23 jobs found in Greenville, SC

Inspire Health. Serve With Compassion. Be The Difference. Responsible for validating/reviewing and assigning applicable CPT, ICD-10, Modifiers and HCPCS codes for inpatient, outpatient and physicians office/clinic settings. Adheres to all coding and compliance guidelines. Maintains knowledge of coding/billing updates and payer specific coding guidelines for multi-specialty medical practice(s). Communicates with providers and team members regarding coding issues. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Validates/reviews codes for assigned provider(s)/Division(s) based on medical record documentation. Adheres to all coding and compliance guidelines. Responsible for resolving all assigned pre-billing edits Communicates billing related issues and participates in meetings to improve overall billing process Provides feedback to providers in order to...

Title - Medical Coder Location - Greenville, SC 29605 Shift - Day 5x8-Hour (08:00 - 17:00) D escription: **remote role** **Candidate's must have 5+ years experience with either inpatient or outpatient experience** Job Summary To code medical information into the organization billing/abstracting systems and to complete the coding function through established best practice processes and professional and regulatory coding guidelines. This position will perform Inpatient coding including major traumas and Neonatal Intensive Care Unit (NICU) records by assigning International Classification of Diseases (ICD) and International Classification of Diseases-Procedure Coding System (ICD-PCS) codes as well as the Diagnosis Related Groups (DRG) assignment. Abstracts and assigns and verifies codes for Major Complications and Comorbidities/Complications and Comorbidities (MCC/CCs), Hospital-Acquired Condition/Patient Safety Indicator (HAC/PSI) and Quality Indicators capture as...

Inspire health. Serve with compassion. Be the difference. Job Summary Conducts prospective review to abstract Hierarchical Condition Categories (HCC's) codes to report for the calendar year. Communicates (via Epic and in person) with providers on any outstanding HCC capture opportunities. Conducts retrospective reviews to ensure that documentation supports reporting the Hierarchical Condition Category code prior to payor submission. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Conducts prospective review of charts to identify HCC opportunity. Conducts retrospective review of charts to confirm documentation supports reporting. Utilizes payor specific software to assist in capturing HCCs. Communicates with providers about HCC opportunities for improvement. Identifies suspect conditions that would potentially support...

Inspire health. Serve with compassion. Be the difference. Job Summary Responsible for validating/reviewing and assigning applicable CPT, ICD-10, Modifiers and HCPCS codes for inpatient, outpatient and physicians office/clinic settings. Adheres to all coding and compliance guidelines. Maintains knowledge of coding/billing updates and payer specific coding guidelines for multi-specialty medical practice(s). Communicates with providers and team members regarding coding issues. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Validates/reviews codes for assigned provider(s)/Division(s) based on medical record documentation. Adheres to all coding and compliance guidelines. Responsible for resolving all assigned pre-billing edits Communicates billing related issues and participates in meetings to improve overall billing process...

Inspire health. Serve with compassion. Be the difference. Job Summary Will consider applicants that only have a CPC certification and qualify only for Ambulatory Coder II position, PF0068. Responsible for validating coding and facilitation of appeals process for all assigned denied professional service claims. All team members are expected to be knowledgeable of payer guidelines related to coding and appeal timelines. Communicates with providers regarding coding denial issues. Ensures documentation supports CPT, Modifiers, HCPCS and ICD-10 codes for submitted appeals, reopenings, reconsiderations, etc. Serves as a subject matter expert for assigned specialty. Communicates with providers and team members regarding coding denial issues and trends. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference. Responsible for working coding claim denials accurately and...

