Claims & Payments Integrity Officer

Job content

The Client
Our highly valued client - a federal government agency is mobilizing a large workforce to deliver a major market transformation.

The role
We are seeking a Claims and Payments Integrity Officer (APS5 Level) for a long term hourly rate contract ($55 per hour + Super) until the 30th of June 2023, with a high likelihood of extension.

With a flexible work policy, this challenging position will be based in the Melbourne CBD.

The Team
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.

Key accountabilities will include:

• Responding to payment anomalies identified via various channels by engaging with providers and
• 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
• 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.

Please note that federal background checks will need to be undertaken as a condition of employment.

APPLICATIONS
Apply today, or call Sam Beckett on 0481 781 801 or email

Application closing date: Thursday 7th December