Claims Insights Consultant

SIS Consultancy is part of the MedHealth Group, a purpose-built collection of industry-leading health, medical, and employment brands. Our unique and diverse capabilities are dedicated to supporting our customers in achieving the best possible health, employment and claim outcomes.

We are looking for a proactive and engaging Insurance and/or Allied Health Professional to provide claims insights and case coordination for cases referred to our Clinical Insights Panel.  You will be the face of our service delivery team, liaising and building rapport with our customers and internally with our Medical Advisors to support fair and reasonable case outcomes for public liability cases. 

Your day to day will involve the following:

• Liaise and build rapport with external customers to better understand referral requirements, case time frames and critical issues.
• Screen incoming referrals to ensure all relevant medical documentation is present; summarise key clinical issues and allocate cases to the most appropriate Medical Advisor based on the information available.
• Coordinate and schedule case conferences involving Medical Advisors, customers and other stakeholders within agreed timeframes and attend case conferences as required. 
• Provide comprehensive case coordination; ensuring deliverables are met in accordance with agreed timeframes and regular communication is maintained with internal and external stakeholders.
• Build rapport and work closely with Medical Advisors on referral allocation, availability, scheduling and report progress and finalisation to maintain visibility on Medical Advisor caseload and capacity. 
• Issue finalised reports and invoices via appropriate systems and gather customer feedback to drive continuous service improvement.
• Provide weekly status updates to the management team on customer referral trends and Medical Advisor utilisation, availability and work in progress.
• Assist in the onboarding of new Medical Advisors including induction on operational processes to ensure consistency in service delivery. 

To be successful in this role you will bring:

• Relationship/account management experience in personal injury, insurance, or compensable healthcare sectors.
• Demonstrated claims management and/or case management experience
• Strong interpersonal and communication skills; with the ability to build rapport with diverse stakeholders
• Excellent organisational skills and ability to work within set timeframes
• Ability to apply personal injury knowledge when reviewing referrals to identify key issues and appropriately assign cases.  
• Current satisfactory Police Clearance, Working with Children check, drivers licence 
• Experience and sound knowledge of Medical and Allied Health Services is also desirable

How we support you

SIS Consultancy is a lively and supportive place to work. You will work autonomously whilst having the support of a strong team environment. You will also benefit from:

• Opportunity to work from any location at a time that suits your schedule
• Varied work in partnership with marquee customers
• Robust onboarding and training supported by an experienced operational and clinical team
• Established referral pathways
• Opportunity to diversify practice hours with medical advisory activities
• Engagement with industry and future opportunities

Help shape the future of medical advisory and embrace the culture of innovation supported by an industry leader.

To Apply

To have a confidential discussion or to find out further information on the role, please contact our Talent Acquisition Lead Erin Mansell on [email protected] and reference job ID REF8744F.

You are welcome here.

Our fast-growing team of more than 3,500 people around Australia represent a huge array of life experiences, skills and ways of thinking. We value all these differences. 

We are an Equal Opportunity Employer, proudly welcoming people with disability including mental health conditions, people from diverse cultural and linguistic backgrounds, people from the LGBTQI community, veterans, carers and Indigenous Australians to our team.

We are happy to adjust our recruitment process to support accessibility needs.