A prominent healthcare organization is seeking an Ambulatory Coder II to validate coding and facilitate appeals for denied claims. The candidate will communicate with providers and ensure that documentation supports coding for appeals. Applicants should possess a CPC certification and five years of professional coding experience. Knowledge of payer guidelines and proficiency in coding software are crucial. This role supports the organization's mission to transform healthcare for the communities it serves. #J-18808-Ljbffr

Inspire health. Serve with compassion. Be the difference. Job Summary Conducts prospective review to abstract Hierarchical Condition Categories (HCC's) codes to report for the calendar year. Communicates (via Epic and in person) with providers on any outstanding HCC capture opportunities. Conducts retrospective reviews to ensure that documentation supports reporting the Hierarchical Condition Category code prior to payor submission. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Conducts prospective review of charts to identify HCC opportunity. Conducts retrospective review of charts to confirm documentation supports reporting. Utilizes payor specific software to assist in capturing HCCs. Communicates with providers about HCC opportunities for improvement. Identifies suspect conditions that would potentially support reporting an HCC. Participates in...

A leading health organization seeks a skilled candidate for HCC coding roles in Boyce Lawn, South Carolina. You will lead prospective and retrospective reviews to identify and confirm coding opportunities with providers. The role requires five years of professional coding experience along with CPC and CRC certifications. The ideal candidate will excel in communication and proficiency in healthcare coding software. Join us to inspire health and serve with compassion. #J-18808-Ljbffr

A medical practice in South Carolina is seeking an experienced Billing Specialist to oversee the billing cycle and manage patient claims. Key responsibilities include reviewing insurance claims, conducting accounts receivable reviews, and resolving billing issues. The ideal candidate should possess at least three years of medical billing experience and a strong understanding of insurance billing practices. This role demands attention to detail and excellent organizational skills. #J-18808-Ljbffr

Job Requirements Position Summary The coder will review documentation of providers and assign CPT codes, ICD10 codes, and modifiers for provider professional services. The coder is responsible for providing coding education to providers and completing daily billing functions. Other duties as assigned by Practice Manager. Minimum Requirements Education High School Diploma or equivalent Experience N/A License/Registration/Certifications Certified Coder-CPC or CCS-P Preferred Requirements Preferred Education Associate's Degree Preferred Experience 2 years billing/coding experience Preferred License/Registration/Certifications N/A Core Job Responsibilities Review provider documentation in the electronic medical record to identify incomplete documentation and communicate with provider for completion Assign appropriate ICD-10 and CPT codes Assign modifiers as appropriate Review and correct (if appropriate) provider audits...

Job Requirements We are hiring a Speech Therapist to join our team! PRN; 8:00am to 4:30pm The Speech-Language Pathologist evaluates and treats patients by referral. He/she plans treatment programs and performs therapy to restore function, prevent disability, and maximize the potential and quality of life following disease, injury or surgery. He/she performs re-evaluations and supervisory visits per state practice act. He/she appropriately modifies treatment plans and procedures and uses appropriate communication techniques to achieve optimal results. He/she may supervise Rehab Techs and students. He/she participates in community presentations, staff education, and other departmental activities as requested by the supervisor, manager, or director. Minimum Requirements Education MS/MA in Speech Language- Pathology License/Registration/Certifications SC SLP License/Certificate of Clinical Competence or CFY CPR-AHA BLS Preferred Requirements...

We are looking for a Medical Billing Specialist for a company in Liberty, SC . The individual in this role will need to have a strong knowledge of medical benefits and their plans, excellent attention to detail, and critical thinking skills. This position is full time and 100% ONSITE. Responsibilities: Sending appeals Following up on aged AR Reviewing and resolving claims Qualifications: High School Diploma 2+ years of medical billing experience Strong understanding of the revenue cycle Strong knowledge of Microsoft Office applications Hours: Monday - Thursday 7:30am to 5:00pm & Friday 1/2 Day from 8am to 12pm Compensation & Additional Information : $18 - $20 hourly Temporary to Hire 100% ONSITE FGP offers contract employees benefits including minimum essential coverage insurance, a fixed indemnity plan and a 401k retirement plan once eligibility requirements are met.

