About the role

Mater Group is currently seeking a committed and enthusiastic Private Health Insurance (PHI) Audit Coordinator to join our Private Revenue team on a permanent full-time basis.

The PHI Audit Co-Ordinator reviews and coordinates Private Health Fund billing audits. The PHI Audit Co-Ordinator is required to identify practices requiring quality improvement and areas where the delivery of education and process re-engineering would benefit Mater.

Salary range: $85,878 - $94,618 per annum plus 11.5% superannuation and access to not-for-profit salary packaging up to $15,900  + access to many staff benefits! 

What you’ll be doing

• Review all health fund billing audits received by all Mater Private Hospitals
• Work closely with the PHI Audit Manager to determine if the recommendation for an audit episode is appropriate, and if not, take relevant steps to work with the health fund to resolve the situation.
• Liaise and co-ordinate with relevant internal teams including Coding, Revenue Assurance, Billing and Privacy to obtain additional information required to perform the audit
• Make recommendations to the PHI Audit Manager and Revenue Operations Analyst where improvements are required based on results from audits
• Maintain the audit database so it is up to date and reflects the status of all audits being undertaken or completed
• Ensure that responses to the health funds are in accordance with instructions from the PHI Audit Manager
• Process audits within Key Performance Targets.
• Prepare internal requests on completion of an audit to assist in finalisation of the audit, including liaising with Accounts payable and the Billing Team
• Keep up to date with healthcare industry and legislation changes
• Keep up to date with renewed HPPA’s, interpretation of contractual obligations and associated billing rules
• Perform any other tasks as reasonably required by the Manager PHI Audit
• Follow processes and procedures in relation to the Audit Coordinator function

About you

To be successful, you need:

• An understanding of clinical terms, to assist in the review of claims
• Strong organisational skills and capable of working on multiple tasks
• Possesses a strong attention to detail
• Strong skill level in use of Excel spreadsheets
• Experience in, or the ability to acquire knowledge of, private healthcare billing or in PHI contract management
• Experience in or the ability to acquire knowledge of managing and reviewing Health Fund billing queries
• Experience in or the ability to acquire knowledge of  interpreting Health Fund contractual obligations, associated billing rules and funding models for private health care 

Why join us?

Mater is Queensland’s largest and most innovative not-for-profit healthcare service, providing care for almost 700,000 patients a year across a network of 11 hospitals.

We are a leader in healthcare, education and research — and that’s because we employ exceptional people. #MAKEYOURMATERMOVE

• Via salary packaging arrangements, allocate some living expenses directly from your pre-taxable income and ultimately increase your take-home pay
• Access to package meal and entertainment expenses via salary packaging
• Access to leading education and professional development via Mater Education
• Access to our Employee Assistance Program and on-site pastoral care teams
• Discounts to local and national business/venues for Dining/Retail/Travel & Accommodation/Other
• Unlimited access to a multitude of discounted fitness facilities through Fitness Passport
• Access to on-site, discounted parking
• Discounted food and beverage at various campus cafés and coffee venues
• Access to gym, pool and end of trip facilities within our new purpose-built corporate office in Newstead

Applications close Wednesday 30 October 2024. Please note, we may contact applications prior to the closing date, please do not hesitate to APPLY NOW! 

Mater is committed to the wellbeing of their staff, and it is underpinned by our flexible and remote working policies.

Please Note: We will not require any support from Recruitment Agencies at this time and kindly request no contact is made. Only direct applications will be considered.

Mater Group is dedicated to creating a workplace that values diversity and inclusion. As an Equal Opportunity Employer, we welcome applications from individuals of all backgrounds and abilities. We believe in providing equal opportunities for all qualified candidates.

For more information regarding Reconciliation at Mater, please visit our Reconciliation webpage.