MAYDAY Recruitment is excited to be partnering with a leading Australian health insurance organisation to recruit a Member Claims Specialist.

This is a fantastic opportunity for an experienced customer serivce professional who loves customer interaction, problem-solving and getting things resolved on the spot.

As part of a blended team, you'll combine member service and claims assessment, providing first-contact resolution across phone, email and chat while also processing and assessing claims in real time.

What you'll be doing

• Respond to member and frontline enquiries across phone, email and chat
• Provide first-contact resolution wherever possible
• Work in modern offices in Parramatta with 3 days working from home.
• Assess and process a broad range of claims within agreed SLAs
• Explain claims outcomes, products and processes clearly and without jargon
• Resolve complex or sensitive member situations with empathy and professionalism
• Ensure claims are processed accurately and in line with relevant fund rules
• Support member retention through excellent service and effective complaint resolution
• Identify opportunities to improve processes, training and customer experience
• Work collaboratively with other teams to resolve member issues
• Share knowledge and support colleagues with more complex claims
• Continuously build your knowledge across different claims types and products

What we're looking for

We're looking for someone who has:

• Experience in Private Health Insurance and/or claims and/or strong customer service skills.
• A genuine passion for delivering outstanding customer service
• Strong communication and relationship-building skills
• Excellent attention to detail and claims processing accuracy
• The confidence to manage difficult or complex customer conversations
• The ability to work effectively in a fast-paced environment
• A positive attitude and willingness to learn and adapt
• Strong teamwork skills, with the ability to work autonomously
• Good computer and systems skills

Why you'll love it

This is a great opportunity to join a customer-focused claims environment where no two days are the same. You'll have the opportunity to broaden your claims expertise, develop your knowledge across multiple areas and play a key role in improving the member experience.

If you're an experienced health insurance or claims professional who enjoys helping people, solving problems and getting things done, we'd love to hear from you.

Apply now or contact the MAYDAY Recruitment team for a confidential discussion.