Healthcare Auditor

Job Summary

A company is looking for a Healthcare Auditor.

Key Responsibilities:

• Conduct independent evaluations and document findings related to fraud, waste, and abuse in medical records and claims
• Perform medical record reviews and apply knowledge of medical procedures, Medicare policies, and coding guidelines
• Prepare audit documentation and engage with team members to validate results while supporting comprehensive audits of contractors' records

Required Qualifications:

• Active Public Trust or ability to obtain one, requiring U.S. citizenship and a favorable background check
• Bachelor's degree with three years of relevant experience, or Master's degree with no experience required, or Certified Physical Therapist with four years of experience
• Experience in auditing by professional standards and knowledge of government payer practices
• Knowledge of CPT, ICD-9, ICD-10, and HCPCS coding
• Healthcare auditing or regulatory compliance experience will be considered