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How to become a medical auditor?

by Uneeb Khan

CPMA means a certified medical auditor. The main work that they do is to conduct review and audits of coding records, records of physical billing, administrative data and clinical documents. They always help in maintaining the quality assurance at the same time comply with the regulations of the industry.

After completing the CPMA certification, the certified medical auditors can start working full time during the business hours just like the other auditors. Most of them work independently but they can also collaborate with the other medical office managers or other accountants and auditors. Once the classes are over and the certification is achieved they can start functioning in an office setting. One can also travel to different medical offices when they are auditing.

Skills needed in a medical auditor

If one wants to make a career as a medical auditor then they will definitely need a bachelor’s degree in Administration of Health Services, Nursing, Medical Record Technology or Business. The potential employers mostly look for people in coding positions who have at least 3 to 5 years of experience.

One needs to have a certification like the Certified Professional Coder (CPC), Certified Medical Auditor Specialist (CMAS), Certified Coding Specialist (CCS) or Registered Heath Information Administrator (RHIA). Those who want to work as a medical auditor professionally must have proper analytical skills along with communication and organisational expertise. They should also have great speech and writing skills so that they have a hassle free flow of communication.

It is also quite useful if one has the capacity and the confidentiality to work in an independent manner or as a member of the team. Medical auditors should have an understanding of Medicate and Medicaid and also an awareness of the medical coding along with data entry, MS word and Excel.

Steps to CPMA certification 

Those who want to become a medical auditor, needs to follow these steps:

  • One can only become a certified medical auditor through an acceptable path of education. One should complete a bachelor’s degree program in health services or administration. If one is getting into a degree program in business administration then healthcare offers them a wide range of topics like finance and accounting, business laws and even operation management. A degree in health services can offer course work in organisational behaviour and management, health economics and even health administration.
  • As mentioned above, in order to get a healthcare compliance, one needs to have 3 to 5 years of experience in nursing or in coding. When applying for the job of a medical auditor one has to have experience in clinical nursing or in healthcare administrative positions. They need to have an idea of medical terminology, coding process and healthcare laws and regulations.
  • Earning a CPMA certification is a necessity here. One can go through the CPMA course and the CPMA examination which provides certification to the medical auditors.

After that, one can start working as a professional medical auditor and serve the healthcare field in a proper manner of course.

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