Medicare Audit Consultant

Summary
Safro Staffing & Consulting is hiring a consultant to help healthcare organizations navigate Medicare audits and medical reviews. This role supports clients with understanding requirements, preparing responses, correcting deficiencies, and improving compliance across all major audit types.

Responsibilities
• Review and interpret ADR, RAC, TPE, UPIC, SMRC, ZPIC, CERT, MAC, QIO, and OIG audit requests.
• Analyze clinical, billing, and coding documentation to prepare accurate response packets.
• Organize and submit all required materials within deadlines.
• Identify gaps in documentation, coding, or workflow that increase audit risk.
• Develop corrective action plans and recommend compliance improvements.
• Guide clients through appeals, redeterminations, and reconsiderations.
• Train staff on Medicare rules, documentation standards, and audit expectations.
• Track audit outcomes, identify trends, and recommend long-term solutions.
• Work closely with leadership, compliance, revenue cycle, and clinical teams to reduce future exposure.

Qualifications
• Experience with Medicare audits, appeals, and medical review processes.
• Strong understanding of Medicare billing rules, medical necessity, and documentation requirements.
• Background in compliance, reimbursement, or revenue cycle preferred.
• Ability to review and analyze clinical and billing records with accuracy.
• Strong communication, organization, and deadline management skills.