US Tech Solutions

$36 per hour Columbia, SC Right to Hire Duration: 6+ Months Job Description: 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. Responsibilities: 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. 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 impact medical costs and contracting rates. Manages records retrieval, release, HIPAA compliance, and all...

A global staff augmentation firm is seeking a candidate with expertise in medical record management to conduct validation reviews and coordinate rate adjustments. This role requires an associate degree in Nursing or Health Information Management and active RN licensure. With at least 3 years of experience, the candidate will manage coding issues and HIPAA compliance while preparing detailed reports. Offered in Columbia, South Carolina, this position provides a typical office environment for effective operations. #J-18808-Ljbffr