WW6261 - Senior Clinical Coding Auditor - (Full-time / Part-time / Contract) - Pavilion Health - Australia

Pay Rate and Benefits:

  • Attractive Hourly Rate and Super which is based on individual experience and;
  • Flexible working arrangements.

The role and responsibilities will be carried out on behalf of Pavilion Health, an Australian-based company focused on providing services and technology solutions to Australian and international healthcare organisations (both public and private) that improve the quality and efficiency of the clinical coding and auditing process.

Position Description:

We are looking for an experienced senior clinical auditor to undertake audit and compliance verification of clinical coding quality and process, primarily in acute care facilities, using Pavilion Health audit tools and processes. The successful professional will be required to uphold the Pavilion Health principles of integrity, discretion, objectivity and confidentiality.

Duties and responsibilities:

  • To undertake coding audits across various hospitals private or public and other health related organisations
  • Understand and apply differing approaches required as dictated by the audit objectives e.g. documentation quality, coding quality, billing accuracy
  • To co-ordinate and manage audit activities
  • To develop concise reports of audit results and communicate feedback to the hospital or health related organisation as required
  • Work with multiple stakeholders – internal or external to Pavilion Health
  • Provide feedback / recommendations on the audit methodology framework and tools
  • Understand how hospitals can improve billing accuracy in a case-mix environment through improved understating of accurate coding and assignment of DRGs

Requirements (qualification / skills)

  • Completion of Health Information Management, Advanced HIMAA ICD-10-AM clinical coding course HIMAA (or equivalent)
  • La Trobe University Clinical Coding Auditing Course – completed at External Auditor level – or equivalent
  • Three years of recent clinical coding/auditing of complex case mix activity, including in ICD-10-AM/ACHI/ACS tenth edition
  • Thorough understanding of Australian Coding Standards and any other relevant regulations and standards
  • Willingness to travel intra/interstate and work in different hospital environments
  • Highly developed organisation and interpersonal skills
  • Experience with Excel, Word, and other office tools
  • Experience with a variety of hospital information systems
  • Knowledge of NHSQS and State and Commonwealth Legislation on Privacy and Confidentiality e.g. HIPRA 2002
  • Have an understanding of private payer models i.e. HPPA’s


Jenny Sinclair
Project Manager
Email: jennys@pavilion-health.com

Applications Close On: 
16 April 2018