Claims & Finance Officer (Aged Care / NDIS)

Primary Purpose

The Claims & Finance Officer (Aged Care / NDIS) ensures accurate, compliant, and timely end-to-end processing of third-party vendor and subcontractor invoices and claims. Working within a remote operational structure, this role acts as a critical link between external service providers, participant care plans, and Australian regulatory guidelines (Services Australia / Department of Health and Aged Care).

Key Responsibilities

Third-Party and Subcontractor Claim Processing

• Enter and upload invoices submitted by associated providers and third-party vendors against approved participant support plans and agreed unit pricing.

• Perform claims checks, ensuring all data is accurate and entered on time.

• Flag billing discrepancies, duplicate claims, or out-of-scope expenditure (non-allowable items under Support at Home guidelines) and escalate to local Managers.

Claims Preparation and System Entry

• Prepare monthly and fortnightly claims data, checking for exact matching of unit quantities, Service IDs, and correct funding sources.

• Coordinate data input for invoice claims, ensuring all eligible claims are coded to the correct Service ID.

• Track invoice processing statuses and data export reports and manage rejection follow-ups arising from primary Australian processing workflows.

Compliance, Auditing, and Record Keeping

• Maintain digital audit trails, ensuring copies of all invoices are uploaded to the client file in Visualcare.

• Adhere to privacy frameworks (including the Australian Privacy Principles / Privacy Act 1988) when handling sensitive participant and financial data from an offshore location.

• Support internal and external compliance audits by promptly retrieving requested financial records and remittance histories.

Key Performance Indicators (KPIs)

• Claim Accuracy Rate: Minimum 98% first-pass accuracy on invoice entry and validation.

• Processing Turnaround Time (TAT): Adherence to established daily/weekly queue processing targets.

• Dispute Resolution Speed: Mismatched third-party invoices identified and logged within 48 business hours of receipt.

• Compliance Adherence: Zero critical data or regulatory breaches regarding unverified third-party expenses.

Qualifications and Experience

Experience

• 2+ years' experience in accounts payable, claims processing, or financial administration, preferably within healthcare, insurance, or Australian aged care / NDIS sectors.

Skills

• Exceptional attention to detail and high-volume data entry accuracy.

• Proficient in modern financial software, client management systems, and MS Excel.

• Strong cross-cultural written and verbal communication skills for liaising with onshore Managers.

Knowledge

• Familiarity with Australian Aged Care or NDIS frameworks is an advantage.

• Working understanding of privacy and data-handling obligations relevant to Australian participant data.