Claims Processing Consultant

General information

Name

Claims Processing Consultant

Ref #

64539

Date

Thursday, September 3, 2026

Full / Part Time

Full Time

Description & Requirements

Claims Processing Consultant

At Bupa, purpose meets possible. Join us and help shape a future where healthcare is more connected, more personal and more human.

We’re a global healthcare leader trusted by millions and committed to helping people to live longer, healthier, happier lives and making a better world. Healthcare is changing, and so are we. We’re investing in more clinics, better systems and smarter, more connected ways to help our customers. As we continue to expand our services and invest in innovation, you’ll help create a healthcare system that meets people where they are, responds to what they need and leaves them better than before.

Here, your work has purpose, your voice matters and your future is full of possibility.

Just imagine the impact you could make.

The purpose of this job

Responsible for managing customer and provider complex Health Insurance claim requests for Ancillary, Medical and Hospital Claims, working directly with customers and providers to proactively assess claims and resolve claiming queries while building strong relationships to deliver a seamless claiming experience for our customers and providers.

What you’ll need to make it possible:

• Excellent customer service focus
• Strong attention to detail
• Previous experience in an operational processing environment or frontline customer service environment
• Skill and knowledge of Claims & Customer admin computer applications (BOSS, Cyclops, Workflow) and Microsoft Office is desirable
• High proficiency in computer literacy, and ability to navigate through multiple systems and processes-essential
• Ability to work under pressure and meet timelines
• Proven ability to provide exceptional customer service

What you’ll be doing in this role:

• Assess and process complex Health Insurance claims in accordance with Bupa, policies, procedures, and fund rules
• End to end claims assessment of Hospital, Medical and Ancillary claim types
• Exception management of complex claims
• Eclipse assessment
• Daily management of Medicare reporting
• Ensure high level quality customer and provider outcomes through both accurate and efficient claims assessment
• Provide best in class service to customers and providers both via phone (inbound and outbound) and written correspondence including account queries
• Achieve or exceed performance targets including but not limited to AHT, Quality, Risk and compliance

Why you’ll love it?

We support our people to be the healthiest and happiest versions of themselves.

If this sounds exciting, we’d love to hear from you. Let’s shape the future of healthcare, together.

At Bupa your wellbeing, identity, and personal story are respected and valued. We are continuing to build teams that reflect the diversity of the communities we serve. Bupa is committed to providing equal opportunities and fostering a workplace and environment that is free of discrimination, bullying and harassment.

We actively encourage applicants from all backgrounds and experiences, including Aboriginal and Torres Strait Islander peoples, veterans, people with disabilities, and LGBTQIA+ applicants.

We are dedicated to removing barriers to participation. If you need any reasonable adjustments during the recruitment process, or if you’d like to discuss how this role can be flexible for you, please let us know so we can support your participation on an equitable basis.

Location

Adelaide Office

Recruiter

Luke Sist