Talent.com
Quality Review Auditor
Quality Review AuditorUS Tech Solutions • Columbia, SC, US
Quality Review Auditor

Quality Review Auditor

US Tech Solutions • Columbia, SC, US
[job_card.variable_days_ago]
[job_preview.job_type]
  • [job_card.temporary]
[job_card.job_description]

Duration : 3+ Months Contract (Possible temp to hire)

Job Description :

  • MONDAY-FRIDAY, 8AM-4 : 30PM.
  • Certified Coding Specialist or RN.
  • A typical day would like in this role : The normal day is DRG reviews and audits.
  • 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.

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.

    • Experience :

  • 3 years medical record management to include coding and validation review experience.

    • Skills :

  • Develops methodologies
  • Follows processes
  • Responds to Inquiries
  • Writes for Impact.

    • Education :

    Associate Degree - Nursing or Health Information Management or Graduate of an Accredited School of Nursing Required Work Experience.

    About US Tech Solutions :

    US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com

    US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

    Recruiter Details : Name : Shailesh

    Email : shailesh.c@ustechsolutionsinc.com

    Internal Id : 25-54912

    [job_alerts.create_a_job]

    Quality Auditor • Columbia, SC, US

    [internal_linking.similar_jobs]
    Quality Engineer

    Quality Engineer

    Harsco Rail • West Columbia, SC, US
    [job_card.full_time]
    Harsco is recognized for technical leadership and worldwide experience in virtually all major aspects of railway track maintenance. We enable railroads to operate at peak efficiency over smooth, pre...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Test Center Administrator / Proctor-Full Time

    Test Center Administrator / Proctor-Full Time

    PSI Services LLC • Columbia, SC, US
    [job_card.full_time]
    Test Center Administrator (TCA) Full-Time.Executive Center Drive, Suite 143, Columbia, SC 29210.Monday - Tuesday, Thursday 8am - 4pm & Friday 8am - 3pm and 2nd and 4th Saturday 8am - 3pm.Join U...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Quality Review Auditor

    Quality Review Auditor

    US Tech Solutions, Inc. • Columbia, South Carolina, United States
    [job_card.temporary]
    Duration : 3+ Months Contract (Possible temp to hire).A typical day would like in this role : The normal day is DRG reviews and audits. Performs validation reviews of Diagnosis Related Groups (DRG), A...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Senior Associate, Audit

    Senior Associate, Audit

    Bauknight Pietras & Stormer • Columbia, SC, US
    [job_card.full_time]
    Founded in 1991, Bauknight Pietras & Stormer, P.BPS) stands as one of the Southeasts leading accounting and consulting firms, and one of the largest locally owned public accounting firms in Sou...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Quality Assurance Technician 1st Shift

    Quality Assurance Technician 1st Shift

    Fresh Express • Columbia, SC, US
    [job_card.full_time]
    Evaluate and address issues with line during pre-op procedures.Work with sanitation crew to release lines during pre-op procedures. Perform and document all in-line checks on predesigned time schedu...[show_more]
    [last_updated.last_updated_30] • [promoted]
    ERP Inventory Quality and Assurance Manager - Midlands

    ERP Inventory Quality and Assurance Manager - Midlands

    Harvest Hope Food Bank • Columbia, SC, US
    [job_card.full_time]
    Join Harvest Hope Food Bank, South Carolina's largest hunger-relief organization, serving 20 counties and distributing 30 million pounds of food annually. We value innovation, collaboration, and...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Auditor, Quality Medical

    Auditor, Quality Medical

    Hornet Staffing, Inc, a GEE Group company • Columbia, SC, US
    [job_card.full_time]
    We are excited to announce an opening for an.If you have strong expertise in.DRG / APC validation, medical record auditing, and HIPAA compliance. The Auditor, Quality Medical plays a key role in.This ...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    MO-7-28- Quality Assurance Analyst - Project Lead 7615.

    MO-7-28- Quality Assurance Analyst - Project Lead 7615.

    FHR • Columbia, SC, US
    [job_card.temporary]
    Job Posting : Quality Assurance Analyst - Project Lead 7615.Candidate Location : Must be a CURRENT SC resident.Work Location : Hybrid (4 days in office, 1 days remote). Employment Type : W2 only, no sub...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Quality Assurance Analyst - Need South Carolina Residents Only

    Quality Assurance Analyst - Need South Carolina Residents Only

    ZIRLEN TECHNOLOGIES INCORPORATED • Hopkins, SC, US
    [job_card.full_time]
    Quality Assurance Analyst HealthCare - Medicaid.Need South Carolina Residents Only - Contract - Hybrid, Columbia.Bachelors degree in technical, business, healthcare or related field.Quality Assuran...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Inventory Control Specialist

    Inventory Control Specialist

    Palmetto State Glass • Columbia, SC, US
    [job_card.full_time]
    Follow and promote safe work practices.Maintain accurate inventory records and ensure stock levels meet operational needs to eliminate shortages. Monitor, track, and reconcile incoming, outgoing, an...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Quality Manager

    Quality Manager

    Pure Power Technologies Inc • Blythewood, SC, US
    [job_card.full_time]
    The Quality Manager role at Stanadyne is responsible for leading and maintaining the plant Quality Management System (QMS) in compliance with IATF 16949, ISO 9001, and customer-specific requirement...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Quality Assurance (QA) Technician- UT Level II

    Quality Assurance (QA) Technician- UT Level II

    American SpiralWeld Pipe Company, LLC • Columbia, SC, US
    [job_card.full_time]
    Tests, inspects, and approves products and samples at various stages of the production process and compiles and evaluates statistical data to determine and maintain quality and reliability of produ...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Sr. Analyst, System Testing I

    Sr. Analyst, System Testing I

    United Global Technologies • Columbia, SC, US
    [job_card.full_time]
    Duties : Provide service for multiple clients.Make recommendations to clients on how to improve testing activities.Perform quality checks across various IT functions to ensure quality standards, pro...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Loss Control Field Inspector

    Loss Control Field Inspector

    ARMStrong Insurance Services • Columbia, SC, US
    [job_card.part_time]
    ARMStrong Insurance Services is the leading and most trusted name in the world of debt recovery and financial solutions.With a track record of excellence and reliability, we have proudly serve...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Quality Review Auditor

    Quality Review Auditor

    US Tech Solutions • Columbia, SC, US
    [job_card.temporary]
    Duration : 3+ Months Contract (Possible temp to hire).Certified Coding Specialist or RN.A typical day would like in this role : The normal day is DRG reviews and audits. Performs validation reviews of...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Quality Director

    Quality Director

    Milliner Talent Solutions • West Columbia, SC, US
    [job_card.full_time]
    Define and monitor goals, KPIs, and objectives for the Quality Management department.Develop, establish, and implement quality procedures and standards. Lead certification activities and ensure comp...[show_more]
    [last_updated.last_updated_variable_hours] • [promoted] • [new]
    Performance Load Test Analyst

    Performance Load Test Analyst

    United Global Technologies • Columbia, SC, US
    [job_card.full_time]
    Not Looking for : I am not looking for a manual tester.Job Title : Analyst, Performance Load Test.Duties : Assist in development and make recommendations for tuning of systems to achieve acceptable pe...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Remote Content QA Reviewer

    Remote Content QA Reviewer

    Outlier • Columbia, SC, United States
    [filters.remote]
    [job_card.full_time]
    Earn up to $16 USD / hourly and work fully remotely and flexibly.Outlier, a platform owned and operated by Scale AI, is looking for. If you're passionate about improving models and excited by the futu...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]