Job Details
  • Reference398125A_1662528416
  • LocationMelbourne
  • SalaryUp to AU$53.63 per hour + super
  • Job TypeContract
  • Posted26 days ago
  • ConsultantJohn Todd
Chandler Macleod is an equal opportunity employer as part of our commitment to creating a diverse and inclusive workplace, Aboriginal and Torres Strait Islander people, people living with disability, and culturally and linguistic diverse candidates are always encouraged to apply.

***Mandatory: Australian Citizenship required to work within Federal Government***

Our Federal Government client is seeking to engage an APS5 Claims and Payments Integrity Project Officer for a 12-month assignment with potential extension in their Richmond or Geelong office.

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 (Primary Program) and generate a statistical sample in SES (Secondary Program) 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 that support the Agency's objectives.

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 and the Agency.

Responsibilities may include but are not limited to:

  • Undertaking control and conformance testing and providing administrative support for the PPC and SMP Programs.
  • Providing input to appropriate assurance and compliance reports to articulate outcomes of reviews and actions required including delivering compliance decisions to participants and providers.
  • Modifying test documentation (Test Guides and Test Forms) to ensure assurance program relevancy.
  • Undertaking reviews of targeted claims through engagement with providers, plan managers and participants.
  • Contributing to the design of new detective and preventative controls using a combination of manual validation check and systematic analytics.
  • Working with various teams to investigate, report on and escalate claims and payments anomalies.

Desirable Skills:

  • Experience in Federal Government
  • It is highly desirable that the successful applicant understand or have lived experience in the field of disability.

What's on Offer?

  • Position located in Geelong
  • APS5 $53.63/ph + super
  • Temporary contract for 12 months, with possibility to extend
  • Standard Full-Time Hours - Monday to Friday, 8:30 am till 5:00 pm

If you are interested in the role and you have the right experience for the position, please apply now following the link below.