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