Certified Medical Auditor (SC)

DaMar Staffing; United States; Remote; USD 70,000 - 90,000; Full time

Job summary

DaMar Staffing offers a full-time remote Certified Medical Auditor (SC) role focused on validating DRGs, APCs, and Never Events while coordinating rate adjustments with claims teams.

The position requires creating monthly and quarterly trend reports, managing records retrieval with HIPAA compliance, and serving as a resource for coding issues; a strong background in medical records and coding is essential.

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.
• RHIA/RHIT/CPC/CIC/CPMA certification or active RN licensure.

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

Skills

HIPAA compliance

Medical coding

Records management

Data analysis

Education

Associate degree

Experience substituted for education

RHIA

RHIT

CPC

CIC

CPMA

RN licensure

Job description

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