How to Become a Medicare Auditor
Get a degree., Complete an internship., Obtain training and experience., Get your state license., Become certified as a Medical Audit Specialist., Keep your computer skills up to date., Expect an hourly wage with bonuses for any money you recover as...
Step-by-Step Guide
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Step 1: Get a degree.
A minimum of an Associate's degree is necessary to find work as a Medicare auditor in every state.
A Bachelor's degree will increase your chances of getting hired.
Major in any field.
While there is no specific degree for an auditor or a Medicare professional, an educational background in finance, business or health administration will help.
Take classes in healthcare law, statistics, math, business, accounting and insurance law. -
Step 2: Complete an internship.
Doing an internship in the auditing or healthcare fields will help prepare you for a career as a Medicare auditor.
Look for auditing internships with accounting firms in your area.
You can also look for internships specific to Medicare with agencies such as CMS, the Department of Health and Human Services (HHS), the Social Security Administration (SSA) or nonprofit groups such as the Center for Medicare Advocacy. , As a Medicare auditor, you will be responsible for reviewing claims, patient records and hospital and physician billing practices.
Look for jobs that will give you experience as a healthcare or medical auditor.
You can work for accounting firms that have medical clients, work in the finance or business offices of a healthcare provider or try to get a job with CMS directly. , In order to work as a Medicare auditor in a specific state, you will need to be licensed by that state.
Expect to take an exam, meet educational requirements and in some cases, take continuing education classes.
All states have different licensure requirements, but an exam and continuing education are standard in most states. , This certification is not required, but will demonstrate an additional level of professionalism and training that sets you apart from other auditors.
Contact the American Association of Medical Audit Specialists (www.aamas.org) for certification requirements and information.
You will need at least 2 years of experience as a healthcare auditor to qualify for certification.
Demonstrate coursework for your certification through AAMAS.
You will need to have 60 college credits in classes such as math, statistics, accounting and finance.
You will need to pass an exam to get your certification. , Medicare auditors will be required to work on site at different medical and healthcare establishments.
You will need to use a laptop and any specific software you are provided for audits.
Get to know all the available medical billing programs.
Each office you visit will have a different way of maintaining their invoices, charts and records. , The amount of your hourly rate will depend on the state you work in.
The average in 2011 is $29.66 per hour. , You will have access to a lot of confidential patient and billing information.
Any past ethical or legal conflicts will limit your ability to work as a Medicare auditor. , Depending on the state and region you live in, you will need to apply through a specific company that Medicare uses.
Identify your area as Region A, B, C or D and then apply to Diversified Collection Services (Region A), CGI (Region B), Connolly, Inc (Region C) or Health Data Insights, Inc (Region 4).
Visit www.cms.gov for information on your region and the Recovery Audit Contracting program. -
Step 3: Obtain training and experience.
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Step 4: Get your state license.
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Step 5: Become certified as a Medical Audit Specialist.
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Step 6: Keep your computer skills up to date.
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Step 7: Expect an hourly wage with bonuses for any money you recover as a result of finding financial discrepancies in Medicare billing.
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Step 8: Demonstrate ethical standards.
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Step 9: Get a job with one of the organizations that contracts Medicare auditors.
Detailed Guide
A minimum of an Associate's degree is necessary to find work as a Medicare auditor in every state.
A Bachelor's degree will increase your chances of getting hired.
Major in any field.
While there is no specific degree for an auditor or a Medicare professional, an educational background in finance, business or health administration will help.
Take classes in healthcare law, statistics, math, business, accounting and insurance law.
Doing an internship in the auditing or healthcare fields will help prepare you for a career as a Medicare auditor.
Look for auditing internships with accounting firms in your area.
You can also look for internships specific to Medicare with agencies such as CMS, the Department of Health and Human Services (HHS), the Social Security Administration (SSA) or nonprofit groups such as the Center for Medicare Advocacy. , As a Medicare auditor, you will be responsible for reviewing claims, patient records and hospital and physician billing practices.
Look for jobs that will give you experience as a healthcare or medical auditor.
You can work for accounting firms that have medical clients, work in the finance or business offices of a healthcare provider or try to get a job with CMS directly. , In order to work as a Medicare auditor in a specific state, you will need to be licensed by that state.
Expect to take an exam, meet educational requirements and in some cases, take continuing education classes.
All states have different licensure requirements, but an exam and continuing education are standard in most states. , This certification is not required, but will demonstrate an additional level of professionalism and training that sets you apart from other auditors.
Contact the American Association of Medical Audit Specialists (www.aamas.org) for certification requirements and information.
You will need at least 2 years of experience as a healthcare auditor to qualify for certification.
Demonstrate coursework for your certification through AAMAS.
You will need to have 60 college credits in classes such as math, statistics, accounting and finance.
You will need to pass an exam to get your certification. , Medicare auditors will be required to work on site at different medical and healthcare establishments.
You will need to use a laptop and any specific software you are provided for audits.
Get to know all the available medical billing programs.
Each office you visit will have a different way of maintaining their invoices, charts and records. , The amount of your hourly rate will depend on the state you work in.
The average in 2011 is $29.66 per hour. , You will have access to a lot of confidential patient and billing information.
Any past ethical or legal conflicts will limit your ability to work as a Medicare auditor. , Depending on the state and region you live in, you will need to apply through a specific company that Medicare uses.
Identify your area as Region A, B, C or D and then apply to Diversified Collection Services (Region A), CGI (Region B), Connolly, Inc (Region C) or Health Data Insights, Inc (Region 4).
Visit www.cms.gov for information on your region and the Recovery Audit Contracting program.
About the Author
Margaret Kim
Committed to making pet care accessible and understandable for everyone.
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