Medical Coding Auditor Certificate (CPMA®) Online Course & Exam Prep
$ 1,299.00Medical Coding Auditor Certificate (CPMA®) Online Course & Exam Prep
Mrs. Ortega teaches this course online with a study guide and 3 months of access.
AAPC® requires Official Medical Auditing Knowledge to pass the certification test.
This “to the point” and “no fluff” guide contains a unique comprehension of the Commercial and Federal Guidelines you will need to enter the industry as a Medical Coding Auditor.
Here’s what you will learn:
| Advanced E&M | Mid-Level & NPP Providers |
| Case Audits | Provider Documentation Incident To |
| Recovery Audits | Split Shared Service |
| Audit Findings | Medical Record Standards |
| Retrospective Audits | Global Surgical Package |
| Prospective Audits | Global Period |
| RATS STATS | Compliance Standards Federal Regulations |
| Statistical Planning | OIG Workplan |
| Provider Dictation | ABN Modifier Application |
| Audit Report Communication | Fraud & Abuse |
| Medical Necessity | Federal Mandate Acts |
| Commercial Policies | CPT – Evaluation & Management |
| CMS Policies | CPT – Guidelines & Modifiers |
| LCD and NCD | ICD-CM Guidelines |
| Preauthorization | CIA |
| Remittance | HIPPA |
| Advice | HCPCS |
| NCCI Edits |
What does the auditor do?
The Medical Coding Auditor employed at the Physician’s office or Health Plan level understands the organizational strategy and operational objectives of the entity. Following established guidelines and procedures, a medical coding auditor will check medical coding and billing information for efficiency, accuracy, and compliance prior to submitting claims in order to prevent audit findings from external audits. The Professional Medical Coding Auditor provides physicians with specific education based on their quality monitoring of claim denials and healthcare trends.
The Medical Coding Auditor employed at the Federal Government Entity understands the organizational strategy and operational objectives of the medical practice, facility, and health plan. The Medical Coding Auditor will identify and fix incorrect and improper payments on claims that have already been submitted in a variety of healthcare settings. These auditors look for both overpayments and underpayments made to providers. They request medical records from providers to review claims known to be at risk for containing errors. These high-demand professionals identify payments for medically unnecessary services, incorrectly coded services, services performed that were medically unnecessary, claims not supported by documentation, duplicate claims, and claims filed primarily to Medicare when Medicare was secondary, and in the process also uncover quite a bit of fraud. These upper-level auditors are paid a percentage of what they recover.
You’ll get a tenfold Return on Investment on this Certification!