US Tech Solutions

Overview Duration: 5 months (Possible contract to hire) Work Schedule: Monday-Friday, 8am-4:30pm. Job Description: A typical day would like in this role: We are opening these positions due to increased volume of DRG review. We currently have 2 Medical Review Auditors on our team already. The normal day is DRG reviews and audits. Responsibilities 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. Determines methodology to identify cases for validation review. Conducts validation reviews/coordinates rates adjustments with appropriate claims area. Creates monthly/quarterly reports to...

A global staffing firm is seeking a Medical Review Auditor in Columbia, SC. The role involves performing validation reviews of Diagnosis Related Groups and managing records retrieval and compliance. Candidates must have at least 3 years of experience in medical record management and hold an Associate Degree in Nursing or Health Information Management. Join a dynamic team dedicated to quality healthcare outcomes and enjoy a structured work schedule of Monday to Friday, 8am to 4:30pm. #J-18808-Ljbffr