Certified Medical Auditor (SC)
Job Summary
To support healthcare services, the full-time remote Certified Medical Auditor (SC) will perform validation reviews of Diagnosis Related Groups (DRG), Ambulatory Procedure Codes (APC), and Never Events, while coordinating rate adjustments and providing trend reports.
Key responsibilities
- Conducts validation reviews and coordinates rate adjustments with claims areas
- Creates monthly and quarterly reports outlining trends and outcomes related to records review
- Manages records retrieval, HIPAA compliance, and serves as a resource for coding issues
Required qualifications
- Associate's degree in a job-related field
- Two years of job-related work experience may substitute for education
- Three years of medical record management experience, including coding and validation review
- Registered health information administrator (RHIA), registered health information technician (RHIT), certified professional coder (CPC), certified inpatient coder (CIC), certified professional medical auditor (CPMA), or active RN licensure
- Extensive knowledge of medical records and coding practices
Complete Job Description
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