Established in 1840, we are Australia's first wellbeing company, delivering health, wealth and care services for our members and the community.

As a social enterprise, we're motivated by our purpose to positively impact the wellbeing of millions. We reinvest profits to deliver products and services sustainably that matter most to our members, customers and the Australian community.

For us, Real Wellbeing encompasses the whole experience of life. It's about feeling supported in your health, connected with your community and empowered to live life on your terms.

About the Opportunity We're looking for an experienced

Health Information Manager

to join our Insurances team.

Reporting to the Head of Strategic Enablement, you'll use your health information management and clinical coding expertise to review hospital and medical claims, helping ensure hospitals are paid accurately and claims are supported by appropriate clinical documentation and coding.

This is an opportunity to combine technical coding expertise with audit, analysis and continuous improvement. You'll conduct targeted pre- and post-payment reviews, support provider audits and recovery activities, and identify recurring trends that can improve claims rules, guidance and processes.

What you'll do:

Review hospital and medical claims:

Conduct targeted pre- and post-payment reviews of complex, high-value and higher-risk claims, assessing coding, clinical documentation and claiming practices.

Apply your coding expertise:

Determine whether claims align with Australian Coding Standards, ICD-10-AM/ACHI, Diagnosis Related Groups, Medicare Benefits Schedule requirements, prostheses arrangements and relevant fund rules.





Support audits and recoveries:

Contribute to provider audits by reviewing documentation, recording findings and identifying potential overpayments, upcoding or non-compliant claiming.

Provide specialist advice:

Support Claims Integrity and operational teams with practical guidance on clinical coding, casemix, hospital documentation and complex claims matters.

Engage with providers and stakeholders:

Work with hospitals, healthcare providers and internal teams to validate findings and resolve claims matters fairly, consistently and accurately.

Identify opportunities for improvement:

Analyse recurring coding, documentation and claiming patterns and contribute to improved claims rules, alerts, workflows and guidance.

Maintain clear audit records:

Document evidence-based decisions and maintain accurate records of claims reviews, audit activity, recoveries and identified savings.

Share knowledge:

Provide technical support and knowledge sharing to colleagues, helping strengthen coding capability and payment accuracy across the business.

About You You're a qualified Health Information Manager with strong clinical coding knowledge and the ability to interpret complex medical records and hospital claims.

Analytical and detail-oriented,



you're comfortable making evidence-based decisions and clearly documenting your findings. You can explain technical information to non-technical stakeholders and enjoy identifying practical ways to improve accuracy, processes and outcomes.

You will bring:

A tertiary qualification in

Health Information Management , or an equivalent recognised qualification

Demonstrated clinical coding experience and current knowledge of

ICD-10-AM/ACHI

and the

Australian Coding Standards

Sound knowledge of

Diagnosis Related Groups, casemix and hospital clinical documentation

Experience reviewing complex medical records, coding or claims and documenting clear, defensible findings

Strong analytical skills, attention to detail and sound professional judgement

The ability to manage competing priorities and complete quality reviews within agreed timeframes

Clear written and verbal communication skills, including the ability to explain technical findings to different audiences

A collaborative approach and the ability to work effectively across multidisciplinary teams

A continuous improvement mindset and an interest in strengthening claims accuracy and audit processes

Experience within

private health insurance or a private hospital environment

will be highly regarded, particularly where you have worked across clinical coding, provider audits, payment integrity, hospital contracting or claims recoveries. Knowledge of the Medicare Perks Schedule, prostheses arrangements, hospital funding or claims analytics would also be advantageous.

Applications will close on Wednesday, 28 October 2026.

Why Join Us? You will enjoy a range of great employee

📌 Health Information Manager (Melbourne)
🏢 Australian Unity
📍 Melbourne