99 jobs found in Columbia, SC

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.

Professional Medical Coder II Coding Full Time AM Shift 8 am to 5pm Sign-On Bonus: 0 Consistently named best hospital, Lexington Medical Center anchors an expansive health care network that includes nearly 600 physicians and advanced practice providers at nearly 80 locations across the Midlands of South Carolina, making it the region's third largest employer. From general medicine and orthopaedics to oncology, cardiology and neurosurgery, these dedicated professionals combine the highest quality care with advanced medicine and state-of-the-art technology to help patients achieve the best possible outcomes. Its postgraduate medical education programs include family medicine and transitional year residencies. Job Summary Assigns appropriate ICD and CPT codes for reimbursement and statistical purposes. Follows ICD, CPT, CMS, and other regulatory coding guidelines. Abstracts clinical information from medical records for complete and accurate statistical documentation. Minimum...

Job Description Job Description Medical CoderJob at a Glance Location: onsite in Columbia, SC Contract: W2 only, contract-to-hire Pay: $36 /hour Key Responsibilities 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 aspects of document management. Serves as expert resource on methodology and procedures for medical records and coding issues. Required Skills 4 years of recent clinical experience in defined specialty area, or 4 years utilization review/case management/clinical/or a combination; 2 of the 4 years must be clinical. Required Licenses a RHIT, RHIA, CIC, CPMA, or CPC An active,...

Job Description Job Description Medical Coder W2 Contract – This will convert to a full-time role. Pay rate: $36 Location: Columbia South Carolina (on-site) - Hybrid Hours: Monday-Friday 8:00am - 4:30pm Do you have any of these certifications on your resume: RHIT, RHIA, CIC, CPMA, or CPC? If so… we want to talk to you! About the Role: Step into a key role within our healthcare organization, where you’ll help safeguard the accuracy and reliability of medical coding and billing operations. In this position, you’ll oversee detailed validation reviews across multiple business areas, drive initiatives that support cost efficiency, and uphold critical regulatory requirements including HIPAA compliance. This is an excellent opportunity to strengthen healthcare quality, support financial integrity, and expand your expertise in medical auditing and coding oversight. Responsibilities In this role, you will take the lead in performing detailed reviews of medical coding accuracy,...

I. Job Summary Under minimal supervision, plans and conducts environmental compliance audits of various entities to determine compliance with Federal and State regulatory requirements, programs and internal policies with a focus environmental regulations and capacity. II. Essential Duties and Responsibilities To perform this job successfully, an individual must be able to perform each of the following essential duties satisfactorily. Other minor duties may be assigned. Plan and conduct internal audits to determine compliance with Federal and State regulations. Review facility operations and records to ensure adequacy of internal controls, compliance with procedures, consistency with established laws, rules and regulations and guidelines applicable to overall compliance for the operation. Prepare audit reports, and implement administrative and technical audit procedures for audit program activities. Review and verify audit corrective actions and...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient's request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you're stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. What We're Looking For We're looking for experienced and credentialed inpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing...

This is a remote based position. Applicants can be located nationwide Back Outpatient Coding Auditor #2675 United States Apply X Facebook LinkedIn Email Copy Position Description About You You are a person who is passionate about performing quality reviews and audits of the assigned staff. We need someone who ensures standards are met in accordance with department and organization policy. In the role of Outpatient Coding Auditor, you will demonstrate skills in organization, prioritization, professionalism and coaching others. Tell us about your experience with Outpatient Coding Auditing. Are you a team player and a self-motivator? We are counting on you to manage multiple projects using your problem-solving skills. We are looking for someone UNCOMMON. What is uncommon about you? Are you highly committed? Are you team-oriented? Do you value professionalism, trust, honesty, and integrity? If so, we cannot wait to meet you. About The Position Advanced knowledge...

Internal Reference Number: R1049430 Summary Responsible for evaluating loss potential for each member. Calculates and assigns risk score via a comprehensive risk analysis approach. Ensures action requests and internal/external issues are addressed in a timely manner.Description Why should you join the BlueCross BlueShield of South Carolina family of companies? other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina... and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. if you are dedicated to the same philosophy, consider joining our team!...

Description: Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we've been part of the national landscape, with our roots firmly embedded in the South Carolina community. Business and political climates may change, but we're stronger than ever. Our A.M. Best rating is A+ (Superior) - making us the only health insurance company in South Carolina with that rating. We're the largest insurance company in South Carolina ...and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! Job Title: Medical Coding Specialist Position Notes: Max...

