Healthcare Auditor with Public Trust

Job Summary

A company is looking for a Healthcare Auditor.

Key Responsibilities

• Conduct independent evaluations and document findings from medical records and claims related to fraud, waste, and abuse
• Perform medical record reviews and apply knowledge of medical procedures, Medicare policies, and coding guidelines
• Engage with team members to gather requirements and validate results while preparing audit documentation in compliance with GAGAS standards

Required Qualifications

• Active Public Trust or ability to obtain one, requiring U.S. citizenship and a favorable background check
• Bachelor's degree with three years of relevant experience, or a Master's degree with no experience, or a Certified Physical Therapist with four years of experience
• Experience auditing by professional standards and industry best practices
• Knowledge of government payor practices and coding systems (CPT, ICD-9, ICD-10, HCPCS)
• Healthcare auditing or regulatory compliance experience will be considered