How To Become A Medical Auditor: What It Is and Career Path

What is a medical auditor and how to become one

Updated January 8, 2025

4 min read

A medical auditor reviews medical records and billing documents to ensure accuracy, compliance, and appropriate reimbursement. They work for healthcare providers, insurance companies, or government agencies. The role involves analyzing data, identifying issues, and recommending improvements. Medical auditors have analytical skills, attention to detail, and knowledge of medical coding and billing. They also communicate with healthcare providers and insurance representatives. A medical auditor aims to maintain quality healthcare services while minimizing waste, fraud, and abuse.

ScoreMedical AuditorUS Average

Salary

4.2

Avg. Salary $53,683

Avg. Salary $59,228

Stability Level

4.8

Growth Rate 11%

Growth Rate 0.3%

Diversity

6.0

Race

American Indian and Alaska Native 1.26%

Asian 8.66%

Black or African American 8.37%

Hispanic or Latino 17.27%

Unknown 4.20%

White 60.24%

Gender

female 81.42%

male 18.58%

Age - 46

Race

American Indian and Alaska Native 3.00%

Asian 7.00%

Black or African American 14.00%

Hispanic or Latino 19.00%

White 57.00%

Gender

female 47.00%

male 53.00%

Age - 46

Stress Level

4.8

Stress level is manageable

7.1 - high

Complexity Level

6.0

Complexity Level is intermediate

7 - challenging

Work Life Balance

8.6

Work Life balance is excellent

6.4 - fair

What are the pros and cons of being a Medical Auditor?

Pros

Competitive salary
Opportunity to work remotely
Chance to work with healthcare providers to promote ethical and compliant practices
High demand for medical auditors in the healthcare industry
Possibility of flexible work hours

Cons

Risk of exposure to infectious diseases when working in hospital settings
May require long hours sitting at a desk or computer, leading to physical strain
May have limited opportunities for upward mobility within the organization
Risk of burnout due to high workload and complex cases
May require travel to different locations for audits

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Key steps to become a medical auditor

Explore medical auditor education requirements

Most common medical auditor degrees

Bachelor's

35.2 %

Associate

26.1 %

Certificate

9.4 %

Start to develop specific medical auditor skills

Skills	Percentages
ICD-10	12.44%
HCPCS	9.77%
HIPAA	9.18%
Patients	7.85%
Surgery	6.48%

Complete relevant medical auditor training and internships

Accountants spend an average of Less than 1 month on post-employment, on-the-job training. New medical auditors learn the skills and techniques required for their job and employer during this time. The chart below shows how long it takes to gain competency as a medical auditor based on U.S. Bureau of Labor Statistics data and data from real medical auditor resumes.

Gain additional medical auditor certifications

Medical auditor certifications can show employers you have a baseline of knowledge expected for the position. Certifications can also make you a more competitive candidate. Even if employers don't require a specific medical auditor certification, having one may help you stand out relative to other applicants.

The most common certifications for medical auditors include Certified Billing and Coding Specialist (CBCS) and Medical Assistant.

More About Certifications

Research medical auditor duties and responsibilities

Review confidential and substantial health documentation and make sound, evidence-base decisions concerning compliance to HIPPA and other manage care policies.
Handle and interpret medical documentation such as UB04 claim forms and EOB's on a daily basis.
Review all EOB's to ensure claim paid per contract and submit appeals for claims underpay or deny payment in error.
Review medical records to determine if clinical documentation support coding and DRG assignments.

Prepare your medical auditor resume

When your background is strong enough, you can start writing your medical auditor resume.

You can use Zippia's AI resume builder to make the resume writing process easier while also making sure that you include key information that hiring managers expect to see on a medical auditor resume. You'll find resume tips and examples of skills, responsibilities, and summaries, all provided by Zippi, your career sidekick.

Choose From 10+ Customizable Medical Auditor Resume templates

Build a professional Medical Auditor resume in minutes. Browse through our resume examples to identify the best way to word your resume. Then choose from 10+ resume templates to create your Medical Auditor resume.

Apply for medical auditor jobs

Now it's time to start searching for a medical auditor job. Consider the tips below for a successful job search:

Browse job boards for relevant postings
Consult your professional network
Reach out to companies you're interested in working for directly
Watch out for job scams

How do medical auditors rate their job?