This is a remote based position. Applicants can be located nationwide Back Medical Coder #2621 United States Apply X Facebook LinkedIn Email Copy Position Description About You You are a person who has Profee Outpatient Coding experience. We need someone who is responsible for assignment of accurate Evaluation and Management (E&M) ICD-10-CM, ICD-10- PCS, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes, modifiers and quantities derived from medical record documentation (paper or electronic) for encounters dependent upon record type. Tell us about your experience with Profee Outpatient Coding. Are you a team player and a self-motivator? What is your experience with conducting business in a way that is credit to a company? We are counting on you to manage multiple projects using your problem-solving skills. We are looking for someone UNCOMMON. What is uncommon about you? Are you highly committed? Are you...

Become a part of our caring community and help us put health first Humana is looking for an experienced medical coding auditor to handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, consider a Fortune 100 company that prioritizes its consumers' and staff's well-being. This company rewards performance, and you should strongly consider the Outpatient Medical Coding Auditor position. This role focuses on Durable Medical Equipment (DME) auditing and is part of the PPI Coding Disputes Team with Humana. The Disputes Auditor - DME Outpatient Coding on the Disputes Team reports to the Manager. This role consults and collaborates with coding professionals within and across departments. The goal is to ensure high accountability of coding disputes outcomes for timeliness, compliance, and quality. Will be an experienced medical coding auditor with in-depth experience in outpatient DME coding disputes and expertise in...

Salary Range: $42,000 - $65,000 Job Posting End Date: March 6, 2026 We've Got You Under Our Wing We are the duck. We develop and empower our people, cultivate relationships, give back to our community, and celebrate every success along the way. We do it all...The Aflac Way. Aflac, a Fortune 500 company, is an industry leader in voluntary insurance products that pay cash directly to policyholders and one of America's best-known brands. Aflac has been recognized as Fortune's 50 Best Workplaces for Diversity and as one of World's Most Ethical Companies by Ethisphere.com. Our business is about being there for people in need. So, ask yourself, are you the duck? If so, there's a home, and a flourishing career for you at Aflac. Worker Designation - This role is hybrid . This means you will be expected to report to one of our Aflac offices located in Columbia, SC for at least 60% of the work week. You will work from your home (within the continental US) for the...

Job Description Summary The Coder III, under the direct supervision of the Hospital Coding Supervisor, serves a dual role focusing on coding accuracy and team education. This position is responsible for abstracting medical record documentation across various settings (inpatient, outpatient, clinic, and emergency department) to select and sequence appropriate ICD-10-CM/PCS, HCPCS, and CPT4 codes. The Coder III ensures adherence to coding compliance guidelines for accurate and timely assignment of codes, including final DRG assignment. A key aspect of the position is providing ongoing education and training to care team members to enhance coding proficiency and compliance with regulatory requirements. Key Responsibilities Provide mentoring and support to new coders to facilitate their professional development and ensure consistency in coding practices. Develop and deliver training programs and educational sessions for care team members on coding practices, documentation...

A healthcare organization in South Carolina seeks a Med Grp Professional Billing Coder II responsible for coding classifications and ensuring billing accuracy. The ideal candidate must have CPC or CCS-P certification and experience in professional coding. Responsibilities include resolving coding edits and communicating with providers. The offered salary ranges from $27.65 to $43.55 per hour, depending on experience, with a comprehensive benefits package for employees. #J-18808-Ljbffr

Job Description The Med Grp Professional Billing (PB) Coder II is responsible for accurately resolving coding edits in assigned Epic WQ’s and assigning ICD‑10, CPT, and HCPCS coding classifications and modifiers based on clinical documentation and/or physician orders. This role ensures the integrity of data for both internal and external reporting, maintains work queues within processing timeframes, responds to inquiries related to billing codes, and adheres to compliance guidelines. Essential Functions Evaluates and resolves all types of coding edits in assigned Charge Review, Claim Edit, and Follow-up work queues in Epic. Assigns ICD, CPT, and HCPCS coding classifications based on clinical documentation and/or physician orders. Accurately evaluates and resolves assigned coding edits in Charge Review, Claim Edit, and Follow-up work queues in Epic within assigned timeframes. Appropriately escalates coding/denial trends and provider education opportunities. Navigates Epic EMR,...

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

Medical Coding Specialist Job Details Professional Discipline : Health and Information Management Specialty : Medical Coder Employment Type : Full Time City : Columbia State : SC Pay Range : Job Description: We are seeking a detail-oriented Medical Coding Specialist to join our team. In this role, you will review medical documentation and perform coding validations across multiple lines of business under Medicare and TRICARE. Your responsibilities will include reassignment and sequencing of diagnostic and procedural codes using universally recognized coding systems, as well as compiling and analyzing data to identify areas for targeted medical review where there is a high potential for inappropriate payments. Key Responsibilities: Review and validate medical documentation for coding accuracy. Reassign and sequence diagnostic/procedural codes as appropriate. Utilize ICD-9, DRG, APC, HIPPS, HCPCS, or RUG coding systems....

