Certified Medical Auditor

3 weeks ago


Chicago, United States Podiatry Service Company LLC Full time
Job DescriptionJob Description

Certified Professional Medical Auditor

A Certified Professional Medical Auditor is responsible for reviewing and auditing medical documentation, including patient records, charts, and clinical notes, to ensure accuracy, compliance with regulations, and adherence to industry standards. This role is crucial in maintaining the integrity of medical records, billing processes, and healthcare facilities' compliance with applicable laws and regulations.

Key Responsibilities:

Medical Documentation Review:

Conduct thorough audits of patient medical records, including physician notes, progress notes, discharge summaries, and other relevant documentation.

Examine medical records to verify their completeness and conformity with established standards, ensuring they accurately reflect the patient's condition, diagnosis, treatment, and other pertinent information.

Verify that documentation adheres to established coding guidelines, such as ICD-10 and CPT, and compliance with healthcare regulations (e.g., HIPAA, Medicare, Medicaid).

Compliance Assessment:

Evaluate medical documentation for compliance with industry standards, hospital policies, and governmental regulations.

Assess policy adherence and procedural efficiency, upholding data integrity through audits and scrutinizing a range of medical documentation.

Identify and report any discrepancies or potential compliance issues, recommending corrective actions as needed.

Billing and Claims Audit:

Analyze medical claims data and associated documentation by conducting continuous auditing with analyses to prevent and address discrepancies and non-conformities in billing and provider chart documentation.

Evaluate coding and documentation to identify recommendations for provider improvement.

Document audit findings and suggest any applicable changes and/or opportunities for documentation improvement.

Recognize and identify trends in billing and documentation at both the practice and provider levels.

Education and Communication:

Assist in providing coding knowledge to providers and billing departments as needed.

Collaborate and communicate verbally and in writing to deliver audit findings, clearly articulating rationale supported by evidence of conclusions.

Knowledge and Compliance with Coding Standards:

Maintain current knowledge of CMS policies and coding applications for CPT, ICD-10, HCPCS, and other applicable coding standards for medical claims.

Compilation of applicable CMS fees and audit findings/results for tracking accuracy and provider productivity analysis.

Qualifications

  • Certified as a CPMA
  • 3+ years of experience in healthcare
  • Detailed oriented, attention to detail and ability to multi-task
  • Good written and verbal communication skills






  • Senior Auditor

    2 weeks ago


    Chicago, United States Northern Trust Full time

    About Northern Trust: Northern Trust, a Fortune 500 company, is a globally recognized, award-winning financial institution that has been in continuous operation since 1889. Northern Trust is proud to provide innovative financial services and guidance to the world's most successful individuals, families, and institutions by remaining true to our enduring...

  • Senior Auditor

    2 weeks ago


    Chicago, Illinois, United States Northern Trust Full time

    About Northern Trust:Northern Trust, a Fortune 500 company, is a globally recognized, award-winning financial institution that has been in continuous operation since 1889.Northern Trust is proud to provide innovative financial services and guidance to the world's most successful individuals, families, and institutions by remaining true to our enduring...

  • Senior Auditor

    3 days ago


    Chicago, Illinois, United States Northern Trust Full time

    About Northern Trust:Northern Trust, a Fortune 500 company, is a globally recognized, award-winning financial institution that has been in continuous operation since 1889.Northern Trust is proud to provide innovative financial services and guidance to the world's most successful individuals, families, and institutions by remaining true to our enduring...

  • Internal Auditor

    1 month ago


    Chicago, United States Gilder Search Group Full time

    Our client, a top-ranked Fortune 500 company looking to hire an Internal Auditor. Everyone knows this company's name globally in the retail space and they show no signs of slowing down! Responsibilities: Assists with a variety of audits in accordance with audit programs through the application of established policies and procedures. Attends kickoff and...

  • Senior Auditor

    2 weeks ago


    Chicago, United States Request Technology Full time

    Senior Auditor – Business/Risk Salary: Open + Bonus Location: Chicago, IL Hybrid: 3 days onsite, 2 days remote *We are unable to provide sponsorship for this role* Qualifications Bachelor's degree in accounting, finance or related 5+ years of experience in risk-based operational and compliance audits and projects, business process reviews and internal...


  • Chicago, United States Allied Benefit Systems, LLC Full time

    QUALITY ASSURANCE AUDITORPOSITION SUMMARY Working independently and in groups the Quality Assurance Auditor will be responsible for the completion of multiple audit tasks including but not limited to auditing the builds of plan coders as needed for all new and existing revisions, along with compiling and reporting results and trends accurately. The QA...


  • Chicago, United States Lauterbach & Amen Full time

    CAREER OPPORTUNITY Job Title: Senior Accountant/Auditor Location: Peoria, IL Date: February 19, 2024 About IPOPIF The Illinois Police Officers' Pension Investment Fund ("IPOPIF") was created by the Illinois Legislature and signed into law by Illinois Governor JB Pritzker on December 18, 2019. The law, Public Act 101-0610, provided for the mandatory...


  • Chicago, United States SQA Services Full time

    SQA Services is a leading Quality Assurance and Supply Chain consultancy firm. SQA manages Supplier Audit and Supplier Development programs for customers in many industries including Pharmaceutical, Medical Device, Automotive, Aerospace, and Electronics manufacturing. Clients leverage SQA's network of Quality Professionals in more than 50 countries as an...


