Quality Claims Specialist – Aged Care

An opportunity has become available for a Quality Claims Specialist to support a growing organisation in the aged care home care sector.

This role will play an important part in ensuring the accuracy, compliance, and quality of claims submitted under the Support at Home program, working closely with finance, operational, and clinical teams.

Initially based full-time on site in Bowen Hills, this position would suit someone who enjoys working with complex information, applying program rules, and maintaining high levels of accuracy across large volumes of data.

About the Role
As a Quality Claims Specialist, you will review and validate supplier invoices and service claims to ensure they align with aged care funding rules, service eligibility, and client approvals.

You will work as part of a cross-functional team supporting the organisation’s claims and quality processes while contributing to improvements in workflows and classification accuracy.

Key Responsibilities

• Review supplier invoices and assess alignment with Support at Home service categories and eligibility requirements
• Ensure correct service classification and claim coding prior to submission
• Identify and flag claims that do not align with program rules or client approvals
• Maintain high levels of accuracy and attention to detail across high-volume claim batches
• Support internal teams with guidance on claim classification and program rules
• Escalate anomalies, coding issues, or compliance risks where identified
• Contribute to process improvement and quality assurance initiatives
• Work collaboratively with finance, operations, and quality teams to maintain claims integrity

About You
We are open to candidates with transferable skills, particularly those who enjoy working with data, compliance frameworks, and detailed information.

You may come from aged care, health, finance, claims processing, or another regulated environment.

Key attributes include:

• Strong attention to detail and analytical thinking
• Ability to interpret and apply complex rules or guidelines
• Experience working with high volumes of data, invoices, or claims
• Strong communication skills and ability to explain processes clearly
• Ability to work independently and manage competing priorities
• A collaborative approach and willingness to support cross-functional teams

Highly Regarded

• Experience in aged care, home care or health services
• Exposure to government funding programs or claims processes
• Background in quality assurance, compliance, billing or audit
• Understanding of Support at Home or aged care funding frameworks

Requirements

• National Police Check
• Valid working rights in Australia
• Professional references

Why This Role?

• Join a growing organisation in the home care and aged care sector
• Work on important quality and compliance processes supporting older Australians to remain living independently
• Opportunity to extend beyond the initial 3-month contract

Also Recruiting:

Clinical Claims Specialist
We are also recruiting a Clinical Claims Specialist for the same program.

This role requires a Registered Nurse, Occupational Therapist or Physiotherapist with AHPRA registration and clinical experience to apply clinical reasoning to claims classification and service eligibility.

If you have a clinical background and experience in aged care, we would also welcome your application for this position.