CEI

Job Description Job Description Sr. Medical Review AuditorJob at a Glance Title:  Sr. Medical Review Auditor Location:  Columbia, SC Contract:  W2 only Pay:  $ 36/hour + optional medical, dental, vision, 401(k) match Overview Performs validation reviews of Diagnosis Related Groups (DRG), Adaptive Predictive Coding (APC), and Never Events for all lines of business. Coordinates rate adjustments with claims areas and provides monthly and quarterly reports outlining trends, outcomes, and savings that directly impact medical costs and contracting rates. Key Responsibilities Performs validation reviews of Diagnosis Related Groups (DRG), Adaptive Predictive Coding (APC), and Never Events 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....