Medical Administration (Healthcare and Medical)
Full time
Classifying
Casemix
Remarkable people. Remarkable careers.
At GMHBA, every day is a chance to make a real impact on people's lives. Join our people-focused, not-for-profit health insurer and enjoy a adaptable workplace, supportive culture, and a rewarding regional lifestyle. For 90 years, we've put our members, and our people, first. Make your career meaningful with GMHBA.
Love uncovering patterns, solving complex healthcare billing puzzles, and turning data into meaningful insights?
We're looking for a passionate and detail-oriented Health Information Manager, Clinical Coder, or Health Data Specialist to join our growing Payments Integrity team at GMHBA.
In this role, you'll be at the forefront of protecting the integrity of health claims payments-investigating anomalies, identifying opportunities, conducting audits, and ensuring our members receive the right benefits while maintaining compliance across the healthcare landscape.
If you're someone who enjoys combining healthcare expertise, analytics, auditing, and problem-solving, this could be the perfect next step in your career
Why This Role Stands Out:
Investigate complex hospital and medical claims
Detect trends, anomalies, and payment leakage opportunities
Use your clinical coding and classification expertise to influence business decisions
Collaborate with healthcare providers and industry stakeholders
Drive improvements that enhance operational performance and member outcomes
Be part of a team that values curiosity, innovation, and continuous improvement
What You'll Be Doing
Conduct audits of hospital and medical claims to identify inaccuracies and recovery opportunities.
Analyse claims and clinical records to ensure correct benefit application.




Investigate unusual billing patterns and provider outliers.
Partner with healthcare providers to resolve complex claim issues.
Generate insights and recommendations through data analysis and reporting.
Support business initiatives that strengthen claims integrity and reduce risk.
Provide expert guidance on health classifications, coding standards, and funding models.
What We're Looking For
Clinical Coder
Health Data Analyst
Health Funding or Casemix Specialist with experience working within the Australian healthcare sector.
You'll Bring:
Strong knowledge of private health funding, hospital billing, casemix, and classification systems.
Experience interpreting claims data, clinical documentation, and identifying discrepancies.
Excellent analytical, communication, and stakeholder engagement skills.
Experience using reporting tools and working with large datasets.
A proactive mindset with a passion for continuous improvement and problem-solving.
Bonus Points If You Have:
Experience with 3M Health Information Systems, Reports Manager, or Rule Authoring Applications.
Strong data analytics capability and experience working with SQL to extract, interrogate, and analyse complex health claims data.
Experience identifying trends and developing data-driven audit strategies.
Why Join GMHBA?
At GMHBA, your work directly contributes to ensuring fairness, accuracy, and value across the healthcare system. You'll join a supportive team where your expertise is valued, your ideas are welcomed, and your impact is visible.
Whether you're uncovering hidden insights, improving processes, or influencing strategic decisions, you'll play a vital role in helping us deliver better outcomes for our members and providers.
If you have any questions about this position or the recruitment process
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📌 Health Information Manager (Victoria)
🏢 GMHBA
📍 Victoria