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Gus Gray
Medical Auditor
Summary
Highly accomplished Medical Auditor with 5+ years of experience in reviewing and analyzing medical records to ensure compliance with industry regulations and healthcare provider billing accuracy. Proficient in medical coding, medical terminology, patient chart review, healthcare regulations, risk assessment and mitigation, and data analysis. Proven ability to identify discrepancies, prepare detailed audit reports, and present findings to clients. Expertise in developing and implementing internal audit procedures to enhance compliance and reduce risk.
Education
Associate’s or Bachelor’s degree in Medical Auditing, Health Information Management
November 2014
Skills
- Medical Coding
- Medical Terminology
- Patient Chart Review
- Healthcare Regulations
- Risk Assessment and Mitigation
- Data Analysis
Work Experience
Medical Auditor
- Collaborated with healthcare professionals to resolve discrepancies and improve documentation
- Developed and implemented internal audit procedures to enhance compliance and reduce risk
- Trained and mentored junior auditors to ensure consistency and quality
- Utilized data analytics techniques to identify trends and patterns in billing practices
Medical Auditor
- Reviewed and analyzed medical records to identify discrepancies and ensure compliance with industry regulations
- Conducted audits of healthcare providers to assess the accuracy and completeness of medical billing
- Utilized auditing software to extract and analyze data from electronic health records
- Prepared detailed audit reports and presented findings to clients
Accomplishments
- Led a team that implemented a new auditing software, resulting in a 15% reduction in audit time
- Developed and implemented a new training program for medical auditors, improving accuracy and consistency of audits
- Identified and recovered over $1 million in overpayments to healthcare providers through diligent auditing
- Streamlined the medical record review process, reducing the average review time by 20%
- Implemented a data analytics tool to identify highrisk claims for targeted auditing, leading to a 10% increase in fraud detection
Awards
- Received the National Medical Auditor Excellence Award for outstanding performance in healthcare auditing
- Recognized by the American Health Information Management Association (AHIMA) for advancing the field of medical auditing
- Awarded the Certified Professional Medical Auditor (CPMA) credential from the American Academy of Professional Coders (AAPC)
- Honored with the Excellence in Audit Management Award by the Healthcare Financial Management Association (HFMA)
Certificates
- Certified Professional Medical Auditor (CPMA)
- Certified Medical Review Professional (CMRP)
- Certified Risk Management Specialist (CRMS)
- Certified Professional Coder (CPC)
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How To Write Resume For Medical Auditor
- Highlight your medical coding and terminology knowledge, as well as your experience with patient chart review.
- Showcase your ability to identify discrepancies and ensure compliance with industry regulations.
- Emphasize your experience with auditing software and data analysis techniques.
- Mention any experience you have with developing and implementing internal audit procedures.
- Demonstrate your communication and presentation skills by highlighting your experience presenting audit findings to clients.
Essential Experience Highlights for a Strong Medical Auditor Resume
- Reviewed and analyzed medical records to identify discrepancies and ensure compliance with industry regulations.
- Conducted audits of healthcare providers to assess the accuracy and completeness of medical billing.
- Utilized auditing software to extract and analyze data from electronic health records.
- Prepared detailed audit reports and presented findings to clients.
- Collaborated with healthcare professionals to resolve discrepancies and improve documentation.
- Developed and implemented internal audit procedures to enhance compliance and reduce risk.
- Trained and mentored junior auditors to ensure consistency and quality.
Frequently Asked Questions (FAQ’s) For Medical Auditor
What are the educational requirements for becoming a Medical Auditor?
Most Medical Auditors have an Associate’s or Bachelor’s degree in Medical Auditing, Health Information Management, or a related field.
What are the key skills and experience required for a Medical Auditor?
Medical Auditors should have strong knowledge of medical coding and terminology, as well as experience with patient chart review and auditing software.
What are the responsibilities of a Medical Auditor?
Medical Auditors are responsible for reviewing and analyzing medical records to ensure compliance with industry regulations and healthcare provider billing accuracy.
What are the career prospects for Medical Auditors?
Medical Auditors can advance their careers by becoming Senior Auditors, Managers, or Directors.
What is the salary range for Medical Auditors?
The salary range for Medical Auditors varies depending on experience and location, but the median annual salary is around $60,000.
What are the top companies that hire Medical Auditors?
Top companies that hire Medical Auditors include Aetna, Cigna, Humana, and UnitedHealth Group.