Job Description
MAYDAY Recruitment is excited to be partnering with a leading Australian health insurance organisation to recruit a Member Claims Specialist.
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This is a fantastic opportunity for an experienced customer serivceprofessional who loves customer interaction, problem-solving and getting things resolved on the spot.
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As part of a blended team, you'll combine member service and claims assessment, providing first-contact resolution across phone, email and chat while also processing and assessing claims in real time.
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What you'll be doing
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Respond to member and frontline enquiries across phone, email and chat
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Provide first-contact resolution wherever possible
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Work in modern offices in Parramatta with 3 days working from home.
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Assess and process a broad range of claims within agreed SLAs
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Explain claims outcomes, products and processes clearly and without jargon
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Resolve complex or sensitive member situations with empathy and professionalism
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Ensure claims are processed accurately and in line with relevant fund rules
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Support member retention through excellent service and effective complaint resolution
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Identify opportunities to improve processes, training and customer experience
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Work collaboratively with other teams to resolve member issues
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Share knowledge and support colleagues with more complex claims
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Continuously build your knowledge across different claims types and products
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What we're looking for
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We're looking for someone who has:
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Experience in Private Health Insurance and/or claims and/or strong customer service skills.
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A genuine passion for delivering outstanding customer service
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Robust communication and relationship-building skills
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Excellent attention to detail and claims processing accuracy
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The confidence to manage difficult or complex customer conversations
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The ability to work effectively in a fast-paced environment
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A positive attitude and willingness to learn and adapt
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Strong teamwork skills, with the ability to work autonomously
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Good computer and systems skills
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Why you'll love it
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This is a great opportunity to join a customer-focused claims environment where no two days are the same. You'll have the opportunity to broaden your claims expertise, develop your knowledge across multiple areas and play a key role in improving the member experience.
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If you're an experienced health insurance or claims professional who enjoys helping people, solving problems and getting things done, we'd love to hear from you.
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📌 Member Claims Specialist (New South Wales)
🏢 Mayday Recruitment Group
📍 New South Wales