Inpatient Auditor Outpatient Auditor

Inpatient/Outpatient Auditor

The Inpatient/Outpatient Auditor is responsible for providing independent auditing to ensure that patient care is compliant with applicable regulations and contractual obligations. The Inpatient/Outpatient Auditor will review inpatient and outpatient medical records to assess accuracy, completeness, and compliance with regulatory, legal, and contractual requirements.

Duties and Responsibilities:

• Review clinical documentation to identify coding and billing discrepancies in medical records

• Analyze clinical documentation to identify areas of improvement in clinical documentation compliance

• Develop and implement audit programs for inpatient and outpatient services

• Perform periodic reviews of clinical documentation, billing, and coding policies and procedures

• Ensure compliance with applicable regulations and contractual obligations

• Collaborate with other departments to identify and resolve coding and billing issues

• Monitor billing and coding trends to identify and address discrepancies

• Monitor medical record accuracy and completeness

• Prepare reports and summaries of audit results

• Provide reports to management and other team members

• Assist with the development and implementation of corrective action plans

• Participate in departmental meetings

• Maintain up-to-date knowledge of coding and billing regulations and standards

Skills and Qualifications:

• Bachelor's Degree or equivalent experience in Healthcare Administration, Accounting, or a related field

• Experience in medical auditing, coding, and/or billing

• Proficiency in Microsoft Office

• Strong analytical and problem-solving skills

• Strong organizational, communication, and interpersonal skills

• Ability to work independently with minimal supervision

• Excellent attention to detail and accuracy

• Ability to handle confidential information and maintain professional ethics