Healthcare Auditor Resume

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Here is the Healthcare Auditor Resume example:

Kenneth Sorensen

2268 Crummit Lane

Cranston, RI 2910

(555)-555-5555

[email]

Job Objective To obtain a Healthcare Auditor position with dependable company where I can further boost my career in this field.

Highlights of Qualifications:

  • Sound knowledge of medical review, chart audits, and quality improvement processes
  • Familiarity with Medicaid reimbursement policies and procedures
  • Sound knowledge in healthcare coding like CPT4, HCPCS, DRG, ICD-9 and Revenue Codes
  • In depth experience with healthcare claim adjudication standards and procedures
  • Proficient in Microsoft office products, with expertise in Access and Excel
  • Great ability to analyze medical information
  • Ability to scheduling own audit projects
  • Strong analytical and investigative skills
  • Excellent communication and organizational skills

Professional Experience:

Healthcare Auditor, August 2005 – Present

Connolly, Inc., Cranston, RI

  • Performed retrospective chart audits of health care services.
  • Collected additional data as necessary to evaluate request applying appropriate clinical criteria.
  • Identified payment errors by thorough investigation of medical claim data and records.
  • Evaluated audit findings and customer processing guidelines.
  • Updated audit findings with the management and assist in error validation process.
  • Audited, mentored, supported and suggested improvements and recommendations to meet client satisfaction.

Healthcare Auditor, May 2000 – July 2005

Connolly, Cranston, RI

  • Performed audits of health care firms.
  • Evaluated, identified, and reported on, quality of health care issues.
  • Ensured to determine compliance with health care standards.
  • Coordinated with various department managers at health care centre and evaluated internal controls.
  • Reviewed financial reports and evaluated recommendations meeting the health care standards.
  • Prepared reports to summarize review activity.

Education

Bachelor’s Degree in Nursing, Gwynedd-Mercy College, Gwynedd Valley, PA

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  • March 1, 2020Create Date
  • March 1, 2020Last Updated