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Regional QLD


Job Category

Clinical Documentation Specialist

Apply now Job no: 531886
Work type: Full time
Location: Cairns Private Hospital
Categories: Nursing - Registered


Clinical Documentation Specialist 

Permanent Full Time position

About the role

An exciting opportunity exists to focus on improving the clinical documentation for the Cairns Private Hospital. If successful in this role, your focus will be to provide a clinically based concurrent review of inpatient medical records to evaluate the utilisation and documentation of acute care services. The primary goal of the review will be the facilitation of appropriate physician documentation of care delivery to accurately reflect patient complexity. 

You will regularly be working alongside medical professionals and the nursing teams in this documentation review process, so this is an opportunity to employ your strong relationship development skills and medical information knowledge to improve the governance and accuracy of patient records within the hospital. This is a crucial role in the hospital’s operations day-to-day.


About You

To succeed in this role, you will bring a proven record of clinical experience in acute care settings with a strong understanding of medical records documentation. You will bring a broad knowledge base of pathology/physiology of disease processes and the ability to quickly analyse and organise clinical information.

Successful candidates will meet the following criteria:

  • Current registration with AHPRA as a Registered Nurse
  • Minimum 5 years recent clinical experience in an acute care setting
  • Knowledge of medical records documentation
  • Strong broad-based clinical knowledge and understanding of pathology/physiology of disease processes
  • Ability to deliver result within tight timeframes
  • Demonstrated ability to build and maintain physician relationships
  • Strong skills in the Microsoft Office suite of programs
  • Strong ability to work autonomously and deliver the desired outcomes

Applicants who meet the following criteria will be highly regarded:

  • Competent using Meditech
  • Strong understanding of Health Fund Contracts


Cairns Private Hospital

Cairns Private Hospital in tropical Cairns in far north Queensland, is a modern, well-equipped facility which offers a comprehensive range of medical and allied services. The hospital is owned and operated by Ramsay Health Care, a global operator of private hospitals and primary care clinics with 72 Australian sites employing over 30,000 people. We have been focused on delivering high-quality patient care and practising the Ramsay Way philosophy of ‘People Caring for People’ since 1972. Benefits of working with us include;


Why choose a Ramsay career?

We believe our people are our most important asset.

That is why we work hard to foster a positive, supportive and inclusive culture across Ramsay Health Care.

With more than 30,000 employees in Australia, as well as hundreds of facilities across 10 countries, Ramsay is proud to be a leader in providing world-class health care. Our international footprint offers a wealth of professional opportunities to suit any stage of your career.

We offer strong, flexible career pathways and have a genuine commitment to work-life balance, learning and development. We are also committed to maintaining our employer-of-choice status through a great range of employee benefits and programs.

Our Ramsay Way values

We are a leading provider of health care services with a special culture known as “The Ramsay Way” and a philosophy of “People Caring for People”.

  • We value strong, healthy relationships by respecting and recognising those we work with.
  • We strive to continuously improve and we take pride in our achievements.
  • We seek to grow sustainably because we care about our people, our community and our planet.



All new employees

  • must be up-to-date in their vaccination against COVID-19 (including the third dose, as required) using a vaccine approved by the Australian Technical Advisory Group on Immunisation.
  • Must provide a National Police check conducted within the previous 12 months

According to the role, Ramsay may require a Working-With-Children check and proof of immunisations against infectious disease.

How to Apply

All applications must be lodged online. Please click the Apply button within this ad to lodge an application (applications should include CV and 2 current work-related referees). 

If you would like to discuss this opportunity, please contact Rochelle Biancotti, via email at


Advertised: E. Australia Standard Time
Applications close: E. Australia Standard Time

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