Senior Clinical Auditor
Share
Job Location:
Monthly Salary:
Posted on:
Yesterday
Vacancies:
1 Vacancy
Job Summary
Job Description:
Enjoy a permanent full-time career with genuine hybrid WFH flexibility
Protect hospital revenue by managing critical healthfund audits
Benefit from generous Not-For-Profit salary packaging increasing your take-home pay
Better and fairer care. Always.
St Vincents has been a leader in Australias health and aged care landscape for more than 165 years. Since our founders the Sisters of Charity opened our first hospital in 1857 our services and nearly 30000 people have been behind some of Australias most important medical breakthroughs. We are a microcosm of Australias health and aged care system and are uniquely positioned to lead and respond to our rapidly changing environment.
We are looking for a special kind of person - a St Vincents kind of person. Someone who puts excellence compassion connection and caring for other people at the heart of everything they do.
Reporting directly to the Group Manager Audit HIS and Billing the Senior Clinical Auditor will be responsible for ensuring hospital claim data complies with private health fund contractual and legislative requirements. You will provide clinical guidance to substantiate St Vincents billing practices and assist in implementing clinical documentation improvement initiatives.
This is a permanent full-time position based in any of our Private Hospital locations nationally on a hybrid working arrangement.
Key responsibilities of the role:
- Manage onsite and offsite clinical health fund audits including ICU Special Care Nursery Rehabilitation and Psychiatry
- Conduct pre-audit financial risk analysis and provide internal audit learnings and recommendations to stakeholders
- Identify and implement continuous process improvement initiatives to minimise future refunds to health funds
- Collaborate with Billing and Revenue Managers Health Information Managers and Clinical Documentation Specialists to resolve ad hoc claim issues
- Maintain accurate records within the Fund Audit Management System (FAMS) and keep apprised of legislative changes and billing rules
Things that work for us:
- A tertiary degree in Nursing or another health-related discipline (highly desirable)
- Demonstrated experience in the Private Health sector with exposure to managing health fund audits (ideally 3 years)
- Strong clinical skills to engage in productive conversations regarding clinical matters and documentation
- Familiarity with ICD-10 AM ACHI codes DRGs and the Medicare Benefits Schedule
- Ability to analyse medical records and interpret them in the context of contractual agreements and legislation
- Excellent verbal and written communication skills with a collaborative and inclusive working style
Things that work for you:
- Ability to visibly see your impact on the business and its service
- Competitive salary packaging options
- Discounted private health insurance
- Employee Assistance Program for staff and their families
- Access to the Fitness Passport (FP)
At St Vincents we value inclusivity and diversity and acknowledge the importance of creating a work environment that is welcoming safe fair and impartial and invites people from all backgrounds to join us.
Pre-Employment Checks
Your employment is conditional upon the completion of all required pre-employment checks including relevant immunisations.
Equal Opportunity
We celebrate diversity & inclusion and are committed to equal employment opportunity for everyone.
How To Apply
Please submit your application via the Apply button include your resume and a brief cover letter outlining your experience and suitability.
Closing Date:
15 April 2026 11:59pmReconciliation Action Plan:
At St Vincents we acknowledge the importance of creating a work environment that is welcoming safe equitable and inclusive for Aboriginal and/or Torres Strait Islander Employees. As part of our Commitment to Reconciliation and Closing the Gap in employment related outcomes we encourage applications from Aboriginal and Torres Strait Islander Peoples.
For further information visit https:// or get in contact at
View Reconciliation Action Plan
Code of Conduct:
Required Experience:
Senior IC
Key Skills
- Auditing
- Accounting Software
- Data Analytics
- GAAP
- Accounting
- Analysis Skills
- SOX
- Financial Analysis
- Financial Report Interpretation
- Internal Audits
- Mentoring
- GAAS
