Pros and Cons of Being A Nurse Auditor
If your interests are in healthcare and finance, nurse auditor is a career worth considering. By becoming a nurse auditor, you can find yourself offering financial advice to hospitals and healthcare companies.
Since nurse auditors are licensed nurses, you'll need to graduate from a nursing program, which requires at least one year of post-secondary education. Consider the pros and cons of a nurse auditor position to decide if it's the right career for you.
|Pros of Being a Nurse Auditor|
|Wide range of education qualifications (certificate, associate's degree, bachelor's degree)*|
|Potential for relatively high salary ($39,000-$77,000)**|
|Employers offer office and work-from-home positions*|
|Professional certifications available for career advancement***|
|Cons of Being a Nurse Auditor|
|Nursing licensure typically required****|
|Jobs usually requires 2-5 years of work experience****|
|Employers require applicants to have knowledge of industry-specific software****|
|Long work hours during the end of tax and budgeting year*|
Sources: *U.S. Bureau of Labor Statistics, **PayScale.com, ***American Association of Clinical Coders and Auditors, ****CareerBuilder.com.
Essential Career Info
Job Description and Duties
Nurse auditors are usually employed by hospitals, insurance companies and medical clinics to audit financial statements for validity and accuracy. As a nurse auditor, your responsibilities will include examining medical records to ensure that patient bills are correct and making sure that insurance claims comply with government regulations. You'll also give advice on budget planning in order to cut the company's costs and increase profits. Strong communication skills are essential for nurse auditors because they spend much of their time contacting healthcare providers and clients to negotiate claims and solve billing issues.
In September 2015, auditors working in the healthcare industry earned salaries between $39,000 and $77,000, according to PayScale.com. Nurse auditors will likely be among the highest paid auditors since a survey conducted by the American Association of Medical Audit Specialists in 2010 reported that over half of medical auditors with a nursing degree earned average salaries of about $70,000.
Career Skills and Requirements
Most employers require nurse auditors to have many years of experience working as licensed practical nurses (LPNs) or registered nurses (RNs). Because LPNs provide basic care to medical patients and work under the supervision of RNs, they only need one year of education and training. Nursing programs for aspiring LPNs can be completed at community colleges and technical schools. On the other hand, RNs spend 2-4 years earning certificates, associate's degrees or bachelor's degrees. All states require LPNs and RNs to pass different versions of the National Council Licensure Examination before they can practice nursing.
As a nurse auditor, you'll need to use a range of interpersonal, analytical and technical skills to complete daily tasks. Based on job postings on CareerBuilder.com, qualifications to be a nurse auditor include:
- Experience using billing and claims forms (UB, CMS and HCFA)
- Knowledge of medical coding systems (ICD-9, HCPCS, DRG and CPT-4)
- Strong verbal and written communication skills
- Understanding of insurance plans, including Medicare
- Strong organizational and computer skills
Job Postings from Real Employers
Job listings for nurse auditors generally request applicants with nursing degrees and several years of experience. They also list the specialized knowledge and skills candidates are expected to have. Below are a few examples of nurse auditor jobs opening during May 2012:
- A company in Texas seeks a full-time nurse auditor who has three years of related work experience. The candidate needs a diploma or certificate from a nursing school. A bachelor's degree is preferred. Other requirements include knowledge of coding and medical related topics, including patient registration and insurance polices.
- A healthcare company in New Jersey is looking for a licensed or registered nurse with 2-5 years of experience auditing. The positing lists knowledge of Microsoft Office and organizational skills as requirements.
- A San Francisco, California hospital wants a candidate with at least three years of experience working as a registered nurse. Job requirements include a 4-year degree, knowledge of coding systems and experience in Utilization Review.
- An Arizona healthcare company seeks candidates with strong analytical and communication skills to conduct medical audits for health facilities. The ideal candidate will have a diploma from an accredited nursing program, at least three years of work experience and a nursing license.
How To Stand Out In The Field
Nurse auditors who attain professional certification can receive several benefits. Not only does certification show your expertise and credibility to potential employers, it can help you earn a higher salary than auditors without certification. The American Association of Clinical Coders and Auditors (AACCA) is the only organization that certifies nurse auditors. To take the AACCA's certification exam, you'll need to be a registered nurse and have completed an approved education program or have at least one year of work experience. Another option is to become a Certified Professional Medical Auditor by the American Association of Professional Coders, which only requires passing an exam.
If you're interested in working in the medical field but don't want to spend years in post-secondary education, consider a career as a medical assistant. Medical assistants can find jobs with only high school diplomas, and many employers offer on-the-job training. Like nurse auditors, medical assistants have clerical duties, including recording medical and personal information and operating computer software. However, unlike nurse auditors, assistants interact with patients by monitoring vitals and administering treatments. The U.S. Bureau of Labor Statistics (BLS) reported that the median annual salary for medical assistants at approximately $29,000 as of May 2011.
You can work with medical records without having to learn coding by becoming a medical transcriptionist. A transcriptionist converts a physician's voice-recorded reports into text documents, checks reports for errors and translates medical jargon. Like nurse auditors, you'll need extensive knowledge of medical terminology, pharmacology and anatomy. To become a transcriptionist, you must earn either a certificate or associate's degree in medical transcription. According to the BLS, the median annual salary for medical transcriptionists was around $33,000 in May 2011.
Alternately, you can become a budget analyst by earning a bachelor's degree in a related field, such as accounting, statistics or finance. As a budget analyst, you could provide financial advice for a private or public healthcare institution. The duties of budget analysts include reviewing budget proposals, evaluating the costs of programs, monitoring spending and estimating future costs. The median annual salary of budget analysts was about $69,000, according to the BLS as of May 2011.