Payment Integrity Manager

Teachers Health
    SYDNEY, Australia
    Job Type
    Application Close Date
    Contact Title
    Benefits Assurance Manager
    Contact Name
    Sujata Singh
    Contact Email


    About the Role

    Teachers Health has relationships with many health providers. Our members are billed by those providers and submit claims, which we access and process. In this role, you will be responsible for Payment Integrity; ensuring all payments made by Teachers Health are done so in accordance with provider agreements and our own policies and guidelines. You will report into the Benefits Assurance Manager and have a couple of direct reports.

    Here’s what you’ll do:

    • Develop, oversee, manage and report on a claims audit program
    • Day-to-day management of the Payment Integrity Team
    • Oversee the recovery of inappropriately paid claims and develop strategies to prevent them.
    • Provide a high standard of customer service by dealing with escalated enquiries from team members and management.

    What’s in it for You?

    One of strengths here at Teachers Health Fund is our diversity. We enjoy being part of one big team, and encourage people from all walks of life, including people with a disability to apply for our roles. (You can request any support or reasonable adjustments that you may need to fully participate in the recruitment process.)

    You’ll also benefit from:

    • A generous six-week annual leave
    • A flexible work model after your training period
    • Subsidised Private Health Insurance
    • A corporate wardrobe allowance
    • Staff discounts on products and services
    • Opportunities for ongoing training, development, and career progression.

    What Do You need?

    • Hospital and/or Private Health Insurance experience
    • 3+ years’ experience as people management with a demonstrated ability to lead, motivate and manage people.
    • Excellent people and customer service skills, high level communication skills
    • Experience preparing management reports
    • Relevant tertiary qualifications (e.g. Health Information Management) and/or relevant work experience
    • Experience using hospital patient information & billing systems or similar (desirable)
    • Knowledge of hospital billing and/or claims processes (desirable)
    • Knowledge of medical terminology (desirable)


    What’s it like to work here?

    We love making a positive difference every day for our customers. And we do it as one big team. As Australia’s largest industry-based health insurer, we know what our members want and over 360,000 people are covered by us. Based in Surry Hills, we’re a one-stop shop for health insurance – plus eye care, dental, travel and general insurance too. And because we’re a not-for-profit health insurer, our members come first every time.

    How Do You apply?

    To apply just click the link above and apply via Seek.

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