Registered Health Information Technician# 26-17687
US Tech Solutions
Medical Review Auditor
A typical day would like in 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.
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.
- 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.
Skills:
- Required Skills and Abilities: Develops methodologies, follows processes, Responds to Inquiries, Writes for Impact.
Education:
- Required Education Level and Degree Type: Associate degree - Nursing or Health Information Management or Graduate of an Accredited School.
- Required Work Experience: 3 years medical record management to include coding and validation review experience.
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions.
US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
AI Statement: By applying, you acknowledge that AI-assisted tools may be used during hiring.
US Tech SolutionsVacancy posted 4 days ago
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