Senior Clinical Auditor

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 Vincent's has been a leader in Australia's 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 30,000 people have been behind some of Australia's most important medical breakthroughs. We are a microcosm of Australia’s 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 Vincent’s 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 Vincent’s 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 Vincent’s 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 11:59pm

Reconciliation Action Plan:

At St Vincent's 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://www.svha.org.au/about-us/reconciliation or get in contact at indigenouscareers@svha.org.au

View Reconciliation Action Plan

Code of Conduct:

View Code of Conduct