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How to Become a Nurse Auditor

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Nurse auditors are used in many different roles within the health care system. A nurse auditor can be used to assess everything from patient satisfaction and quality care to whether charges and procedures provided were not only medically supported but also properly documented. Health care is a vast industry that just like any other business must be constantly scrutinized and audited to maintain and improve its level of professional quality care. Depending on where you live a nurse auditor can make a income of approximately $100,000 a year, according to the Indeed.com website.

Evaluate your case-management skills and knowledge of the medical-review process. Nurse auditors must be registered licensed nurses in their states of residence and should have a significant amount of experience in many medical specialties, as well as medical-record reviews.

Review your familiarity with medical coding, nurse auditors should have a good working knowledge of ICD-9, ICD-10 and HCPCS coding. It is highly recommended that any registered nurse seeking a nurse auditor position have at least one year of medical-coding experience.

Review your knowledge of medical insurance programs such as Medicaid, workers' compensation and Medicare. Nurse auditors must possess a good understanding of handling all facets of medical billing, including coding and handling many types of insurance.

Consider taking a nurse auditor certification examination. Although nurse auditor certification is not required for many nurse auditor positions, it is available, and you must possess a minimum of a bachelor's in nursing to take the nurse auditor exam. Your nursing license also must be current in your state of residence.

Try actively to increase any skills and certifications, such as nursing management, that can help secure you a nurse auditor position. A nurse auditor should possess a good working knowledge of all facets of the health care system including health care policies and guidelines.

Tip

Make sure you maintain your membership in the American Association of Clinical Coders and Auditors once you have become certified as a nurse auditor.

Make sure your professional resume outlines all your medical-management skills as well as any medical coding experience you may have had previously.

About the Author

Kimberly Cummings has been a nurse for more than 28 years and has worked in almost every department in the medical field. She's done legal work and is a nonfiction writer. She has worked in business administration for more than 15 years, been in the military and freelanced for Associated Content as a featured health and wellness contributor as well as a featured travel contributor.

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