How to Become a Certified Medical Auditor: Career Guide
Research the requirements to become a certified medical auditor. Learn about the job duties and read the step-by-step process to start a career in medical auditing.
Certified Medical Auditor Requirements
Certified medical auditors, also known as compliance auditors, perform audits and reviews of clinical documents, physician billing records, administrative data and coding records. They ensure compliance with industry regulations and maintain quality assurance. Most certified medical auditors have a bachelor's degree in business, medical records technology, health services administration or other healthcare-related degree. Some are certified in medical coding or health information administration. The following table contains some of the common requirements according to online job ads posted in January 2013:
|Degree Level||Bachelor's degree|
|Degree Field||Business, medical records technology, health services administration, nursing or related field|
|Certification||Registered Health Information Administrator (RHIA), Certified Medical Auditor Specialist (CMAS), Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) designations preferred|
|Experience||3-5 years of experience in a coding or clinical position|
|Key Skills||Strong communication, analytical and organizational skills, excellent writing and speaking skills, ability to maintain confidentiality, ability to work independently or in a team environment|
|Technical Skills||Knowledge of Medicaid and Medicare, HIPAA and JCAHO / TJC regulations, understanding of CPT and ICD coding processes, medical terminology|
|Computer Skills||Experience with MS Word, Excel and data entry|
Step 1: Get a Bachelor's Degree
Several acceptable education paths allow one to become a certified medical auditor. A bachelor's degree program in business, health services administration or related administrative field can help prepare students for their careers in medical auditing. A bachelor's degree program in business administration may provide coursework in a variety of useful topics such as accounting and finance, business laws, anatomy and physiology and operations management. A health services administration degree program might provide coursework in health economics, health administration, management and organizational behavior, managed care and related topics. A degree in nursing would provide a more clinical-based education that can be applied to a career in medical auditing.
Step 2: Gain Work Experience
Most employers require candidates to have 3-5 years of experience in coding or legal, regulatory, nursing or healthcare compliance position. An entry-level healthcare administrative position or clinical nursing experience can be useful when looking for employment as a medical auditor. Candidates should have a strong knowledge base in medical terminology, coding processes and healthcare laws and regulations before seeking a position as a certified medical auditor.
Step 3: Get Certified
Many certifications are accepted by employers for a certified medical auditor position. The American Health Information Management Association (AHIMA) offers an RHIA designation that shows competency in health information and records management and knowledge of medical ethics and law. Requirements include graduation from an accredited bachelor's degree program in a healthcare-related field. The CCS designation shows competency in medical coding and billing practices and knowledge of medical terminology, disease processes and other related topics. Requirements vary and include previous RHIA certification, 1-2 years of coding experience or completion of a coding education program. Both certification programs require passing a written examination.
The American Association of Medical Audit Specialists (AAMAS) offers a Certified Medical Audit Specialist (CMAS) designation that demonstrates an auditor's professional integrity and knowledge. Requirements include 2 years of experience in healthcare claims auditing, completion of an accounting, finance or related education program or experience as a licensed healthcare professional. Applicants must become members of the AAMAS to apply. Applicants must pass a written examination to become certified.
Related to How to Become a Certified Medical Auditor: Career Guide
- Recently Updated
Most people have a perception of med school that includes countless hours of lectures, lab work and studying without much sleep...
Individuals with bachelor's degrees can be employed in various technological, patient care and administrative areas in the...
It may no longer be so difficult to get into medical school in the U.S. - almost two dozen new med schools have just opened or...
Medical psychologists are clinical psychologists who use their knowledge of medical, psychological and social factors to...
- Top Schools for Medical Ethics and Bioethics
- Associate of Medical Radiography: Degree Overview
- Best Medical Residency Programs: List of Top Schools and Hospitals
- Schools for Aspiring Slot Technicians: How to Choose
- Schools for Aspiring Forensic Pathology Assistants: How to Choose
- Aircraft Avionics Schools: How to Choose
- Mechatronics Engineering Schools and Degree Programs: How to Choose