Clinical Coding Specialist
Heidi Health
full-time
Posted on:
Location Type: Hybrid
Location: Melbourne • Australia
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About the role
- Work as the clinical coding subject matter expert to ensure our AI-powered systems meet the highest standards of medical coding accuracy and compliance for the Australian healthcare system
- Lead medical coding validation for AI-generated documentation, ensuring accurate application of ICD-10-AM, ACHI, and MBS item numbers across diverse clinical scenarios in both public and private settings
- Develop coding guidelines and protocols that translate complex Australian Coding Standards (ACS) into systematic processes our AI can learn and apply consistently
- Conduct quality audits of AI-coded documentation, identifying patterns, gaps, and opportunities for improvement in coding accuracy, DRG assignment, and compliance
- Collaborate with engineering teams to translate medical coding expertise into technical requirements, validation rules, and system improvements
- Work directly with Australian clinicians to understand documentation patterns, clinical decision-making, and coding challenges across private hospitals, public health systems, and GP practices
- Ensure regulatory compliance with Department of Health coding standards, Medicare Australia requirements, DVA guidelines, and private health insurer specifications
- Analyze coding data and metrics to identify trends, accuracy patterns, and areas for system optimization across our Australian customer base
- Stay current with coding updates including annual ICD-10-AM/ACHI releases, MBS schedule changes, and ACCD standards updates
- Support customer implementations by providing coding expertise during enterprise client onboarding and troubleshooting
Requirements
- 3-5+ years of professional medical coding experience in Australian hospital, clinic, or health system environments
- HIMAA certification in Clinical Coding or equivalent qualification (university/TAFE clinical coding certificate)
- Expert-level knowledge of ICD-10-AM/ACHI and Australian Coding Standards (ACS) across multiple specialties
- Strong understanding of DRG (Diagnosis Related Groups) and AR-DRG classification system
- MBS knowledge and understanding of Medicare Australia billing requirements
- Multi-specialty coding experience including public/private hospital, GP, emergency department, and specialty clinic coding
- Experience with coding audits and quality assurance processes, including accuracy measurement and improvement initiatives
- Familiarity with EHR systems such as Epic, Cerner, Best Practice, Medical Director, Genie, or hospital PAS systems
- Analytical skills with ability to identify coding patterns, trends, and systematic issues
- Adaptability to work in a fast-paced technology environment and translate traditional coding processes into innovative AI-powered solutions
Benefits
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Applicant Tracking System Keywords
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Hard Skills & Tools
medical codingICD-10-AMACHIAustralian Coding StandardsDRGAR-DRGMBScoding auditsquality assurancedata analysis
Soft Skills
leadershipcollaborationanalytical skillsadaptabilitycommunication
Certifications
HIMAA certification in Clinical Codingclinical coding certificate