Medical Chart Auditor in Miami, Florida at Physicians Dialysis

Arista Recovery seeks an experienced Medical Chart Auditor (MCA) with a background in medical chart auditing, Utilization Management (UM), or Utilization Review (UR) within mental health or addiction treatment settings. This role requires comfort and proficiency with AI tools to enhance documentation efficiency, improve accuracy, and support compliance. The MCA will work closely with clinical teams to ensure documentation aligns with ASAM standards and payer requirements, fostering a culture of precise, efficient charting.

Duties and Responsibilities:

• Medical Record Audits: Conduct thorough audits of patient medical charts, ensuring accurate documentation that meets ASAM standards and payer criteria.
• Real-Time Support & AI-Driven Training: Use AI tools to assist clinical staff in real-time, improving efficiency in documentation and compliance.
• Compliance Monitoring: Ensure all medical records adhere to ASAM standards, insurance requirements, and HIPAA regulations.
• Discrepancy Management: Identify and address documentation inconsistencies, leveraging AI tools to streamline audit processes and enhance efficiency.
• Data Analysis: Use AI-driven insights to analyze trends in documentation, identifying opportunities for improved efficiency and accuracy.
• Reporting & AI-Enhanced Documentation: Prepare detailed audit reports and utilize AI tools to support accurate, efficient record-keeping.
• Quality Improvement Initiatives: Engage in projects to advance documentation accuracy and efficiency, including the integration of AI tools to optimize processes.

Education/Experience/Qualification:

• Minimum of 3 years in medical chart auditing, Utilization Management (UM), or Utilization Review (UR) within mental health or addiction treatment.
• A Bachelor’s degree or certifications like CPMA are preferred but not required if the candidate has relevant experience.
• AI Proficiency: Comfortable and proficient with AI tools relevant to documentation, with a focus on enhancing efficiency and accuracy.
• Strong knowledge of medical terminology and healthcare documentation standards.
• Detail-oriented with analytical skills to detect trends and inconsistencies.
• Proficiency in electronic health record (EHR) systems.
• Excellent communication and interpersonal abilities
• Ability to work both independently and as part of a team in a dynamic environment.