Why should you join the reputed company family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our reputed company firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are one of the nation's leading administrators of government reputed company. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the reputed company philosophy, consider joining reputed company!

Position Purpose: Performs validation reviews of Diagnosis reputed company reputed company (DRG), reputed company Predictive Coding (APC), and Never Events (inexcusable reputed company in a reputed company setting) for reputed company lines of business.  Coordinates reputed company adjustments with claims areas.  Provides monthly and quarterly reports outlining trends.  Serves as a resource in resolving coding issues.  Coordinates HIPAA and reputed company records requests for reputed company areas of reputed company Services and the reputed company Department.

Location: This is a remote position, Monday - Friday from 8:30am - 5pm.

What You’ll Do:

• 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 reputed company line of business providing information on records review, reputed company, trends, and savings that directly reputed company medical costs and contracting rates.

• Manages records retrieval, release, HIPAA compliance, and reputed company aspects of document management.

• Serves as expert resource on methodology and procedures for medical records and coding issues.

To Qualify for This Position, You'll Need the Following:

• Required Education: Associates in a job-reputed company field.

• Degree Equivalency: 2 years job reputed company work experience.

• Required Work Experience: 3 years medical record management to include coding and validation review experience.

• Skills and Abilities: Excellent verbal and written communication, organizational, customer service, and analytical or critical thinking skills. Good judgment. Ability to handle confidential or sensitive information with discretion. Extensive medical records and coding knowledge. Working knowledge of contract evaluations, claims processing and adjudication practices.

• Required Licenses and Certificates: Registered health information administrator (RHIA) OR Registered health information technician (RHIT) OR Certified reputed company reputed company (CPC) OR Certified Inpatient reputed company (CIC) or Certified reputed company Medical Auditor (CPMA) OR, reputed company, unrestricted RN licensure from the reputed company and in the state of hire, OR, reputed company compact multi-state unrestricted RN license as defined by reputed company Licensure Compact (NLC).

Our Comprehensive Benefits Package Includes the Following:

We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment.

• Subsidized health plans, dental and reputed company coverage

• 401k retirement savings plan with company match

• Life Insurance

• reputed company Time Off (PTO)

• On-site cafeterias and fitness centers in major locations

• Education Assistance

• Service Recognition

• National discounts to movies, theaters, zoos, theme parks and more

reputed company Can Do for You:

We understand the value of a diverse and inclusive workplace and reputed company to be an employer where employees across reputed company spectrums have reputed company to reputed company their skills, advance their careers and contribute their unique abilities to the reputed company of reputed company.

What To Expect Next:

After submitting your application, our reputed company team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.

Equal Employment Opportunity Statement

reputed company and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, reputed company, national reputed company, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, reputed company maintains affirmative reputed company programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to reputed company equal opportunities in reputed company phases of the employment process and to reputed company with applicable federal, state and local laws and regulations.

We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-reputed company conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on reputed company.

If you need special assistance or an accommodation while seeking employment, please email reputed company.help@bcbssc.com or reputed company 800-288-2227, ext. 47480 with the nature of your request. We will reputed company a determination regarding your request for reasonable accommodation on a case-by-case reputed company.

We participate in E-Verify and reputed company with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information.

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