CMS Audit Coordinator

Coordinates with the AD/CA concerning all Medicare and Medicaid audits. This includes but is not limited to the following audit entities: RAC, MAC, PERM, MIC, CERT.

In conjunction with AD/CA supports the hospital processes regarding interaction with audit/contractor entities including filing responses and appeals. Assists/supports timely medical record production.  Efficiently manages appeals, including assuring record submission and appeal timelines are met, for federal payers.  Provides CMS audit activity education for hospital staff, physicians and administration.  Works to continuously improve processes and policies associated with CMS audit entity record submission and appeal activities. Works directly with E.H.R. on record submission, tracking status of levels of appeal, documentation of appeal levels and results. Assures input and accuracy into the audit tracking tool and submits reports to AHA and CMS Audit entity team as needed on issues related to CMS audits.