Claims Escalations Officer

Claims & Escalations Officer | Private Health Insurance

Looking for a fast-paced customer service role where you can actually make a difference? A leading Australian private health insurer is looking for a Claims Escalations Officer to join their close-knit team in Parramatta.

This is a 12-month contract with a strong view to convert to permanent, offering a great supportive culture, hybrid flexibility, and a manager who genuinely has your back.

The Role
You'll be the go-to person for resolving escalated member inquiries and complex claims across Medical, Hospital, and Extras categories. Day-to-day, you will:

• Investigate, reassess, and resolve complaints and rejected claims with empathy and clarity.
• Manage around 30 inbound/outbound member calls daily.
• Break down fund rules, policy limits, and claims decisions so members feel heard and supported.
• Process direct credit reversals and utilize internal claims systems (ELMO/Claims Portal).

Work Schedule & Location

• Hours: Monday to Friday, 9:00 AM - 5:15 PM.
• Location: Parramatta office for initial 2-4 week training, then a flexible hybrid model (2 days in-office: Tuesdays & Wednesdays).

Salary & Benefits

• Base: $80,000 + Super.
• Culture: Warm, collaborative team led by a highly approachable, long-term Team Leader.
• Opportunity: High potential to transition into a permanent role.

What We're Looking For

• Background: Solid experience in customer service complaint handling, complex escalations, or health insurance claims.
• Communication: Exceptional phone manner with the ability to de-escalate tough conversations using patience and empathy.
• Mindset: People-first approach-we need someone who thrives on direct phone interactions and loves solving problems for customers rather than just managing cases behind a screen.

Ready for a role where your de-escalation skills are genuinely appreciated? Apply now or send your updated CV to [email protected]

At Randstad, we are passionate about providing equal employment opportunities and embracing diversity to the benefit of all. We actively encourage applications from any background.