2397 Comfort Court
Madison, WI 53703
Job Objective To secure a position with a reputable company in which to exercise my knowledge and training as a Medical Auditor.
Medical Auditor, August 2005 – Present
Slidell Memorial Hospital, Madison, WI
- Performed prospective audits of revenue-generating departments throughout the hospital.
- Reviewed medical record documentation upon receipt of RAC/MIC requests and provided feedback of findings.
- Worked closely with RAC Coordinator to ensure timely review and submission of record requests and appeals.
- Maintained retrospective/defense audits with commercial carriers and prepared monthly reports.
- Performed patient request audits.
- Ensured compliance with governmental and payer regulations.
Medical Auditor, May 2000 – July 2005
Aurora Health Care, Madison, WI
- Audited medical records and hospital bills and identified problems and opportunities for improvements.
- Researched applicable regulatory and billing rules to ensure compliant billing of hospital bill accounts.
- Assisted in the development of processes to ensure the underlying integrity of the billing systems.
- Identified trends/charging issues and reported to supervisor.
- Evaluated concurrent audit reports.
- Supported department in submitting appeals.
Summary of Qualifications:
- Sound experience in primary care nursing, medical records coding, case management, utilization review and third party defense audits
- Good knowledge of ICD-9, CPT and HCPCS coding
- Proficient with Microsoft Office applications
- Familiarity with general Medicare billing regulations
- Ability to work independently and with a team facility
- Excellent personal relations and customer care skills
- Strong communication, organizational, analytic skills
Bachelor’s Degree in Health Care Administration, Stony Brook University, Stony Brook, NY