Senior Medical Auditor

AAPC; Salt Lake City (UT); On-site; USD 85,000 - 120,000; Full time

Job summary

AAPC seeks a Sr. Auditor reporting to the Manager of AAPC Services to audit medical records and validate clinical documentation supporting evaluation and management services, procedures, and diagnoses per guidelines.

This role requires 5+ years of auditing experience across multiple specialties, strong knowledge of AMA/OIG/CMS rules, and RHIT or CPMATM certification. You will uphold 95%+ quality, mentor teams, and push improvements in workflows to meet client deadlines.

Qualifications

• Minimum 5 years of auditing experience across 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 and meet deadlines.
• Detail oriented with strong time management and organizational skills.

Responsibilities

• Audit medical records to validate clinical documentation for evaluation and management services, ancillary services, procedures, diagnoses, and guidelines.
• Research regulatory guidelines for supporting documentation when necessary.
• Prepare audit summary findings with detailed comments and recommendations.
• Maintain production standards and quality metrics of 95% or greater.
• Support department KPIs and SLAs, and mentor team members.
• Identify opportunities for process improvement and workflow enhancements.

Skills

Auditing

Regulatory knowledge

Communication

Project ownership

Detail oriented

Time management

Education

RHIT

CPMATM

Tools

Excel

Word

Internet

Job description

The Sr. Auditor will report to the Manager of AAPC Services with a direct line of communication to Project Leads.

Responsibilities will include but not be limited to:

• 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. Auditor will 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
• Strong time management, organization skills, and work ethic
• Requires long periods of time sitting and using keyboard and mouse.

Certification Requirements:

• RHIT or CPMATM

Attributes:

• Humble - Learns, adapts, and improves relentlessly. Seeks feedback without insecurity and implements coaching. Recognizes others' contributions gratefully. Approaches work and relationships with an abundance mentality. Places the needs of others above self.
• Supportive - Empowers and uplifts others. Listen actively and respond with empathy and understanding. Prioritizes well-being and growth of team members and customers ahead of own interest. Faces challenges together, believing in collective strength and unity.
• Driven - Self-starts and stays highly motivated to achieve ambitious goals. Shares contagious energy and enthusiasm liberally. Takes initiative without always being directed. Demonstrates confidence in decision-making and effectively balances autonomy and authority with accountability.
• Transparent - Aligned with a culture of openness, integrity, and trustworthiness. Follows through on commitments to internal and external parties. Maintains strict accountability and values the trust placed in them by others.
• Innovative - Entrepreneurial spirit with a scrappy mentality. Dreams big, sees opportunity, pursues full potential, and finds ways to accomplish the impossible. Rolls up sleeves and does real work. Works quickly, intelligently, and flexibly.