Duties: 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.
Skills and Abilities: Develops methodologies. Follows processes. Responds to inquiries. Writes for impact.
Schedule Notes: MAX PAY RATE - ***/HR CONTRACT TO HIRE NON SCA MONDAY-FRIDAY, 8AM-4:30PM MANAGER WILL CONDUCT TWO INTERVIEWS, 1ST ROUND VIA TEAMS, 2ND ROUND WILL BE ONSITE WITH MANAGER AND CODER.
Please provide License/Certification required: a RHIT, RHIA, CIC, CPMA, or CPC should be the top search credentials (not RN or CCS). FULLY REMOTE WORK- will accept candidates from SC or NC preferably but could expand the region if necessary. Client will provide equipment. A typical day would be like this role: We are opening these positions due to increased volume of DRG review. We currently have 2 Medical Review Auditors on our team already. The normal day is DRG reviews and audits. Experience: IP coding or RHIA/RHIT designation, that be in lieu of the actual experience. Inpatient is a heavily preferred criterion.
Auditor, Quality Medical • Columbia, SC, United States
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