Spectraforce Technologies

Job Title: Medical Coding Specialist (part time) Client Location: Columbia, SC | 29203 Work environment: Remote with occational onsite Duration: 3 months assignment with possible conversion Shift Schedule: 25 flexible hours per week Job Description: Reviews medical documentation to perform a variety of coding validations for multiple lines of business under Medicare/TRICARE to determine accuracy of billing and payment. Reassigns and sequences diagnostic and procedural codes using universally recognized coding system as appropriate. Compiles and analyzes statistics to determine focus areas for targeted medical review activities where there is the greatest potential for inappropriate Medicare/TRICARE payments. Key Responsibilities: 60% Determines methodology to identify cases for DRG, HIPPS, HCPCS, RUG, and APC validation. Conducts targeted coding, documentation reviews, and validation reviews coordinating rate adjustments and adjudication of corresponding claims....

Job Title: Associate Director, Global Aesthetics Medical Affairs - Facial Aesthetics Length of assignment: 9 Months Remote Job Description The Associate Director provides medical and scientific strategic and operational input into core Medical Affairs activities such as health care professional interactions, generation of clinical and scientific data (enhancing therapeutic benefit and value), and educational initiatives. Works closely with teams across Medical Affairs and other functions to provide strategic input and subject matter expertise. Executes core Medical Affair tactics to support assigned on-market products and assigned projects. Responsibilities 1. Supports Medical Affairs initiatives and executes tactics for the assigned products and projects. 2. Serves as subject matter expert to internal stakeholders such as Field Medical and Commercial. 3. Assists in the identification, design, and implementation of focused and impactful internal training programs,...

Role Name: Quality Medical Auditor Location: Columbia, SC 29223 Work Environment: Remote (Preferred Onsite) Schedule: Mon - Fri, 8AM-4:30PM Contract length: 4 months assignment with possible conversion Job Summary Performs validation reviews of Diagnosis Related Groups (DRG), Adaptive Predictive Coding (APC), and Never Events (inexcusable outcomes in a healthcare setting) for all lines of business. Coordinates rate adjustments with claims areas. Provides monthly and quarterly reports outlining trends. Serves as a resource in resolving coding issues. Coordinates HIPAA and legal records requests for all areas of Healthcare Services and the Legal Department. Day to Day 75% Determines methodology to identify cases for validation review. Conducts validation reviews/coordinates rates adjustments with appropriate claims area. Creates monthly/quarterly reports to present to each line of business providing information on records review, outcomes, trends, and savings that directly...