Benefit Integrity Analyst

At HCF, our Benefit Integrity team is dedicated to protecting our members’ interests by ensuring claims are processed accurately, fairly, and in full compliance with industry regulations. We combine analytical rigour with a commitment to continuous improvement, helping to maintain the financial health of Australia’s largest not‑for‑profit health insurer. As a Benefit Integrity Analyst, you will play a key role in identifying trends, risks and opportunities related to health insurance claims and benefits utilisation. This position reports to the Benefit Integrity Manager and works closely with colleagues in Analytics, Compliance and Claims Processing to support HCF’s mission of member care and integrity. Full‑time contract position until the end of June 2027. Key Responsibilities Conduct data analysis to identify unusual claim patterns, potential fraud and errors. Prepare clear and actionable reports for internal stakeholders, including management and regulatory bodies. Support and manage benefit integrity projects, from planning through execution and review. Undertake research to inform policy updates, system improvements and risk mitigation strategies. Contribute to ongoing process‑improvement initiatives aimed at enhancing operational efficiency and accuracy. Ensure all activities comply with relevant health industry regulations and HCF’s internal policies. Key Focus Areas Claims Data Analysis Project Management Industry and Policy Research Continuous Process Improvement Regulatory Compliance and Reporting Essential Skills, Experience & Qualifications Bachelor’s degree in Data Analytics, Finance, Business, Health Administration or a related field. Demonstrated experience in data analysis, reporting or auditing, preferably within the health insurance sector. Strong proficiency in Excel and analytical software (e.g., SQL, Power BI). Excellent written and verbal communication skills. Ability to manage multiple projects and meet deadlines. High attention to detail and commitment to accuracy. Understanding of regulatory frameworks applicable to health insurance. Desirable Experience with fraud detection techniques and software. Knowledge of Australian health sector regulations. Familiarity with continuous improvement methodologies (e.g., Lean, Six Sigma). Project management certification (e.g., PRINCE2, PMP) or equivalent experience. Experience working in a cross‑functional team environment. 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 2 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. Culture & Benefits Purpose‑driven passion: We’re united by a common purpose: to make healthcare affordable, understandable, high quality and member‑focused. Wellness and work‑life balance: We’ll empower you with the necessary skills and tools to support your personal wellbeing journey, ensuring you perform at your best. Flexible working arrangements 50% subsidy on HCF hospital and/or extras cover Family‑friendly certified employer 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 – 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. #J-18808-Ljbffr