Quality Medical Auditor

Columbiaremote

Posted today · via Workday

About this role

Summary Performs validation reviews of Diagnosis Related Groups (DRG), Ambulatory Procedure Codes (APC), and Never Events (serious, preventable medical errors) 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. Description Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more.…

Read the full description on 001 Blue Cross And Blue Shield Of South Carolina's site →

What we'd score you on

reqspace match rubric

Five dimensions, recruiter-grade. Upload your resume and we'll generate a written explanation of where you fit and where the gaps are.

1

Skills match

For this role: go, hipaa

2

Level fit

We check your title trajectory against the seniority signal of the role.

3

Domain experience

Your work in the role's domain matters more than your years total. We weight recent and direct experience.

4

Recency

A skill you used last quarter weighs more than one from five years ago. We grade on recency, not lifetime.

5

Location fit

This role is remote-eligible — we factor in your stated location and time-zone overlap.

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Free · no card · written explanation included
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Skills in this role

Pulled from the job description. These are the keywords we'll weight when scoring your fit.

gohipaa

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