Medical Auditor Job Description
Job Title: Medical Auditor
Job Description:
OrthoPro Orthopedics, a renowned healthcare organization, is seeking an experienced and detail-oriented Medical Auditor. In this role, you will be chiefly responsible for conducting comprehensive audits of patient medical records to verify clinical documentation, coding, and billing accuracy. Your profound understanding of medical codes, billing practices, and compliance assessment would be crucial in strengthening the company's commitment towards adherence to payer guidelines and regulations. This role lays an excellent opportunity for healthcare professionals seeking a challenging and rewarding career in medical auditing.
Responsibilities and Duties:
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Perform meticulous audits of patient medical records to ensure the accuracy and completeness of clinical documentation, coding, and billing.
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Evaluate medical codes (ICD-10, CPT, HCPCS) assigned to diagnoses and procedures to ensure they align with medical record documentation and industry standards.
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Analyze billing practices and claims submissions to verify adherence to payer guidelines and regulations, preventing overbilling or underbilling.
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Assess compliance with federal and state healthcare regulations, including HIPAA, Stark Law, and Anti-Kickback Statute, and identify potential risk areas.
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Collaborate with healthcare providers and clinical staff to educate them about proper documentation practices and assist in improving the quality of medical records.
Qualifications, Skills, and Competencies:
To qualify for this role, you should have a bachelor's degree in nursing, Healthcare Administration, or a related field. A minimum of five years of experience in healthcare auditing or medical coding is preferred, along with a Certified Professional Coder (CPC) or Certified Clinical Documentation Specialist (CCDS) credential. An in-depth understanding of ICD-10, CPT, HCPCS codes, federal and state healthcare regulations, medical record documentation, and the ability to analyze billing practices is required. Excellent communication skills, both written and oral, along with strong analytical and collaborative abilities, are also expected.
Benefits and Perks:
At OrthoPro Orthopedics, we believe in driving success by valuing our staff. We offer a competitive salary package, comprehensive medical benefits, retirement options, and continual professional development opportunities. In addition, we also ensure a healthy work-life balance with flexible working hours.
Application Process:
If you are ready to take up these duties and meet all the specified qualifications, please do not hesitate to forward your resume to info@orthoproorthopedics.fict or call 222 555 7777. Visit our webpage at orthoproorthopedics.fict for more information about our company and services. Our office is located at 3245 Todds Lane, San Antonio, TX 78205. We look forward to your application!
About the Company:
OrthoPro Orthopedics is a respected provider of comprehensive orthopedic solutions and services. We strive to deliver optimal healthcare by maintaining high standards of care, accuracy, and attention to detail. Come join our dynamic team in driving the standard of healthcare services!
