Medical auditor vs medical records technician

Differences between medical auditor and medical records technician duties and responsibilities

Medical auditor example 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.
• Advance knowledge - CMS and provider contract rules.
• Process HCFA and UB claims in a production environment.
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Medical records technician example responsibilities.

• Enter all patient in-take into EMR, manage triage, scheduling, and maintain a sterile clinic setting.
• Manage medical treatment authorizations and durable medical equipment (DME) requests and verify medical eligibility for all patients requesting treatment.
• Perform examinations in the ER, main radiology area and surgery.
• Order medical records for patients, medical staff, outside entities, and court subpoenas for certain dates of services.
• Audited/Validate daily outpatient medical coding accounts involving emergency rooms, surgery, interventional radiology, radiology, and ancillary services.
• Staff education on EMR and industry regulations.
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