How To Become a Healthcare Auditor: Step-by-Step Guide

Healthcare auditors are responsible for ensuring that healthcare organizations are compliant with laws and regulations. They also work to improve the efficiency and quality of healthcare services. If you are interested in a career in healthcare auditing, it is important to understand the job responsibilities, educational requirements and skills needed to be successful in this field. In this article, we will discuss what healthcare auditors do, how to become one and what the average salary is for this profession.

What Does a Healthcare Auditor Do?

Healthcare auditors are responsible for ensuring that healthcare organizations are in compliance with laws, regulations and standards. They also work to improve the efficiency and effectiveness of these organizations. Healthcare auditors typically have a background in accounting, finance or business administration. Some of their duties include:

• Conducting audits of healthcare organizations to assess compliance with laws, regulations and standards
• Identifying areas where improvements can be made to increase efficiency and effectiveness
• Developing audit plans and programs
• Supervising staff members who are conducting audits
• Reviewing audit findings and making recommendations to management
• Testifying as an expert witness in legal proceedings
• Preparing reports on audit findings
• Presenting audit results to management

Healthcare Auditor Salary and Job Outlook

The average salary for healthcare auditors is $74,675. However, salaries can vary based on factors such as experience, education, and geographical location.

The Bureau of Labor Statistics predicts that job prospects for healthcare auditors will grow at an average rate over the next decade. The aging Baby Boomer population is one of the main reasons for this projected growth. As this population continues to age, they will likely need more medical care, which in turn will require more audits to ensure billing accuracy and compliance with regulations.

How to Become a Healthcare Auditor

Here are several steps you should take to become a healthcare auditor.

1. Earn a bachelor’s degree in accounting, finance or a related field

A bachelor’s degree is the minimum educational requirement for healthcare auditing jobs. Common degrees that are useful for this career include accounting, finance and business administration. Coursework in these programs typically includes classes on financial analysis, statistics, economics and business law.

While pursuing your undergraduate degree, consider taking additional courses in healthcare management or a related field to better prepare you for this role. You may also choose to pursue an advanced degree such as a Master of Business Administration (MBA) or a Master of Science in Healthcare Management.

2. Obtain certification as a Certified Public Accountant (CPA) or Certified Internal Auditor (CIA)

The next step in your career as a healthcare auditor is to obtain certification from the American Institute of Certified Public Accountants (AICPA). To become a CPA, you must pass the Uniform Certified Public Accountant Examination. This test covers auditing, taxation and management advisory services.

To earn the CIA designation, you must first be a CPA and then complete an additional course on internal auditing. The AICPA also offers several other certifications for healthcare auditors such as the Healthcare Compliance Certification Board’s HCAB Certified Professional Auditor credential or the International Association of Healthcare Compliance Professionals’ IAHCSMM Certified Healthcare Safety Management and Monitoring professional credential.

3. Gain experience working in auditing or a related field

Most healthcare auditors have at least five years of experience in a related field such as accounting, finance or risk management. Entry-level positions in auditing and financial analysis can provide you with the skills and knowledge you need to succeed as a healthcare auditor.

You may consider working for an audit firm where you can gain hands-on experience reviewing financial statements and providing recommendations on how to improve processes. You can also work for a consulting firm that provides auditing services to companies. Working for these types of organizations can help you develop your communication and analytical skills.

4. Develop strong analytical and research skills

Healthcare auditors must be able to analyze large amounts of data and research complex issues. They need to be able to identify trends in the information they receive and determine whether it is accurate or if there are any discrepancies that may affect patient care.

As you work toward becoming a healthcare auditor, develop your analytical skills by taking classes or participating in group projects. You can also gain experience in this area through an internship or entry-level position in accounting or auditing.

5. Understand healthcare regulations

Healthcare auditors must have a thorough understanding of the regulations that govern healthcare facilities. The Joint Commission, Centers for Medicare and Medicaid Services (CMS) and Health Insurance Portability and Accountability Act (HIPAA) are some of the most important regulatory bodies to be familiar with when working in this field.

The CMS establishes guidelines for hospitals and other healthcare facilities through its Conditions of Participation program. The Joint Commission is an independent non-profit organization that accredits healthcare organizations based on these conditions. The HIPAA Privacy Rule protects patient information from unauthorized use or disclosure.

6. Stay up to date on changes in the healthcare industry

Healthcare is a dynamic industry that is constantly changing. New regulations, new technologies and new healthcare facilities are all factors that can affect the auditing process. To stay up to date on these changes, it’s important for healthcare auditors to regularly monitor news sources and attend professional development seminars or webinars.

7. Join professional organizations such as the American Institute of Certified Public Accountants (AICPA)

The American Institute of Certified Public Accountants (AICPA) is a professional organization that offers training and networking opportunities to CPAs. The AICPA provides resources for healthcare auditors, including information on regulations and guidelines for conducting audits in the healthcare industry.

The Healthcare Financial Management Association (HFMA) is another professional organization that offers continuing education courses and certifications for healthcare auditors.