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Job Title 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 resolv... Job ID and other requisition information can be found at the bottom of the post.

Hours: 20 flexible hours per week (Part time). Mon- Fri Duration: Possible contract to hire Job Description: Hours/Schedule: 20 flexible hours per week (Part time). Training hours will start between 8:00am - 11:00am. 3 years of ICD-10 or HCC experience. License/Certification required: CCS or CPC. Occasionally comes onsite for teams meetings. Risk adjustment coding for all models. Coding a minimum of 25 charts per day. Hold an accuracy of 95%. Microsoft office skills. 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. Responsibilities: Determines methodology to identify...

$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