Medical Coder - CPC
W2H Contract to Hire
Pay rate: $36/hr
Location: Columbia South Carolina (remote option for local candidates)
Join our dynamic healthcare team as a Quality Medical Auditor and play a critical role in ensuring the accuracy and integrity of medical coding and billing processes. You will be instrumental in validating complex diagnoses, coding accuracy, and identifying opportunities for cost savings, all while supporting compliance and legal standards. This position offers a unique opportunity for career growth in healthcare auditing, coding accuracy, and data analysis.
Key Responsibilities:
- Conduct comprehensive validation reviews of Diagnosis Related Groups (DRGs), Adaptive Predictive Coding (APC), and Never Events (medically inexcusable outcomes) across all lines of business, ensuring coding accuracy and compliance.
- Develop and implement robust methodologies for case selection to identify records for validation reviews efficiently.
- Collaborate closely with claims and billing departments to coordinate rate adjustments based on audit findings, thereby contributing to cost containment and optimal reimbursement.
- Prepare detailed monthly and quarterly reports analyzing review outcomes, identifying trends, and presenting actionable insights to leadership. These reports will highlight savings, process improvements, and areas for further review.
- Serve as a subject matter expert on coding, documentation, and review methodologies, providing guidance and resolving complex coding issues.
- Manage HIPAA compliance and oversee the retrieval, release, and secure handling of medical records and legal documents, maintaining strict confidentiality and legal adherence.
Qualifications:
- Proven experience in medical coding, auditing, or healthcare compliance, preferably with knowledge of DRG, APC, and Never Events.
- Strong analytical skills with the ability to interpret data and produce comprehensive reports.
- Excellent knowledge of HIPAA regulations, legal record management, and confidentiality standards.
- Detail-oriented with excellent organizational skills for managing documentation and review processes.
- Effective communication skills for collaborating across departments and delivering clear reports.
- Certifications such as CPC, CCA, or RAPC are highly desirable.
What We Offer:
- Competitive salary and benefits package
- Opportunities for professional development and certifications in healthcare auditing and coding
- A collaborative work environment committed to quality and compliance excellence
- Career advancement pathways into senior auditing, compliance, and healthcare analytics roles
- A meaningful impact on healthcare quality and cost management
Join us to contribute to the integrity and quality of healthcare services while advancing your career in a rewarding and growing field.
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