We are so glad you are interested in joining Sutter Health! Organization: SHSO-Sutter Health System Office-Valley Position Overview: This position conducts review of outpatient medical records using International Classification of Disease Coding ICD-10-CM and Current Procedural Terminology (CPT), Medicare Advantage, ICD-10-CM, and Centers for Medicare and Medicaid Services (CMS) coding and reporting guidelines. Performs medical record reviews to ensure accurate assignment of medical diagnoses and procedures. Responsible for pre-appointment review of each encounter in scope, including Medicare Advantage encounters, to ensure accurate reporting of diagnoses and to alert the physician of potential clinical conditions that may require review. Job Description : EDUCATION: HS Diploma or General Education Diploma (GED) CERTIFICATION & LICENSURE: CRC-Certified Risk Adjustment Coder OR CPC-Certified Professional Coder OR AHMA or AAPC Coding Certification...

Join Datavant, a leading data platform company that is revolutionizing health data exchange. Our mission is to ensure every healthcare decision is backed by accurate data at the right moment and in the most useful format. As part of a premier health data network, our platform provides secure, accessible, and actionable data, empowering various healthcare stakeholders, including life sciences firms, government agencies, and care providers. By joining Datavant's dynamic team, you'll contribute to innovative technology solutions that address significant challenges in healthcare. We celebrate diversity and value a wide range of professional, educational, and personal experiences to achieve our ambitious goals in the healthcare sector. Key Responsibilities: Perform comprehensive audits of coded medical charts in compliance with specific client guidelines as directed by the quality supervisor. Expertly navigate and apply various client protocols. Maintain a quality...

This is a remote-based position open to candidates across the nation. About You Are you an experienced coder with a specialty in Profee Outpatient Coding? If so, we would love to have you join our team! As a vital part of our organization, you will be responsible for the timely and accurate assignment of Evaluation and Management (E&M) ICD-10-CM, ICD-10-PCS, CPT, and HCPCS codes from both paper and electronic medical records. We want to hear about your Profee Outpatient Coding experience! Are you a proactive team player who thrives in a collaborative environment? What unique qualities make you stand out as a professional? Do you possess problem-solving skills to effectively manage multiple projects? Bring your exceptional talents to our team and help us excel! If you value teamwork, integrity, and professionalism, we are eager to connect with you! About The Position Conduct thorough reviews of medical documentation to accurately assign principal...

Join Datavant, the leading data collaboration platform in healthcare dedicated to making health data secure, accessible, and actionable. Our mission is to provide vital data solutions for healthcare organizations including providers, health plans, researchers, and life sciences companies. Contribute to the future of healthcare by enabling advanced data connectivity and transformative change. What We Are Looking For: We seek experienced and credentialed inpatient coders to join our dynamic team. If you have a keen eye for detail and a solid understanding of medical terminology, this is your chance to make a meaningful impact while enjoying the flexibility of working remotely! Your Responsibilities Include: Assigning diagnostic and procedural codes using ICD-10-CM and ICD-10-PCS. Accurately sequencing and abstracting medical codes from patient records to ensure compliance and quality. Overseeing and auditing the work of Level 1 & 2 Coders, as needed....

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and communicates results to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts with external consultants regarding billing, coding and/or documentation and evaluates their recommendations and/or teaching...

Coder II | Responsibilities and Metrics Are you looking for your next challenge? The Virtual Business Office Associates is the perfect balance of a diverse and growing workforce that still feels like home. If you are a Coding Professional, come join our best in KLAS Extended Business Office today! Hiring remotely from: FL, GA, TX, NC, SC, VA, KY, AL. FLSA Status: Exempt What's in it for you: Add to your portfolio by joining our fast-paced, exciting, diverse and inclusive work environment Endless growth opportunities and continuous professional development You'll support one of the largest professional services firms in the world, with access to cutting edge automation and AI technologies to enhance your workday experience A permanent position with our company that offers stability and growth opportunities A flexible schedule that allows you to enjoy a work life balance, and leave early on Friday's Use the latest EMR systems and utilize full portal...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: This job performs thorough medical record review to abstract medical and demographic data, interpret and apply diagnoses and procedures utilizing ICD coding systems and assists in decreasing the average accounts receivable days. ESSENTIAL RESPONSIBILITIES Reviews and interprets medical information, physician treatment plans, course, and outcome to determine appropriate ICD codes for diagnoses and procedures. (65%) Abstracts data elements to satisfy statistical requests by the hospital, health system, medical staff, etc. and enters all coded/abstracted information into designated system. (15%) Ensures efficient management of medical information and cash flow as it pertains to the unbilled coding report. (10%) Keeps informed of the changes/updates in ICD guidelines by attending appropriate training, reviewing coding clinics and other resources and implementing these...