Medical Coder

Notes: This is a remote position , but we are currently considering local candidates in Columbia . If you are interested in the role, please share your most updated resume . Responsibilities 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. 75% 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. •15% Manages records retrieval, release, HIPAA compliance, and all aspects of document management. •10% Serves as expert resource on methodology and procedures for medical records and coding issues. Required Training and Qualifications Registered Records Administrator or Technician, OR; active, unrestricted RN licensure from the United States and in the state of hire; OR active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC). Certified Codi Skills and Abilities: •Develops methodologies •Follows processes •Responds to Inquiries •Writes for Impact Seniority Level Executive Employment Type Contract Job Function Other, Customer Service, and Accounting/Auditing Industries Staffing and Recruiting, Hospitals and Health Care, and Insurance #J-18808-Ljbffr Hornet Staffing, Inc, a GEE Group company