Health Fund Audit & Assurance Lead

Employment Term: Permanent Full Time

Location: Ann Street, Brisbane CBD

Remuneration: $45.24 p/h  + Super + Salary Packaging Benefits

Make a meaningful difference

We are seeking a motivated and experienced Health Fund Audit & Assurance Lead to join our newly established Assurance & Revenue team. This is an exciting opportunity to play a key role in strengthening audit and assurance practices across our hospital network while contributing to a high-performing function focused on protecting and optimising hospital revenue. You'll work closely with stakeholders across the business to drive compliance, identify revenue opportunities and support continuous improvement initiatives.

Your part in our Revenue Services Team

The Health Fund Audit & Assurance Lead is responsible for supporting and processing health fund audits, identifying discrepancies, and ensuring compliance with payer guidelines and regulatory standards. This role plays a critical part in minimising revenue leakage, reducing billing and eligibility errors, and supporting accurate reimbursement outcomes.

Leading a small team, you will provide expert guidance, drive best practice audit processes and collaborate with stakeholders across hospital operations to strengthen compliance, improve billing accuracy and optimise revenue integrity outcomes.

This role will be instrumental in supporting the centralisation of post-paid desktop audit activities and establishing best practice audit processes across the organisation. You will use audit insights and trend analysis to identify systemic issues, improve billing accuracy and support revenue optimisation outcomes.

Key duties will include:

• Lead a small team dedicated to health fund audits, including desktop and onsite reviews.
• Lead and provide an exceptional audit review and reconciliation service, establishing best practice processes.
• Maintain detailed audit logs and prepare reports for management, identifying trends, findings and recommendations.
• Analyse audit trends, variances and revenue opportunities, providing recommendations to improve compliance, reduce revenue leakage and support operational improvements.
• Monitor trends in health fund audit results and escalate identified issues to support ongoing education and improvement initiatives.
• Monitor and action Queensland Health HCP data validation errors and implement corrective actions to minimise recurring issues.
• Provide training and guidance to staff on compliance requirements and audit readiness.
• Collaborate with Coding, Billing, Hospital Registration and Clinical teams to ensure accurate charge capture and documentation alignment.
• Support the identification and resolution of billing, eligibility and compliance discrepancies.
• Maintain strong relationships with key internal and external stakeholders.
• Contribute to continuous improvement initiatives to enhance audit outcomes and minimise revenue leakage.

What makes a difference for us?

Essential:

• Demonstrated experience in health fund audits, revenue assurance, private health insurance (PHI), hospital billing or a related healthcare environment.
• Strong understanding of health fund contracts, healthcare funding and reimbursement processes.
• Strong contract interpretation skills with the ability to apply complex health fund agreements, funding models and business rules.
• Experience leading, coaching or mentoring team members.
• Strong analytical and problem-solving skills with exceptional attention to detail.
• Demonstrated experience identifying trends, variances and opportunities through audit and data analysis.
• Excellent communication and stakeholder engagement skills.
• Proven ability to manage competing priorities and work autonomously.
• Strong computer skills, including Microsoft Excel and other Microsoft Office applications.

Desirable:

• Knowledge of acute hospital billing requirements, revenue codes, ICD-10 coding, MBS items, prosthetics and private health fund contracts.
• Experience working within private hospital administration, patient accounts, health fund auditing or revenue services.
• Understanding of Queensland Health HCP reporting requirements and validation processes.
• Certificate III in Business Administration or equivalent qualification.
• Knowledge of medical terminology.

What makes a difference for you? 

• NFP Salary Packaging: Save tax and increase your take home pay by salary packaging your everyday living expenses and bills (up to $15,900) and meal entertainment (up to $2,650) per annum. To learn more about this benefit watch the video via the following link: Salary Packaging Explained

• Flexible work arrangements to support work-life balance 

• A recognition and rewards platform, providing employee discounts at hundreds of retailers, including everyday expenses, holidays, health insurance, annual awards celebration, wellbeing and employee assistance programs  

• 12 weeks paid parental leave and 2 weeks paid partner leave, available after 6 months service, in addition to the government scheme  

• Diversity and inclusive leave, offering paid gender affirmation leave and cultural leave options (paid and unpaid) for those who may celebrate Lunar New Year, Diwali, Ramadan, NAIDOC weeks and other significant cultural events  

• Career development opportunities to challenge yourself, grow and make a meaningful difference   

• A positive and inclusive team based on respect, shared standards, strong values and a commitment to serving others 

We’d love you to be part of our UnitingCare family   

By joining our Hospitals, you’ll also be welcomed as part of the UnitingCare family. The second-largest Queensland employer, we’re a proud not-for-profit with more than 17,500 staff and 9, 000 volunteers across our brands of BlueCare, Lifeline, ARRCS, The Wesley Hospital, Buderim Private Hospital, St Stephen’s Hospital, and St Andrew’s War Memorial Hospital, and have been leading by example for more than 100 years. Our team are compassionate, inclusive and committed to the work we do, helping people live life in all its fullness. 

Child safe, Child friendly 

UnitingCare is committed to being a Child Safe, Child Friendly organisation and will:  

• provide welcoming, safe and nurturing services for children  

• implement measures to prevent child abuse and neglect within our services 

• appropriately and immediately address child abuse and neglect if it does occur 

• abide by the Child Safe Standards and adhere to the Reportable Conduct Scheme  

Diversity & Inclusion   

Our approach is simple – everybody is welcome here.  At UnitingCare, diversity is at the core of our who we are, our mission and our values. We are committed to providing equal opportunities to all employees no matter their sex, race, culture, sexual orientation, disability or gender identity. Demonstrating our commitment to reconciliation and building long-term employment opportunities for First Nations peoples, UnitingCare strongly encourages Aboriginal and Torres Strait Islander applicants for this position.   

Safe workplace   

We work hard to make our services welcoming and safe for every person. We are united in keeping children, young people and the elderly safe from harm, within our services, workplaces and the communities we support. We are committed to speaking up loudly for their safety.   

Commitment to Safeguarding

We are committed in creating services and workplaces that are welcoming and safe for every person. We work together to protect children, young people, adults and the elderly from harm within our services and the communities we support. We speak up for their safety to ensure their voices are heard. Our recruitment and workplace practices reflect our dedication in preventing abuse, harm and exploitation across UnitingCare.