Clinical Claims Auditor

1 week ago


Melbourne, Victoria, Australia Head Office St Kilda Rd Full time

Hospital Claims Auditor
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Flexible working arrangements:

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Work for one of the largest private hospital groups in Australia:


  • Permanent and contract positions available


An exciting opportunity exists for two superstars with billing, clinical coding, or clinical experience to join our supportive team of auditors.

The Hospital Claims Auditor ensures that our hospitals are appropriately reimbursed for the high quality service we provide to our patients by:

  • Regularly monitoring hospital compliance with various health fund business rules and other funding criteria
  • Assisting hospitals to validate claims flagged by health funds and providing the necessary clinical documentation to support our billing
  • Helping hospitals to understand their contractual and legislative funding obligations by providing advice and expertise on DRG, MBS, prostheses, theatre banding, clinical and care type criteria and other funding criteria

Selection Criteria:

  • Experience working in a similar role for a private or public hospital
  • A qualification in Health Information Management, Clinical Coding, Nursing, Allied Health, or have extensive billing experience in a health environment
  • Can confidently use Excel and Access
  • Thrives in a team environment and promotes a culture of collaboration

Applications close: 23 April 2023

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