Auditor, Quality Medical
Are you an experienced Medical Coder/Auditor with a desire to excel? If so, then Talent Software Services may have the job for you! Our client is seeking an experienced Auditor, Quality Medical to work in Columbia, SC.
Contract Type: Contract to Hire
Work Arrangement: Remote
Position Summary: Join our dynamic team in Columbia, SC, a vibrant city known for its rich history and welcoming community. We are seeking a dedicated professional to perform critical validation reviews and manage records for our healthcare services.
Primary Responsibilities/Accountabilities:
• Perform validation reviews of Diagnosis-Related Groups (DRG), Adaptive Predictive Coding (APC), and Never Events for all lines of business.
• Coordinate rate adjustments with claims areas and provide monthly and quarterly reports outlining trends.
• Serve as a resource in resolving coding issues and coordinate HIPAA and legal records requests for all areas of Healthcare Services and the Legal Department.
• Determine methodology to identify cases for validation review and conduct validation reviews/coordinate rate adjustments with the appropriate claims area.
• Create monthly/quarterly reports to present to each line of business, providing information on records review, outcomes, trends, and savings impacting medical costs and contracting rates.
• Manage records retrieval, release, HIPAA compliance, and all aspects of document management.
• Serve as an expert resource on methodology and procedures for medical records and coding issues.
Qualifications:
Required Licenses: An active
• CPC (Certified Professional Coder) OR
• CIC (Certified Inpatient Coder) OR
• CPMA (Certified Professional Medical Auditor) OR
• RHIT (Registered Health Information Technician) OR
• RHIA (Registered Health Information Administrator)
Skills and Abilities: Develops methodologies, follows processes, responds to inquiries, and writes for impact.
Required Education: Associate Degree in Nursing or Health Information Management, OR Graduate of an Accredited School of Nursing
Required Work Experience: 3 years of medical record management experience, including coding and validation review experience
Interview Process: MS Teams
Apply Now
Apply Now
Contract Type: Contract to Hire
Work Arrangement: Remote
Position Summary: Join our dynamic team in Columbia, SC, a vibrant city known for its rich history and welcoming community. We are seeking a dedicated professional to perform critical validation reviews and manage records for our healthcare services.
Primary Responsibilities/Accountabilities:
• Perform validation reviews of Diagnosis-Related Groups (DRG), Adaptive Predictive Coding (APC), and Never Events for all lines of business.
• Coordinate rate adjustments with claims areas and provide monthly and quarterly reports outlining trends.
• Serve as a resource in resolving coding issues and coordinate HIPAA and legal records requests for all areas of Healthcare Services and the Legal Department.
• Determine methodology to identify cases for validation review and conduct validation reviews/coordinate rate adjustments with the appropriate claims area.
• Create monthly/quarterly reports to present to each line of business, providing information on records review, outcomes, trends, and savings impacting medical costs and contracting rates.
• Manage records retrieval, release, HIPAA compliance, and all aspects of document management.
• Serve as an expert resource on methodology and procedures for medical records and coding issues.
Qualifications:
Required Licenses: An active
• CPC (Certified Professional Coder) OR
• CIC (Certified Inpatient Coder) OR
• CPMA (Certified Professional Medical Auditor) OR
• RHIT (Registered Health Information Technician) OR
• RHIA (Registered Health Information Administrator)
Skills and Abilities: Develops methodologies, follows processes, responds to inquiries, and writes for impact.
Required Education: Associate Degree in Nursing or Health Information Management, OR Graduate of an Accredited School of Nursing
Required Work Experience: 3 years of medical record management experience, including coding and validation review experience
Interview Process: MS Teams
Apply Now
Apply Now