Insight Global is seeking an experienced Outpatient Coding Auditor to support the accuracy, consistency, and compliance of outpatient coding operations. This role is responsible for reviewing outpatient medical records to validate appropriate ICD-10-CM and CPT coding while ensuring adherence to official coding guidelines, regulatory requirements, and payer policies. The Outpatient Coding Auditor performs routine and quarterly compliance audits; reviews accounts returned for medical necessity and diagnosis-related issues and maintains detailed documentation of audit findings. This position supports concurrent reviews for newly hired coders and partners with revenue cycle and billing teams to assist with RAC denials, emergency department E/M denials, and payer-requested coding changes. The auditor also identifies education opportunities and conducts training sessions as needed to promote coding accuracy and continuous improvement. The ideal candidate is a detail-oriented coding...

SUMMARY Resolves complex coding scenarios. Provides feedback and documentation advice to the physician and practice management. Works with AR to resolve coding related denials. Serves as liaison between the practice and Physician Network Services and/or other departments SPECIFIC DUTIES MAY INCLUDE: Reviews and codes complex operative procedures for all service lines Assist and direct specialty practices or other appropriate staff in surgical documentation, billing, coding, and reimbursement issues Assists in the auditing of all service lines Work in conjunction with billing staff on follow up and resolution of coding related denials and rejections Responsible for maintaining current knowledge of coding guidelines and relevant federal regulations through the use of current CPT-4, HCPCS II, and ICD-9/ICDD-10 materials, the Federal Register, and other pertinent materials QUALIFICATIONS Minimum education: must be high school graduate or GED required...

Supervises and coordinates all clinical activities to ensure efficient daily operations of clinical area in the physician practice. Ensures patients and patient care areas are prepared for examinations and office procedures, assists physicians with all aspects of direct patient care, performs procedures and other tasks involved in patient care, triage patient calls that come in to the office. Qualifications: Current CMA, LPN or equivalent degree or at least 10 years of clinical supervisor experience required. Appropriate certification/licensure associated with degree required. If CMA, HSD/GED also required. Minimum of 10 years clinical experience preferred. Associate's degree in business or related field preferred. Physician practice experience preferred. Good interpersonal, administrative, organizational, professional and computer skills required. Must interact well with staff, patients and the public.

Job Description Insight Global is seeking an Inpatient Medical Coder to support accurate and compliant coding operations. This role is responsible for reviewing medical record documentation to determine and validate appropriate inpatient codes, analyzing physician documentation for completeness and accuracy, and providing feedback to support documentation improvement. The Inpatient Medical Coder collaborates with internal and external stakeholders to obtain additional documentation as needed to support services rendered and codes billed. The ideal candidate demonstrates strong attention to detail, analytical skills, and proficiency with electronic health record (EHR) systems and coding software. We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for...

Job Full Description We are excited to share that Express is partnering with a family-owned Durable Medical Supply company based in Belton, SC. Here are some perks: Mon-Thurs from 8a-5p & 8a-12p -(1/2 days on Fridays) Company benefits Upbeat and calm work environment Room for growth 401k Paid Holidays, Vacation, and Medical Benefits Job Responsibilities: Reading Medical Charts Documentation Posting Payments Reworking Rejections Communicate Significant Findings to Management McKesson Monthly Orders Billing Medicare, VA, NC, and GA Medicaid Learning Newly Acquired Payer Rules and Reimbursements Shared housekeeping within the office The company will provide continued education resources required by state and federal government to educate the employee on various topics. These will be monthly, quarterly, and annually. Proof of completion with satisfactory scores will be kept in the employee file. Requirements: Must have previous...

We are seeking a professional Medical Billing Specialist to join a growing team in Seneca, SC . This is a full time, temporary role. The ideal candidate will have a strong understanding of medical terminology and coding practices, particularly ICD-10 and ICD-9. Job Description: Conduct insurance verification to confirm patient coverage and benefits Complete ICD-10 and ICD-9 coding Organize and manage medical records Resolve any discrepancies related to insurance claims Provide necessary information to both patients and providers. Perform administrative tasks as needed Qualifications: High School Diploma or GED 2 years of medical billing experience Strong understanding of medical terminology and coding practices, particularly ICD-10 and ICD-9 Excellent communication and strong attention to detail Hours: Monday to Thursday 7:45am to 5:00pm Friday - 7:45am to 1:00pm 100% ONSITE Compensation & Additional...

