Monday, Mar 20, 2023

Medical Billing and Coding - How to Become a Medical Auditor

The medical audit process can be beneficial for practice revenue generation and patient outcomes. Regular evaluation of this process enhances..

The medical audit process can be beneficial for practice revenue generation and patient outcomes. Regular evaluation of this process enhances compliance and data management. The right medical billing and coding services can accelerate insurance reimbursement and cut financial losses. You should hire the best auditors to increase your practice revenue. However, if you're interested in this field but are not sure how to get started, read on to discover the benefits and requirements. Become a medical auditor and start generating higher profits today!


The American Association of Medical Audit Specialists (AAMAS) is the credentialing body for certified medical auditors. Its members are professionals with backgrounds in medical reimbursement and health care. They include hospital bill auditors, compliance auditors, independent review consultants, and utilization review and quality assurance specialists. AAMAS works to advance the profession by supporting and promoting the practice of medical audit. The organization is administered by an elected board of directors and appointed committees and its Bylaws are approved by the general membership.

To become an AAMAS certified medical auditor, you must have two years' experience in auditing and at least 60 college credits in statistics, math, and accounting. Additionally, you must have passed a specialized exam. To apply for certification, go to AAMAS' website and search for "certified medical auditor" to view job postings. To apply, you must have two forms of identification. One of these forms of identification must be a photo ID. The other form of identification must be a confirmation letter. Also, bring a solar-powered calculator, black ink pen, and two forms of identification.

In order to qualify for AAMAS certification, you must be a member of a recognized revenue integrity or quality management organization. You must have twenty-four months of authenticated health care audit experience, including UB 04, CMS 1500, stop-loss terminology, and managed care. AAMAS' certification examination is based on Core Curriculum Domains. In addition to a comprehensive training course, you will be required to attend an annual conference held by the organization.

To become an AAMAS certified medical auditor, you must have a nursing degree. You must also have completed an accredited nursing program. If you have completed your program, you must also sit for the licensing exam in the state you will practice. The AAMAS certification exam is a comprehensive examination that tests your knowledge of the field of medical audit, as well as your professional behavior. The American Association of Medical Audit Specialists requires candidates to complete one or two college level courses in statistics and finance.

Career path

A career as a medical auditor may not seem like a great choice for someone looking for a fulfilling career. It requires business acumen and the ability to understand the financial aspects of a medical practice. Medical auditors are important in ensuring that medical practices are providing the highest level of care and are operating within their budget. Those with business acumen may be able to provide improvements and recommendations for practices that save money and improve care.

To become a medical auditor, you must first obtain a bachelor's degree in a related field, such as health services administration or accounting. You can also pursue a certified medical auditor program. Aside from a bachelor's degree, you will need to have experience in a healthcare regulatory position. You will also need to be highly detail-oriented, as this will enable you to provide accurate information to patients and improve operations.

A career as a medical coder auditor will require you to learn the intricacies of the medical coding industry. It requires you to be able to understand complex medical terms and to read and understand medical records. Obtaining a master's degree may be preferable, but you are not required to have one. Medical coder auditors may be paid between $36,000 and $56,000 per year. The demand for these professionals is growing steadily, so it is important to stay on top of industry trends to stay ahead of the competition.

Medical auditors may work in a variety of settings, including private organizations and government agencies. Many work in an accounting firm with clients in the health care industry. They are typically employed during regular business hours, but can occasionally work on weekends and on holidays. Some travel to other locations to audit medical records. This profession requires that you stay on top of three trends. If you are interested in being a medical auditor, consider becoming one!


While the primary purpose of a medical auditor is to help improve reimbursement, their education is not limited to improving reimbursement. In addition to gaining technical knowledge, medical auditors learn how to communicate and document clinical documentation. These are essential elements of good compliance. In addition to learning how to communicate information back to providers, medical auditors can also educate ancillary staff. Training can be tailored to address identified deficiencies. It can range from proper medical code coding to billing and modifiers.

A medical auditor has to be detail-oriented. They must be able to spot irregularities in medical documentation and numbers. The education of medical auditors includes a certification course that prepares students to pass the Certified Professional Medical Auditor exam. Certification will increase your employability as a medical auditor. For those who already have some medical coding experience, the CPMA training course is a great starting point. It costs only a small fraction of other training programs.

As a general rule, Medical Auditors have Bachelor's degrees in Health Care Administration, Nursing, or Business. Approximately 35% of these professionals hold a Bachelor's degree, while 26% of them hold an Associate's degree. According to a CareerBuilder study of 1,248 resumes, the majority of Medical Auditors have at least a Bachelor's degree. So, if you're looking for an education as a Medical Auditor, consider completing a certificate program in health care coding or a medical assistant degree.

While medical auditors are responsible for assessing the accuracy of medical billing and coding, they also need to understand the policies and procedures of the healthcare industry. Moreover, they need to be well-versed in medical terminology and anatomy. You can complete a course on your computer, using any web browser. Adobe Flash Player and Adobe Acrobat Reader are required for the course. You can also complete the course from your computer if you're using a Mac or a PC.

Medical auditors conduct internal and external reviews of policies and procedures to ensure liability-free operation. In addition, they need to be knowledgeable about clinical documentation, medical coding, and compliance and regulatory guidelines. As a result, medical auditors need to be able to define a scope of audit, compile data, and report findings to the appropriate parties. Successful medical coding audits help protect patients by addressing noncompliant billing activity. They also ensure optimal reimbursement without the risk of punitive action.

Job outlook

The healthcare industry is constantly changing, and this has resulted in an increased demand for workers in the field of medical insurance claims processing. Additionally, recent changes in health insurance regulations have led to a growing need for skilled professionals with experience in this field. This white paper examines the job outlook for medical claims auditors. Interested applicants should consider pursuing this career path. There are a variety of different job opportunities in the medical claims processing industry, so there is a wide range of job titles available.

A post-secondary certificate in medical auditing is the minimum educational requirement. However, associate degrees are also available. A certificate in medical auditing may take one year to complete. While an associate degree isn't necessary, many employers prefer candidates with some medical experience. Other types of job opportunities exist for people with a bachelor's degree in medical fields. However, the requirements for becoming a medical auditor are similar to those for other medical-related professions.

A medical auditor uses business acumen to understand the financial aspects of a medical practice. Their expertise can help ensure that the practice's operations are running smoothly and within budget. Furthermore, these professionals can help medical practices cut costs by suggesting improvements that can benefit the bottom line. However, this position does not necessarily involve extensive travel. However, it does require a lot of attention to detail. If you have excellent communication skills, you can be a great medical auditor.

The salary range for a Medical Auditor is around $21,017). This can vary widely based on location, years of experience, and skill level. There are a few companies in Maryland hiring Medical Auditors, which ranks 16th out of 50 states when it comes to medical auditor salaries. With the help of ZipRecruiter, you can find thousands of open positions in the state. They are constantly scanning millions of local jobs to make sure they are relevant and updated.

The OIG targets for medical auditors are set based on trends in claim errors throughout the U.S. Several publications outline the problem areas and current targets. The OIG's Comprehensive Error Rate Testing (CERT) report and OIG Work Plan are two of the definitive publications in this regard. These publications outline what the OIG prioritizes as the top priority areas for audits. Moreover, these publications are updated regularly to reflect emerging issues and targets.