largest not-for-profit health fund, we cover over 1.9 million members with health, life, travel and pet insurance and our vision is to make healthcare understandable, affordable, high quality and member centric. We want to be true health partners to our members, easily guiding the healthcare choices that are right for them. At HCF, our values are the way we do things and create the necessary culture to help us realise our purpose and deliver our Strategy. Living our values in action we step forward, walk in their shoes, stay human, make it better and get there together. Purpose-driven passionWe're united by a common purpose: to make healthcare affordable, understandable, high quality and member-focused. Wellness and work-life balance 50% subsidy on HCF hospital and/or extras cover 18 weeks of parental leave for all new parents Mental health and wellbeing programs, including workshops, fitness classes, flu vaccinations, skin checks and more Discounts on HCF's products, including life, pet and travel Insurance, as well as discounts at Fitness First gyms and on our eyecare products. Collaboration and inclusivity We embrace diversity as our strength and are committed to maintaining an inclusive and collaborative work environment. Our workplace is welcoming and safe for all our employees, irrespective of their unique characteristics including age, ethnicity, cultural or spiritual background, gender identity, disability, education and socio-economic status. Continuous learning and growth We believe in lifelong learning. HCF provides opportunities for personal and professional development. From workshops to mentorship programs, we encourage your growth and curiosity. Next steps If you require any adjustments to assist you in making your application or during the recruitment or onboarding process, please reach out to Talent Acquisition - **************@hcf.com.au to discuss. We encourage applicants to submit their applications at their earliest convenience, as at HCF, we review applications as they are submitted, and may have filled the role prior to the job closing date. Be careful - Don’t provide your bank or credit card details when applying for jobs. Don't transfer any money or complete suspicious online surveys. If you see something suspicious, report this job ad. #J-18808-Ljbffr