Audit medical records to validate clinical documentation to support evaluation and management services, ancillary services, procedures, diagnoses, and clinical documentation requirements and gaps, missed opportunities, and meet quality and production requirement standards.
Review project guidelines to ensure deliverables are on-time and meeting client specific requirements.
Research regulatory guidelines for supporting documentation when necessary.
Prepare audit summary findings, provide detailed comments related to the audit findings and make recommendations.
Consistently maintain production standards for job role, and quality metrics of 95% or greater.
Responsible for maintaining department audit standards, clinical documentation standards, protocols and guidelines.
Support team with department key performance indicators and goals (SLAs).
Embrace workforce transformation by engaging in continuous knowledge expansion across additional functional areas and/or upskilling (learning new skills) to support evolving organizational and client needs.
Contribute to organizational optimization by collaborating to identify opportunities for process improvement and supporting continuous enhancements to workflows and operations that promote quality and efficiency.
Prepare oral and/or written reports of audit activity to Manager meeting with them on a regular basis to review individual performance, mentoring, and succession planning.

Minimum 5 years of auditing experience
Extensive auditing in multiple specialties
Extensive knowledge of AMA, OIG, CMS and other national coding and compliance guidelines
Excellent written and verbal communication skills
Ability to “own” an entire project
Detail oriented and deadline driven attitude
Ability to think critically and determine the best method for completing tasks
Strong computer skills (Excel, Word, and internet)
Ability to multitask and keep a sense of urgency
Excellent customer service skills
Strong time management, organization skills, and work ethic
Certification requirements: CPC® & CPMA, RHIT or CPMATM

Senior Auditor

Key skills