Police Health - Work at Home?
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- Branden Rose
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1 JOB AND PERSON SPECIFICATION Title of Position: Reports to: Officer Team Leader THE ORGANISATION Police Health Limited (trading as Police Health) a company limited by guarantee is registered under the Private Health Insurance Act 2007 as a restricted access, not for profit private health insurer. Under the terms of the registration under the Private Health Insurance Act 2007, it is restricted to providing hospital and general treatment benefits primarily to employees and former employees of Australian Police Departments and their dependents. OUR PURPOSE/MISSION Police Health supports the police culture of caring for each other by improving the health and wellbeing of our police community OUR BUSINESS Police Health provides exclusive, quality, value for money health insurance for the benefit and security of contributors OUR CULTURE Police Health s culture is underpinned by the shared organisation values of: Caring Integrity Prudence Doing the right thing Personal service
2 OUR VISION To be the preferred health insurer of the national policing community ORGANISATIONAL CULTURE Police Health strives to exceed in its organisation value of being an employer who values its employees and contributes to their personal and professional development and is active in supporting personal and work place balance. These are achieved by way of: Leadership Team Business Plan Employer of Choice Policy Employee Code of Conduct Policy and Agreement Equity and Diversity Policy Grievance Policy Remuneration Policy Workplace Harassment Bullying & Occupational Violence Policy and Procedures Working Hours Policy COMPLIANCE CULTURE Police Health is committed to compliance at all levels within the organisation and aims to be and maintain the status of good corporate citizen at all times and is articulated in Police Health s Compliance Policy and Program. ORGANISATIONAL CHART Board of Directors (8) Chief Executive Officer (Managing Director) Business Services Manager Marketing Product Development Green fields Provider Relations Corporate Development Manager Risk Management Legislative Compliance Corporate Governance Corporate Services Manager Information Technology Human Resources Finance Manager Financial Management Actuarial Calculations Statutory Reporting Company Secretary Data Analyst Marketing & Communications Co-Coordinator Team Leader Hospital and Medical Agreement Officer Systems Administrator Finance Officer Officers IT Support Officer
3 s Officer Job Purpose The Officer will be responsible for providing a high level of service and advice on private health insurance in accordance with Police Health s Mission, Business, Culture, Vision, and it s commitment to the Private Health Insurance Code of Conduct. SPECIFIC RESPONSIBILITIES Handling counter and telephone enquires at all times in a friendly and courteous manner Provide information to members and potential members on contribution rates, benefits and conditions of membership Comply with requirements of the Private Health Insurance Code of Conduct Memberships New & Changes Actioning whilst checking and verifying the data with a strong focus on attention to detail ensuring the membership details are correct and up to date Generating correspondence for same Ensuring outstanding queries are diarised, followed up and actioned in accordance with Police Health s policies and procedures Ensuring processes are completed within time frames set by the Team Leader Customer Service Contributions Processing to system Reconciling - ensuring totals are consistent with remittance totals Ensuring processes are completed within time frames set by the Team Leader Customer Service Claims assessing Key information from claim forms whilst checking validity of membership, claims history, correspondence etc Daily benefit payments (i.e. cheques & direct credits) Electronic claiming processes are actioned in accordance with contractual agreement Dispatches claim benefit cheques and remittance advices Ensuring all claims are assessed, payments produced and dispatched within Police Health s service turnaround time of 3 days Medical Agreement Claims Processing (i.e. Simplified Billing and ECLIPSE) Keys information from claim forms whilst checking validity of Medical Practitioners accounts Batching and sending of information to Medicare Australia Medicare Australia message and file response monitoring Claim assessing Ensuring all are batched, assessed, payments produced and remitted within agreed Medical Agreement contract turn around times of 21 days
4 Hospital Claims Keys information from claim forms whilst checking validity of Hospital accounts Ensuring benefits are being paid in accordance with Hospital Agreement Ensuring payments are produced and remitted within agreed Hospital Agreement turn around times of 28 days General Office Duties Assist with Preparation and dispatch of Member Kits Opening and actioning incoming mail Filing, photocopying errands etc Housekeeping Knowledge and Experience Demonstrated skills in o o Team work o Time management o Working autonomously o Dealing with multi tasks o Problem solving Knowledge of claims, membership procedures and health fund rules will be an advantage Personal Characteristics Self motivated, innovative and enthusiastic Friendly Team person Professional in conduct Activity Parameters All Officers will ensure their key result areas are timely undertaken with accuracy and a high focus on providing it s members with customer service in accordance with Police Health s: Mission Business Culture Vision, and Commitment to the Private Health Insurance Code of Conduct Risk Management Ensures compliance and adherence to Police Health s Occupational Health and Safety Policy Brings to the attention of the Team Leader new or potential risks
5 Information Technology Respect, maintain and use computer resources in accordance with the information technology policy KEY RELATIONSHIPS Within Police Health Board Members Leadership Team Finance Team Team Leader Team Marketing Team Information Technology Team Police Health Members External HAMBS Systems Limited Medicare Australia Health Service Providers All States Police: o Associations o Unions o Payroll departments o Credit Unions September 2012
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