Medical Coder/Auditor

Job Description

Job Description

Medical Coder/ AuditorJob at a Glance

Title: Medical Coder/ Auditor
Location: Columbia, SC
Contract: W2 only
Pay: $ 36/hour + optional medical, dental, vision, 401(k) match

Must have inpatient coding experience  Overview

Performs validation reviews of Diagnosis Related Groups (DRG), Adaptive Predictive Coding (APC), and Never Events for all lines of business. Coordinates rate adjustments with claims areas and provides monthly and quarterly reports outlining trends, outcomes, and savings that directly impact medical costs and contracting rates.

Key Responsibilities

• Performs validation reviews of Diagnosis Related Groups (DRG), Adaptive Predictive Coding (APC), and Never Events 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.
• 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

• Inpatient coding

Required Education

• Associate Degree - Nursing or Health Information Management
• Graduate of an Accredited School of Nursing

Preferred Skills

• WILL HAVE POTENTIAL FOR REMOTE WORK, BUT PREFERS ONSITE
• Can live anywhere in SC or bordering NC as long as they are able to commute to the worksite location as needed.
• License/Certification required: a RHIT, RHIA, CIC, CPMA, or CPC 

Why Should I Apply?

Join a team expanding DRG review capacity and contribute to accurate reimbursement, compliance, and defensible coding outcomes through validation reviews and expert record/coding methodology.

About CEI:

As a trusted technology partner, CEI delivers solutions that help our customers transform their business and achieve meaningful results. From strategy and custom application development through application management - our technology and digital experience services are tailored to meet each unique need of our customers. Our staffing solutions bring specialized skills to complement our customers' workforce and project requirements.

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