An exciting opportunity has become available to join MIPS as a QA Specialist (Claims) within our Performance team.

Working closely with our Claims team, this role will provide quality assurance across Medicolegal Claims and Medicolegal advisory support, helping ensure claims are managed consistently, accurately and in line with MIPS’ quality standards and regulatory obligations.

This is a great opportunity for an experienced claims professional who brings strong, recent hands-on claims management experience and an understanding of relevant legal processes and is looking to apply their technical expertise in a quality assurance environment. You’ll use your claims knowledge to review files, identify trends and risks, provide credible feedback and help strengthen claims practices and member outcomes across MIPS.

What You’ll Be Doing

As our QA Specialist (Claims), you’ll work in partnership with the Claims Experience team and Claims leaders to support the ongoing delivery and improvement of our Claims Quality Assurance Framework.

• Conduct structured quality reviews of Medicolegal Claims files and Medicolegal advisory support, assessing technical accuracy, file strategy, decision-making, documentation, timeliness and compliance.
• Apply your claims expertise and understanding of relevant legal processes to identify technical risks, gaps, inconsistencies and opportunities for improvement.
• Provide constructive, evidence-based feedback to Claims Advisors, Claims Specialists and Claims leaders following quality reviews.
• Analyse quality review outcomes to identify trends, recurring issues, emerging risks and opportunities for systemic improvement.
• Prepare quality assurance reporting, dashboards and practical recommendations to support informed decision-making.
• Participate in debrief and calibration sessions to promote consistency and technical excellence across claims management.
• Support the development and refinement of QA methodologies, review criteria, scorecards and quality measures.
• Partner with Claims leaders to identify and implement improvements to claims processes, file management, documentation, systems and procedures.
• Contribute to learning, coaching and capability initiatives arising from quality assurance findings.
• Maintain contemporary knowledge of relevant legislative, regulatory, legal and organisational requirements affecting Medicolegal Claims.

About You

You’ll bring strong, recent hands-on claims management experience and the technical credibility to review the work of experienced claims professionals and provide meaningful, practical feedback.

Ideally, you’ll have:

• Demonstrated end-to-end claims management experience within medicolegal, medical indemnity, professional indemnity, liability or another complex claims environment.
• Strong technical knowledge of claims assessment, strategy, decision-making, documentation, resolution and file management.
• A sound understanding of legal processes relevant to complex claims and the ability to apply this knowledge when reviewing claims handling practices.
• Experience using claims management systems, processes and frameworks.
• Strong analytical and critical-thinking skills, with the ability to identify trends, risks and opportunities for improvement.
• Excellent communication and stakeholder engagement skills, including the confidence to provide constructive and credible feedback to experienced claims professionals.
• The ability to translate technical findings into clear, practical and evidence-based recommendations.
• Experience in quality assurance, technical claims reviews, claims auditing or compliance within a claims environment will be highly regarded.
• Experience within a Medical Defence Organisation or Medicolegal Claims environment will also be highly regarded.

A tertiary qualification in insurance, law, health, business, risk, quality assurance or a related discipline is desirable; however, equivalent demonstrated claims management experience will also be considered.

At MIPS, you’ll do meaningful work that helps protect healthcare professionals so they can focus on caring for others. As a not-for-profit organisation, we offer broad exposure across functions, genuine influence, direct access to leaders and the opportunity to shape your own growth from day one.

We believe you are more than just your job title. Our flexible, hybrid approach empowers you to work your way, with flexibility that respects your life, not just your diary. Wellbeing is woven into the rhythm of work, creating an environment where you can own your work, grow your career and feel good while making a real difference.

What We Offer

• Hybrid and flexible working arrangements that support the way you work best.
• One dedicated wellbeing leave day each year, in addition to your annual leave entitlements.
• Additional purchased leave to help you create the work-life balance that suits you.
• Paid volunteer leave so you can give back to your community.
• Opportunities to work remotely from anywhere in Australia for up to two weeks each year.
• Tailored career, leadership and talent development programs, plus access to Go1’s extensive library of online courses for personal and professional growth.
• Education assistance to support further study aligned with your role and career aspirations.
• Paid professional memberships and subscriptions.
• A year-round wellbeing program beyond an EAP, including complimentary seated massages, annual flu vaccinations, health and skin checks and wellbeing events designed to support you.
• Fresh fruit provided regularly in the office to keep you fuelled throughout the week.
• Novated leasing options and discounted health insurance.

Why MIPS?  At MIPS, we protect healthcare professionals so they can focus on caring for others. Our ambition is to be an industry leader in member-first protection, advice and support.

We live by our values: 

Working together | Have fun | Own it | Make a difference | Embrace challenge

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