Health Information & Claims Auditor

Australian Unity Limited; Melbourne; On-site; AUD 120,000 - 160,000; Full time

Benefits offered by this job

Competitive salary

Bonus program

Parental leave (14 weeks)

Employee referral program

Employee Assistance Program

Well-Being and Community leave

Learning & development access

Job summary

Australian Unity Limited is seeking an experienced Health Information Manager to join the Insurances team. You will review hospital and medical claims, applying coding standards to verify accuracy and support appropriate documentation.

You will conduct pre- and post-payment reviews, assist audits, and drive improvements in rules, workflows and guidance. The role requires specialist knowledge of ICD-10-AM/ACHI and Australian Coding Standards, with a focus on casemix, hospital documentation and

Qualifications

• Qualified Health Information Manager with strong clinical coding knowledge.
• Experience interpreting complex medical records and hospital claims.
• Demonstrated ability to audit, analyze and improve claims processes.

Responsibilities

• Review hospital and medical claims, conducting targeted pre- and post-payment reviews.
• Apply coding expertise to ensure alignment with ICD-10-AM/ACHI, DRGs and MBS requirements.
• Support provider audits by reviewing documentation and identifying overpayments or non-compliant claiming.
• Provide specialist guidance on clinical coding, casemix and hospital documentation.
• Engage with hospitals, providers and internal teams to validate findings and resolve claims matters fairly.
• Identify patterns to improve claims rules, alerts, workflows and guidance.
• Maintain audit records of decisions, reviews, recoveries and savings.
• Share knowledge to strengthen coding capability and payment accuracy across the business.

Skills

Clinical coding

Health information management

Data analysis

Stakeholder communication

Auditing

Documentation

Education

Bachelor/degree in Health Information Management

Tools

ICD-10-AM/ACHI

Australian Coding Standards

Job description

Australian Unity Limited is seeking an experienced Health Information Manager to join the Insurances team. You will review hospital and medical claims, applying coding standards to verify accuracy and support appropriate documentation.

You will conduct pre- and post-payment reviews, assist audits, and drive improvements in rules, workflows and guidance. The role requires specialist knowledge of ICD-10-AM/ACHI and Australian Coding Standards, with a focus on casemix, hospital documentation and