Allison McCallum
Ocean Grove,VIC
Summary
I am a well organised and detail oriented Compliance Officer with key experience in auditing and provider compliance. I am knowledgeable in overseeing contracts and policies, enforcing policies, analysing information and optimising procedures for a great outcome for the team. I am focused on maintaining consistency, quality, and compliance in all areas of our injured workers' claims journey. I truly enjoy working collaboratively with my team and stakeholders, but I am also more than capable of working autonomously. With an 8 year career in the insurance industry and a 10 year career in banking I have learnt much about the regulatory requirements of these industries. Above all, I thrive on the challenge of learning new skills and being a productive and integral employee.
Overview
23
23
years of professional experience
Work History
Provider Compliance Officer
WorkSafe
10.2023 - Current
- Supporting the effective and efficient billing and payment of providers who support injured workers.
- Provide input to provider risk reviews conducted by the team.
- Provide support to the team for recoveries/reimbursements of incorrect provider payments.
- Adhere to audit principles, standards, and practices.
- Contribute to the delivery of cross-team projects.
- Accountable for ensuring accurate records in accordance with policy and procedure.
- Provide regular reports that assist the team in monitoring and assessing the cases that are being referred
- Triage and document cases referred to the team
- Liaising with other stakeholders regarding cases that are referred to our team
- Support team members with data collection and interpretation
Payments Integrity Officer / Hospital Auditor
GMHBA
10.2019 - 10.2023
- Meet crucial goals and KPI's
- Audit hospital and medical claims both pre and post payment
- Understand and interpret hospital contracts and The Medical Benefit Schedule
- Liaise with providers via phone and email to advise of short payments or recover funds
- Have the ability to make sound decisions and show good judgment under pressure
- Flexible and adaptable skills to ensure high quality outcomes for the business
- Liaise with solicitor's and lawyers in relation to compensation payouts
- Reconcile, report and follow up hospital, medical, ancillary and compensation payments
Insurance Customer Service Advisor
GMHBA
Geelong
04.2015 - 10.2019
- Providing customer service to our members either face to face, phone or email
- Taking on the role of Head Cashier when the Branch Manager is away
- Promoting growth within the business by providing our members information on our products and services
- Processing ancillary and medical claims, contributions and member alterations
- Efficient cash handling and balancing procedures
- Meet or exceed set goals
- Sufficient job knowledge to ensure correct information is provided within the Company and Health Insurance Industry
- Software testing for new releases
Self Employed Director
Click On Glass
Ocean Grove
04.2009 - 04.2015
- Sales queries
- Customer queries
- Sales queries
- Data entry
- Bank account reconciliations
- BAS completion at the end of each quarter
- Invoicing
- Utilising Microsoft Office to
Business Lending Training Manager
Westpac Banking Corporation
Melbourne
07.2006 - 03.2009
- This position entailed supporting Westpac staff (Australia widein using Westpac systems to provide customers a seamless business lending experience
- Training, coaching and assisting my colleagues was either delivered in person, via training courses, emails, teleconferences or on the phone
- Involving travel Australia wide, the role was multi faceted and ever evolving which required me to remain current and adaptable
- High level of Westpac product and process knowledge
- A high level of autonomy
- Our direct report was based in Sydney therefore I was required to responsibly manage each day and situation
- Effective communication to my Westpac colleagues whilst assisting them with their difficulties and learning experiences
- Unwavering patience and an ability to manage stressful situations
- Understanding and adhering to Australian banking regulations
Business Manager, Lending Support
Westpac Banking Corporation
Melbourne
04.2002 - 07.2006
- As a Lending Support Manager, I assisted the Business Lending Managers with their administration needs and customer lending requirements
- Primarily a phone-based role, excellent communicative skills were needed with customers and internal groups to ensure a high standard of customer service
Education
Brief Writing For Government
WorkSafe
06-2024
Payments Guided Analytics Program
WorkSafe
04-2024
Structured Writing For Business
WorkSafe
03-2024
Medical Terminology Course -
Health Information Management Association of Australia
Certificate IV in Bookkeeping -
Investment Banking Institute
Skills
- Ability to Work Under Pressure
- Document Review
- Teamwork
- Fast Learner
- Effective Time Management
- Adaptability
- Ability to Multi Task
- Analytical Skills
- Self Motivated
References
- Kelly, Speakman, Compliance Co-Ordinator, kelly_speakman@worksafe.vic.gov.au, 03 4243 8379
- Carly, Johnson, Provider Compliance Specialist, carly_johnson@worksafe.vic.gova.au, 03 4243 7746
- Jane, Stevenson, Medibank, Hospital and Medical Audit Manager, 0404 449 294
Timeline
Provider Compliance Officer
WorkSafe
10.2023 - Current
Payments Integrity Officer / Hospital Auditor
GMHBA
10.2019 - 10.2023
Insurance Customer Service Advisor
GMHBA
04.2015 - 10.2019
Self Employed Director
Click On Glass
04.2009 - 04.2015
Business Lending Training Manager
Westpac Banking Corporation
07.2006 - 03.2009
Business Manager, Lending Support
Westpac Banking Corporation
04.2002 - 07.2006
Brief Writing For Government
WorkSafe
Payments Guided Analytics Program
WorkSafe
Structured Writing For Business
WorkSafe
Medical Terminology Course -
Health Information Management Association of Australia
Certificate IV in Bookkeeping -
Investment Banking Institute
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