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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- Strong 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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- Solid 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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📌 Customer Service Specialist (New South Wales)
🏢 MAYDAY Recruitment Group - Winner Outstanding Agency 2023
📍 New South Wales