Who Taught Me to Audit: A Tribute to My Mentor
Article Reference Code: NAMAS.06.05.2026
Written by: Dawn R. Carter, BSBA, MHA, CPC, CRC, CPMA, CDEO, CPCO, AAPC Fellow
In the mid-1990s, I was a full-time nursing student who needed to help with family income. Friends from my program had become hospital registrars, so I followed their lead and took a PRN registrar role in the main admissions office. Soon I moved to a full-time second shift, going to school by day and working by night. I call it my first “real” job because it came with benefits and career mobility, unlike my earlier food service jobs. That job revealed something I didn’t expect: I preferred the administrative backbone of healthcare to the bedside. My nursing studies eventually shifted to a business degree because technical and informatics pathways didn’t yet exist. That PRN role launched a 31-year journey in healthcare administration and brought mentors whose influence still resonates.
Before I introduce the mentor who taught me to audit, I’ll go back to day one in patient access. I learned to record demographics and insurance cleanly, to capture everything needed for accurate registration, and to be subject to “quality assurance (QA),” which was auditing a sample of registrations to confirm, among other things, that insurance data matched the card image on the chart. My team lead, Doris, believed in incentives over punishments. If we hit an accuracy threshold, we earned bonuses; if not, we partnered with team leads to improve. She later promoted me to QA analyst. The lessons I learned moving from being audited to being the auditor, under Doris’s leadership, shaped my career.
Lesson 1: Start With the Question
“An audit without a question,” Doris said, “is just counting.” Every review began with a clear objective: What are we verifying, and why does it matter? What decision will these findings enable? Reordering a dropdown, retraining, fixing a scanning step, or updating a payer table? Framing the question turned audits from checklists into purposeful investigations and became my compass.
Lesson 2: Assume Good Intent, Verify Every Field
Doris believed most errors were system errors in disguise. “If three people make the same mistake, it’s not a people problem, it’s a process problem.” When “Medicaid” kept being selected instead of the specific managed care plan shown on the card, we observed real-time registrations and discovered the system displayed straight Medicaid first, even when the ID prefix signaled a managed care organization. The fix wasn’t “retrain harder” or “punish errors.” We reordered options, added helper text, and accuracy followed.
Lesson 3: Trace the Data
Doris taught me to trace a single element of data like a thread through the fabric of care: card image → registration → claim → remittance → (too often) patient bill. For one Blues plan, group and policy numbers were routinely transposed on registrations. Later in the revenue cycle, claims ping-ponged between denials and rebills. “Don’t just note the error,” she said. “Follow it to its consequence. That’s where you’ll find the story, and the leverage to fix it.”
Lesson 4: Patterns Over Points
I loved a clean tally. Doris loved a trend. “Counting shows what happened; patterns tell you what will keep happening.” We analyzed by site, shift, payer, registrar, time-of-day, and card type. Errors stopped looking random; they became predictable. Predictability is power, and you can design controls and workflows that anticipate it.
Lesson 5: Close the Loop
The best nights were when we returned to the team with proof that upstream changes worked. We re-ran a sample, showed error reductions, and celebrated the team, not the auditors. “Audits are only as good as what they change,” Doris insisted. She had me write short memos with three parts that everyone was required to acknowledge by signature: what we checked, what we found, and what we fixed. Those memos clarified ownership and momentum.
Lesson 6: Teach as You Audit
As my eye for exceptions sharpened, Doris kept steering me toward teaching. She’d pull up chairs and walk through examples with registrars, always starting with what went right. “Never walk away without leaving someone better.” Over time, audits became less about judgment and more about shared craft and capability-building.
Lesson 7: Document So It Can Be Repeated
This lesson changed my career. Doris required definitions clear enough that another auditor could run the same test and reach the same result: scope, population, sampling, criteria, decision rules, and escalation. She insisted on versioning checklists, dating procedures, and embedding screenshots. “If it isn’t reproducible,” she’d say, “it’s not an audit; it’s an opinion.”
One night, a puzzling pattern of denials traced back to a copier that clipped the far-right edge of insurance cards. Enough of the card showed to pick the payer, but the last policy digit disappeared. Denials peaked on second shift. Instead of blame, Doris convened maintenance, IT, and patient access for a ten-minute huddle. We fixed the copier, added a simple “corner check” visual cue at scanning stations, and updated the QA checklist to include image quality verification. Denials dropped. Morale rose. I learned that good auditing is stewardship—of data, of people, and of trust.
Looking back, that PRN job did more than pay bills. It nudged me from bedside care toward the backbone of healthcare, the systems, rules, and processes that quietly protect patients and organizations alike. Doris’s influence pulled a thread from QA to operations, then to compliance, policy, and ultimately to the work I do today. I still hear her voice when I scope a review, write a standard, or translate regulation into workflow: Start with the question. Fix upstream. Close the loop. Teach as you go. Document so it can be repeated.
I’ve had many mentors since, each adding a tool to the kit. But Doris gave me the mindset. She turned auditing from a task into a craft, and from a craft into a calling. Doris, wherever you are—thank you for showing me the people inside the numbers and how to build systems that honor both.
Contact Dawn LinkedIn by Clicking her Name Below:
Dawn Carter, BSBA, MHA, CPC, CRC, CPMA, CDEO, CPCO, AAPC Fellow
Dawn Carter is a nationally recognized healthcare compliance and risk adjustment leader with decades of experience in regulatory compliance, revenue cycle management, healthcare technology, and strategic business development. Throughout her career, she has worked with industry-leading organizations including Centauri Health Solutions, Edifecs, and Cotiviti, helping clients improve payment accuracy, strengthen compliance initiatives, and optimize risk adjustment and revenue cycle operations.
Known for her ability to bridge healthcare operations, technology, and regulatory strategy, Dawn has extensive expertise in healthcare compliance, EDI transactions, product development, healthcare policy advisement, and risk adjustment analytics. She is also a published author, public speaker, adjunct instructor, and frequent podcast guest, presenting at respected industry conferences including RISE, HFMA, AAPC, CAHAM, and SSA. Her passion for education, innovation, and collaboration continues to make her a trusted voice within the healthcare industry.
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