Head Of Claims
Manage the delivery of excellent customer service including the provision of a reliable, timely and accurate claims assessment service for the Hospital, Medical and Ancillary suite of claims.Oversee operations business processes to ensure optimal service quality and efficiency, implement robust quality assurance processes and deliver continuous process improvement resulting in reduced operating costs.Project sponsor, owner, manage or contribute as a subject matter expert through participation at steering committee and working group meetings for a range of key strategic projects.Manage the risk profile of operations, ensure compliance with fund policies/procedures, and identify, review, resolve and report incidents within Risk Management Policy Guidelines.Leadership of claims in order to leverage staff potential, motivate staff, develop and deliver reward and recognition programs, identify and satisfy staff well being and development, define and manage performance expectations for staff and manage and resolve escalated staff issues.Represent CBHS at relevant industry forums including meetings of the Australian Health Care Alliance (AHSA), Private Healthcare Australia (PHA) and Health Industry Claims and Payments Service (HICAPS).Responsibility for cost centre management, identification and prevention of inappropriate claims and hospital/medical contracting expenditure.Previous winner of the Top Achiever (Gold) award
