Clinical Documentation Auditor

Head Office - Sydney; Sydney; Remoto; AUD 54.000 - 90.000; Part-time

Descrizione del lavoro

Ramsay Health Care is seeking an experienced Clinical Documentation Auditor to join our national Revenue Cycle Management team. The role is part-time (three days per week) and can be based anywhere in Australia.

You will audit medical records, support accurate coding, funding and compliance, and provide education to improve documentation practices nationwide. You’ll work with clinical documentation specialists, coders and clinicians to strengthen documentation, coding integrity and revenue

Competenze

• Current AHPRA registration as a Registered Nurse or Allied Health professional.
• Minimum four years’ recent experience as a Clinical Documentation Specialist.
• Recognised CDI or Health Informatics certification.
• Strong experience in clinical documentation auditing and query writing.
• Knowledge of public and private healthcare funding models, Health Fund Contracts and AR-DRG methodology.
• Strong understanding of pathophysiology, disease processes, pharmacology and surgical terminology.
• Excellent communication, organisation and time management skills.

Mansioni

• Audit discharged overnight inpatient records pre-bill.
• Review clinical documentation and coding per Australian Coding Standards.
• Validate diagnoses, treatment plans, procedures and clinical evidence.
• Identify documentation gaps and opportunities reflecting patient complexity.
• Analyse audit findings for trends, risks and improvements.
• Provide feedback and post-audit education to CDS and coding teams.
• Identify and escalate documentation, coding and compliance risks.
• Prepare audit reports and recommendations for stakeholders.
• Contribute to Ramsay’s national CDI program.

Conoscenze

CDI auditing

Communication

Analytical thinking

Autonomous

Formazione

AHPRA registered clinician

Strumenti

AR-DRG knowledge

Descrizione del lavoro

Head Office - Sydney – St Leonards Park NSW

Are you an experienced Clinical Documentation Specialist with a keen eye for detail and a passion for improving documentation quality? Ramsay Health Care is seeking an experienced Clinical Documentation Auditor to join our national Revenue Cycle Management team. You’ll use your clinical and CDI expertise to audit medical records, identify documentation opportunities and support accurate coding, funding, compliance and revenue integrity across Ramsay. Working closely with Clinical Documentation Specialists, clinical coders, clinicians and Health Information Services teams, you’ll provide feedback and education to help strengthen documentation practices nationally. Please note, this role can be based anywhere in Australia and is a part-time position working three days per week.

What You’ll Do

In this role, you’ll use your CDI expertise to audit, analyse and improve the quality of clinical records across Ramsay. You’ll work with a range of clinical and coding stakeholders to identify opportunities, provide feedback and education, and support stronger documentation, coding accuracy and compliance.

• Conduct pre-bill audits of discharged overnight inpatient medical records.
• Review clinical documentation and coding in accordance with the Australian Coding Standards.
• Validate diagnoses, treatment plans, procedures and clinical evidence.
• Identify documentation gaps and opportunities to better reflect patient complexity and care.
• Analyse audit findings to identify trends, risks and improvement opportunities.
• Provide constructive feedback and post-audit education to CDS and coding teams.
• Identify and escalation documentation, coding and compliance risks.
• Prepare audit reports and recommendations for relevant stakeholders.
• Contribute to continuous improvement across Ramsay’s national CDI program.

What You’ll Bring

You’ll be an experienced Clinical Documentation Specialist with strong clinical knowledge, a sharp eye for detail and a genuine interest in improving documentation and coding integrity.

You’ll bring:

• Current AHPRA registration as a Registered Nurse or Allied Health professional.
• Minimum four years’ recent experience as a Clinical Documentation Specialist.
• Recognised CDI or Health Informatics certification.
• Strong experience in clinical documentation auditing and query writing.
• Knowledge of public and private healthcare funding models, Health Fund Contracts and AR-DRG methodology.
• Strong understanding of pathophysiology, disease processes, pharmacology and surgical terminology.
• Strong analytical, problem-solving and critical thinking skills.
• Excellent communication, organisation and time management skills.
• Ability to work autonomously and manage competing priorities.

Why Join Us?

This is a unique opportunity to use your Clinical Documentation expertise in a national role with broad impact. You’ll have the opportunity to influence documentation quality across Ramsay, work with a diverse range of clinical and corporate stakeholders, and contribute to improving coding accuracy, compliance and revenue integrity.

• Join Australia’s largest private hospital operator and contribute to a national CDI program.
• Work across a broad and complex healthcare environment.
• Use your clinical and CDI expertise to influence best practice nationally.
• Access professional development and career opportunities across the Ramsay network.
• Enjoy a range of employee benefits, wellbeing initiatives, discounts and recognition programs.
• Be part of an organisation driven by our purpose of People Caring for People.

About Ramsay Health Care

Founded in 1964, Ramsay Health Care is Australia’s largest private hospital operator and a recognised global leader in healthcare delivery. Across the country, we operate 76 hospitals and 12 surgical centres, caring for more than 1.1 million patients each year with the support of over 30,000 dedicated professionals. Guided by our ethos, “People Caring for People,” we are committed to delivering exceptional patient care, building meaningful relationships, and driving continuous improvement and sustainable growth. In addition to our hospital network, Ramsay operates a growing community pharmacy network of more than 35 locations. Through our culture, The Ramsay Way, we place our people at the centre of everything we do - fostering collaboration, empowering teams, and achieving outstanding outcomes for patients and communities.

Applications close Sunday, 11th October 2026.