  • Chicago, United States SQA Services Full time

    SQA Services is a leading Quality Assurance and Supply Chain consultancy firm. SQA manages Supplier Audit and Supplier Development programs for customers in many industries including Pharmaceutical, Medical Device, Automotive, Aerospace, and Electronics manufacturing. Clients leverage SQA's network of Quality Professionals in more than 50 countries as an...


  • Chicago, United States Lauterbach & Amen Full time

    CAREER OPPORTUNITY Job Title: Senior Accountant/Auditor Location: Peoria, IL Date: February 19, 2024About IPOPIF The Illinois Police Officers' Pension Investment Fund ("IPOPIF") was created by the Illinois Legislature and signed into law by Illinois Governor JB Pritzker on December 18, 2019. The law, Public Act 101-0610, provided for the mandatory...


  • Chicago, United States Lauterbach & Amen Full time

    CAREER OPPORTUNITY Job Title: Senior Accountant/Auditor Location: Peoria, IL Date: February 19, 2024About IPOPIF The Illinois Police Officers' Pension Investment Fund ("IPOPIF") was created by the Illinois Legislature and signed into law by Illinois Governor JB Pritzker on December 18, 2019. The law, Public Act 101-0610, provided for the mandatory...

  • Auditor 1

    1 week ago


    Chicago, United States Metra Full time

    Description Metra is one of the largest and most complex commuter rail systems in North America, serving Cook, DuPage, Will, Lake, Kane, and McHenry Counties. The agency is linking communities in Northeastern Illinois by providing safe, reliable, and efficient commuter service. The Audit Department reports to the Chief Audit Officer, who reports directly to...

  • Sr Auditor

    3 days ago


    Chicago, Illinois, United States Metra Full time

    Date Posted: 5/3/2024Posting End Date: 5/17/2024Location: 98-Non-ContractCity: ChicagoState: ILCountry: United States of AmericaCategory: ProfessionalsFLSA Status: --Salary Mid Point: --Salary Range: $76,709.00 - $115,064.00Metra is one of the largest and most complex commuter rail systems in North America, serving Cook, DuPage, Will, Lake, Kane, and McHenry...

  • Sr Auditor

    2 weeks ago


    Chicago, Illinois, United States Metra Full time

    Date Posted: 5/3/2024Posting End Date: 5/17/2024Location: 98-Non-ContractCity: ChicagoState: ILCountry: United States of AmericaCategory: ProfessionalsFLSA Status: --Salary Mid Point: --Salary Range: $76,709.00 - $115,064.00Metra is one of the largest and most complex commuter rail systems in North America, serving Cook, DuPage, Will, Lake, Kane, and McHenry...

  • Auditor 1

    4 days ago


    Chicago, United States Metra Full time

    Description Metra is one of the largest and most complex commuter rail systems in North America, serving Cook, DuPage, Will, Lake, Kane, and McHenry Counties. The agency is linking communities in Northeastern Illinois by providing safe, reliable, and efficient commuter service. The Audit Department reports to the Chief Audit Officer, who reports directly to...

  • Auditor 1

    2 weeks ago


    Chicago, Illinois, United States Metra Full time

    Date Posted: 5/15/2024Posting End Date: 5/31/2024Location: 98-Non-ContractCity: ChicagoState: ILCountry: United States of AmericaCategory: ProfessionalsFLSA Status: --Salary Mid Point: --Salary Range: $52,393.00 - $78,590.00Description Metra is one of the largest and most complex commuter rail systems in North America, serving Cook, DuPage, Will, Lake,...

  • Auditor 1

    2 days ago


    Chicago, Illinois, United States Metra Full time

    Date Posted: 5/15/2024Posting End Date: 5/31/2024Location: 98-Non-ContractCity: ChicagoState: ILCountry: United States of AmericaCategory: ProfessionalsFLSA Status: --Salary Mid Point: --Salary Range: $52,393.00 - $78,590.00Description Metra is one of the largest and most complex commuter rail systems in North America, serving Cook, DuPage, Will, Lake,...

  • Staff Auditor

    2 weeks ago


    Chicago, United States Chicago Public Schools Full time

    Chicago Public Schools (CPS) is one of the largest school districts in the United States, serving over 330,000 students in 600+ schools and employing nearly 36,000 people, most of them teachers. CPS has set ambitious goals to ensure that every student, in every school and every neighborhood, has access to a world-class learning experience that prepares each...

  • Staff Auditor

    3 weeks ago


    Chicago, United States Chicago Public Schools Full time

    Chicago Public Schools (CPS) is one of the largest school districts in the United States, serving over 330,000 students in 600+ schools and employing nearly 36,000 people, most of them teachers. CPS has set ambitious goals to ensure that every student, in every school and every neighborhood, has access to a world-class learning experience that prepares each...

  • Staff Auditor

    2 days ago


    Chicago, United States Chicago Public Schools Full time

    Chicago Public Schools (CPS) is one of the largest school districts in the United States, serving over 330,000 students in 600+ schools and employing nearly 36,000 people, most of them teachers. CPS has set ambitious goals to ensure that every student, in every school and every neighborhood, has access to a world-class learning experience that prepares each...