Healthcare: Auditing Practices

Internal medical audits can be divided into prospective and retrospective ones. The benefits of the prospective audits include prevention of sending incorrect claims, reduced denials’ chance, and demonstration of the organization’s proactivity. The weaknesses are that it is only possible to review a small number of claims, and this process is too timely. Retrospective audits “have the advantage of time,” but they do not prevent incorrect claims from being sent (Nassiopoulos, 2019, para. 12). Internal audits are considered more effective as they provide a fresh perspective on controls and allow maintaining accurate financial reporting. However, when it is essential to ensure that the existing documents are free of errors, external audits are conducted. As a future medical coder or reimbursement specialist, I am interested in auditing because I enjoy working with data and numbers. This skill will help me be more patient, careful, and attentive to the details.

Preciado Cardiology is urgently looking for a medical biller/coder. Three years of ICD-10 and CPT coding and five years of medical billing are preferred but not required. The main responsibility is to transfer insurance and patient information and initiate payment procedures (Indeed.com, n.d.). Further, a Supervisory Medical Records Technician vacancy is offered by US Veterans Health Administration. One of the main requirements is to have Apprentice/Associate Level Certification, Mastery Level Certification, or Clinical Documentation Improvement Certification (Indeed.com, n.d.). I would tailor my resume by mentioning all the skills I have that are requested by the organizations, such as advanced knowledge of current coding classification systems and abilities to resolve staff issues and analyze data sets. I found the terms ‘medical coding entry level’ and ‘healthcare billing specialist’ helpful and effective. Finally, to highlight my certification and experience, I would mention these points at the very beginning of the resume.

References

Indeed.com. (n.d.). Job positions. Web.

Nassiopoulos, V. (2019). Prospective vs. retrospective audits? Our view: You need both. Hayes Management. Web.

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StudyCorgi. 2023. "Healthcare: Auditing Practices." March 9, 2023. https://studycorgi.com/healthcare-auditing-practices/.

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