Job Details
  • Reference384251A_1638337207
  • LocationMelbourne
  • SalaryUp to AU$55 per hour + + Super
  • Job TypeContract
  • Postedabout 2 months ago
  • ConsultantVedangi More

About the Organization:
This leading government agency supports those in need and provides tools for Australians to be able to achieve their goals. Their work has an impact on a significant area in the social sector, and you can contribute to the difference that they make in this role. This agency has a great team culture and excellent office locations in Melbourne.

About the team:
The Claims and Payments Integrity section comprises of two teams:

The Claims and Payments Assurance Team is responsible for payments assurance control testing for the Provider Payment Correctness (PPC) and Self-Managed Participant Payments (SMP) Programs. It is also responsible for engaging with the Scheme Actuary Group to request the payments sample to be assessed to return the outcome of the assurance activities for the purpose of determining the error rate, and to complete relevant surveys.


The team is responsible for engaging with providers and participants to request information and supporting evidence to facilitate assurance activities of the sampled payments. It reports on outcomes of assurance activities and assists with remediation. It is also responsible for establishing and maintaining internal and external relationships to improve the payments control environment.
The Claims and Payments Integrity Team is responsible for implementing detective and preventative measures that will reduce claims and payments error and improve compliance through performing a combination of manual validation checks and systematic risk & behavioural analytics.

The team is responsible for engaging with providers, plan managers and participants to increase the testing and validation of claims and to also design and implement control measures that are preventative. It reports on outcomes of detective and preventative validation activities and assists with remediation. It is also responsible for establishing and maintaining internal and external relationships to improve the claims and payments control environment.

About the role:
The APS5 Claims and Payments Integrity Officer will provide operational support and advice in relation to complex problems. It may be required to coordinate and assist in the strategic planning, program and project management and policy development.
The position has reasonable autonomy and accountability to exercise both initiative and judgment to interpret legislation and policy, in the application of practices and procedures to achieve outcomes within the functions. The APS5 Claims and Payments Integrity Officer will have a considerable level of public contact in relation to complex, difficult or sensitive issues. It may liaise with a range of internal and external stakeholders in a representational role on behalf of the branch/division.

Responsibilities may include but are not limited to:

  • Responding to payment anomalies identified via various channels by engaging with providers and participants.
  • Undertaking control and conformance testing of the PPC and SMP Programs.
  • Providing input into the preparation of advice, including briefs and correspondence.
  • Modifying test documentation (Test Guides and Test Forms) to ensure assurance program relevancy.
  • Undertaking reviews of assurance activities, liaising with internal teams and supporting engagement activities with internal and external stakeholders.
  • Providing administrative support for PPC and SMP Programs.

What you will bring to the role:

  • Strong and adaptable communication and interpersonal skills.
  • Experience in building relationships both with internal and external stakeholders.
  • Ability to work within and across teams and adapt quickly to a changing environment
  • Ability to manage confidential and sensitive information.
  • Ability to prioritise and allocate tasks in an efficient manner while also maintaining high work standards and accuracy

You MUST be an Australian Citizen or Permanent Resident to be considered for this opportunity and eligible to clear a national police check.

How to apply:
Please click 'APPLY" to upload your details and resume to be considered for this role. You can also send in your resumes directly to Vedangi.more@chandlermacleod.com or call me on 0469 889 351 for a confidential chat regarding the role.

APPLICATIONS CLOSE 07/12/21 at 12pm