Certified Medical Auditor

Job Summary

A company is looking for a Medical Documentation Auditor.

Key Responsibilities

• Conduct medical record reviews for ProFee auditing
• Utilize NCD/LCD/LCA for medical necessity determinations and documentation
• Ensure compliance with relevant coding standards and Medicaid policies

Required Qualifications

• Certified Professional Coder (CPC) or Certified Professional Medical Auditor (CPMA) with a minimum of two years of experience
• 2-5 years of relevant experience in medical auditing
• Prior experience in Special Investigations Unit (SIU) or Fraud Waste and Abuse (FWA)
• Knowledge of CPT/HCPCS coding related to professional fee services
• U.S. residency and employment eligibility required