Overview Inspire health. Serve with compassion. Be the difference. Job Summary Responsible for abstracting and validating CPT, ICD-10 and HCPCS codes for inpatient, outpatient and physician's office/clinic settings. Adheres to all coding and compliance guidelines. Maintains knowledge of coding/billing updates and payer specific coding guidelines. Serves as a subject matter expert for assigned specialty. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference. Abstracts/codes for assigned provider(s)/division(s) based on medical record documentation. Adheres to all coding and compliance guidelines. Utilizes appropriate coding software and coding resources in order to determine correct codes. Communicates billing related issues to assigned supervisor/manager and participates in meetings in order to improve overall billing, when applicable. Follows departmental...

Inspire Health. Serve With Compassion. Be The Difference. Responsible for abstracting and validating CPT, ICD-10 and HCPCS codes for inpatient, outpatient and physician's office/clinic settings. Adheres to all coding and compliance guidelines. Maintains knowledge of coding/billing updates and payer specific coding guidelines. Serves as a subject matter expert for assigned specialty. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference. Abstracts/codes for assigned provider(s)/division(s) based on medical record documentation. Adheres to all coding and compliance guidelines. Utilizes appropriate coding software and coding resources in order to determine correct codes. Communicates billing related issues to assigned supervisor/manager and participates in meetings in order to improve overall billing, when applicable. Follows departmental policies for charge...

POSITION:   RCM AR Specialist RESPONSIBLE TO: RCM Supervisor, AR Collections JOB SUMMARY:   Follows up on Claim Denials and overdue insurance balances using Explanation of Benefits (EOB) documents and reports.  RCM AR Specialist are assigned specific book of business based on Financial Class and Payers. Work to support the field related to claim denials. RESPONSIBILITIES INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING: Daily Duties Follows up on denied claims and no response within a timely manner. Submits appeals related to contract rate variances with a discrepancy in allowed amounts; notifies Supervisor of payers for which this is a consistent problem. Submit Medical Records when requested by the payer for claims processing determination. Monitor and review Payer correspondence from the lockbox and faxes. Monitor, review, and respond to Hub (field) communication inquiries within the 48-hour requirement. Account Follow-Up Using data from the...

Job Requirements We are hiring a Nursing Supervisor to join our team at Cherokee Medical Center! Full-Time Nights; 6p-6a The Nursing Administrative Supervisor represents Hospital and Nursing Administration to the hospital and medical staff, families and the public within established guidelines. The Nursing Administrative Supervisor (NAS) acts as a clinical and administrative resource for nursing personnel. The NAS has delegated authority to support, advice and direct overall management of nursing practice for a specific period of time. The NAS acts as an advisor/collaborator to other departments as required for problem solving and maintaining the quality of care we wish to provide for our customers. Minimum Requirements Education Graduate of an accredited school of nursing. BSN Experience 5 years' experience as a registered nurse in a clinical setting License/Registration/Certifications Current R.N. licensure in the state of South Carolina...

Job Requirements The Nursing Administrative Supervisor represents Hospital and Nursing Administration to the hospital and medical staff, families and the public within established guidelines. The Nursing Administrative Supervisor (NAS) acts as a clinical and administrative resource for nursing personnel. The NAS has delegated authority to support, advice and direct overall management of nursing practice for a specific period of time. The NAS acts as an advisor/collaborator to other departments as required for problem solving and maintaining the quality of care we wish to provide for our customers. Education Graduate of an accredited school of nursing. BSN Experience 5 years' experience as a registered nurse in a clinical setting License/Registration/Certifications Current R.N. licensure in the state of South Carolina BLS, ACLS, PALS/ENPC Preferred Requirements Preferred Education MSN Preferred Experience 2-3 years' experience in a nursing...