Certified Medical Auditor

Job Summary

A company is looking for a Medical Documentation Auditor.

Key Responsibilities

• Conduct medical record reviews and audits for compliance with coding and documentation standards
• Utilize NCD/LCD/LCA guidelines to assess medical necessity and document findings
• Apply knowledge of CPT/HCPCS codes in relation to professional fee services

Required Qualifications

• Certified Professional Coder (CPC) or Certified Professional Medical Auditor (CPMA) with a minimum of two years of experience
• Experience in ProFee auditing; extensive HCC experience will not be considered
• Prior experience in Special Investigations Unit (SIU) is a plus
• Understanding of Medicaid policies and rules is advantageous
• Must reside in the US and have employment eligibility; no sponsorship available