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Join to apply for the Clinical Adviser & Claims Auditor role at AIA Australia1 day ago Be among the first 25 applicantsJoin to apply for the Clinical Adviser & Claims Auditor role at AIA AustraliaBE THE DIFFERENCEAt AIA we dont simply believe in being the best. We believe in better because theres no limit to how far better can take us. Everything we do is driven by our purpose to make a difference by helping people embrace Healthier, Longer, Better Lives. And every one of our people has an important role to play. If you want to make a difference by helping shape a healthier, better-protected Australia, read on.The opportunity:AIA has a fantastic opportunity for a Clinical Adviser & Claims Auditorto join our Health Insurance team based in Melbourne, on a 12-month max term contract.As the Clinical Adviser & Claims Auditor, you will measure and test procedures with an eye to improving overall efficiency, drive the improvement of processes and systems, quality focus, and implement programs that will have continuing long-term benefits.The successful applicant will also ensure the ongoing and productive auditing of hospital, medical and ancillary claims as required by the business, and as determined through the annual review of identified savings targets.To do this successfully you will:Complete clinical advice & claims auditing supporting the claims department and assessors, driving continuous improvement of processes and systems, ensuring accuracy and complianceEnsure audits conducted are compliant with PHI Rules, Contract Agreements and Schedules, HICAPS Terms and Conditions, Fund Rules and other policy requirements of the businessAssist the Customer Service Team Managers in implementing policies, procedures, guidelines and audit schedulesContribute to AIA overall claims leakage strategic plan and objectives through planning own work and timely attendance to all delegated tasks and functions.Consider problems or issues that may arise and use lateral thinking to resolve or recommend solutions.Provide clinical advice to assessors and business where required.Liaise with hospital and provider billing teams as required to undertake the audit function effectivelySuccessful applications will have:Experience working with PHI Hospital and Ancillary claim dataSuccessful completion of recognised Medical Terminology courseCoding experience with knowledge of ICD-10-AM (11th edition), ACHI & ACSKnowledge of private sector funding modelsDegree Qualification in Health Information Management (HIM) will be highly regardedAble to read and understand claims data and medical records with the ability to determine where inconsistencies and/or outliers have occurred.Excellent organizational and time management skills, including demonstrated experience in coordinating input from a number of contributorsEffective consulting and stakeholder management skillsWhy choose AIA:At AIA, weve made a promise to help people live healthier, longer, better lives. And it starts with our own people.Access our training and development to build on your current skillsCareer development through internal mobility opportunitiesWork for a business helping millions of Australians and make a difference to someones life everydayAccess additional leave days a year to recharge and refresh yourselfEnjoy wonderful Health and Wellbeing initiatives that support youWork with supportive and inclusive managersAt AIA Australia, were proud to help guide, support and protect the wellbeing of over 3.5 million Australians. As part of the AIA Group - the largest independent publicly listed pan-Asian life insurance group it is our ambition to engage one billion people to live Healthier, Longer, Better Lives by 2030.Lots of companies like to say theyre different. What makes us truly different at AIA, is the difference we make in peoples lives. We are proud that this difference has been recognised in the 2024 ANZIIF awards by being named Life Insurance Company of the YearAIA is different. Are you?If you want to be part of an organisation that helps people live better every single day, apply via the link.Seniority levelSeniority levelNot ApplicableEmployment typeEmployment typeFull-timeJob functionJob functionAccounting/Auditing, Analyst, and FinanceIndustriesInsurance and Financial ServicesReferrals increase your chances of interviewing at AIA Australia by 2xGet notified about new Clinical Advisor jobs in Melbourne, Victoria, Australia.Gladstone Park, Victoria, Australia 1 month agoCasual Clinical Consultant - Joint ReplacementMelbourne, Victoria, Australia 3 days agoClinical Consultant (Robotics) - Relocate to Geelong!Melbourne, Victoria, Australia 2 weeks agoMelbourne, Victoria, Australia 2 weeks agoMelbourne, Victoria, Australia 2 weeks agoMelbourne, Victoria, Australia 5 days agoMedical Science Liaison (MSL) / Medical Scientific Advisor (Victoria, South Australia, Tasmania)Melbourne, Victoria, Australia 3 months agoSouth Melbourne, Victoria, Australia 2 days agoClinical Consultant - Relocate to Perth!Melbourne, Victoria, Australia 1 week agoMelbourne, Victoria, Australia 6 days agoMelbourne, Victoria, Australia 2 weeks agoForest Hill, Victoria, Australia 1 week agoJoin Kenko as a Clinical Advisor or Research Lead (Equity-Based) Help Drive Real-World Pilots in Hospitals and Health InstitutionsWere unlocking community knowledge in a new way. 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