Medical Auditor Job Description


Medical auditors are healthcare professionals and they are responsible for performing systematic assessments in the healthcare organization. They can audit any element of healthcare and they should evaluate the compliance with payer guidelines following state and federal regulations. They should know about performing certain duties which includes examining the quality of care given to the patients train the providers about documentation guidelines, make out if organization policies are effective and latest, optimize the revenue cycle management, ensure apt revenue is gained, find out errors and plan remedial actions to eradicate them, and defend against the federal audit and health plan denials. The healthcare auditors are responsible for handling precise documentation, unaccountable operations and discover the area of enhancement for any healthcare firm. They have to conduct internal and external assessments about coding accuracy, policies, and strategies ensuring systematic and feasible delivery of patient care.

Medical Auditor Job Titles:

  • Medical Auditor
  • Healthcare Auditor
  • Professional Medical Auditor
  • Medical Coding Auditor

Medical Auditor Job Summary:

We are looking to hire a successful candidate who has a degree in Bioscience or Bioengineering or a relevant field. we are currently seeking to hire medical auditors for our chain of healthcare centers. The role requires candidate knowledge in performing internal audits, assessing external audits, analyzing the data, and providing necessary training to the medical staff. They are responsible for training the staff on coding rules as well as local and non-local policies and procedures to ensure compliance.  They should remain updated on the EPM and HER process. They should coordinate with the operation and surgical personnel and practice that could make an impact on billing, coding, or reimbursement. They should perform internal chart audit, provide training for the personnel based on results and report the outcome to the management.

Medical Auditor Job Responsibilities and Duties:

  • Examine the medical records and billing information
  • Identify inaccuracies, compliance issues, and inefficiencies
  • Review the patients’ medical records to ensure their accuracy
  • Conduct meetings with the medical professionals to verify the medical record data
  • Gather documentation that verifies the accuracy of these record
  • Examine the negotiated rate with healthcare providers, medical plans, and the benefit they provide
  • Work with the billing department of healthcare centers as opposed to the claimed departments of insurance companies
  • Aid medical research organizations to maintain the quality of their medical studies
  • Review, revise and implement medical research organizations standards operating procedures

Medical Auditor Skills and Qualification:

  • Bachelor degree in Bioscience or Bioengineering or relevant field
  • Must possess a minimum of 5 years of experience in the similar field
  • Must possess exceptional analytical skills
  • Must be able to work outside for long hours and should be able to travel to other offices
  • Must be ready to work at the scheduled time
  • Take part in department and company meetings
  • Should have strong, analytical and problem-solving skills
  • Must be able to provide attention to detail

Leave a Comment