Medical Billing Specialist Physician Services USAMedical Billing SpecialistColumbia, South CarolinaResponsibilities include the billing and account resolution aspects of revenue cycle management, providing management and clients with reports and account updates with some direct client- and patient-interaction while handling multiple projects and deadlines simultaneously. Family-oriented physician practice management company in NE Columbia is seeking to hire experienced and driven professionals in the medical billing field.
Medicaid Risk Adjustment Market Manager CVS Health CorpMedicaid Risk Adjustment Market ManagerSC$54,300–$145,860 / yearPartner with segment product, sales, network, clinical teams to implement processes aimed at strengthening member and provider engagement of Revenue Integrity programs resulting in improved outcomes. This is a high-visibility role responsible for driving market level engagement, delivering insights, and demonstrating the value of Medicaid risk adjustment performance to senior leaders and market partners.
Certified Nurse Midwife - PRN Prisma HealthCertified Nurse Midwife - PRNColumbia, South CarolinaParticipates in establishment of quality assurance programs for the Division of Midwifery, including maintaining a midwifery client data base and clinical outcomes data set consistent with ACNM Benchmarketing Project. *Develops treatment plan for well-woman gynecological patient, including contraceptive management, pre-conception care, initial infertility evaluation, peri-menopause and treatment of common gynecological disorders and complaints.
Medical Director - ENT CVS Health CorpMedical Director - ENTSC$174,070–$374,920 / yearLeads all aspects of utilization review/quality assurance, directing case management Provides clinical expertise and business direction in support of medical management programs through participation in clinical team activities Acts as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams Responsible for predetermination reviews ad reviews of claim determinations, providing clinical, coding, and reimbursement expertise. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Medical Billing Specialist Midlands Neurology and Pain Associates, P.A.Medical Billing SpecialistColumbia, South CarolinaThis role requires a keen attention to detail, knowledge of medical billing best practices, and the ability to work collaboratively across departments to resolve claim issues and improve reimbursement outcomes. The Medical Billing specialist is responsible for working all aspects of the billing cycle, specifically in Accounts receivable, payment posting, denials, appeals, etc.
Medical Director - Radiation Oncology - MD or DO CVS Health CorpMedical Director - Radiation Oncology - MD or DOSC$174,070–$374,920 / yearThe Radiation Oncology Medical Director supports the CVS Health Specialty oncology business in managing oncology specific utilization of providers, clinical reviews of oncology specific data, and assist with growing our oncology footprint. In the Medical Director role, you will provide oversight for medical policy implementation; you will support the ensuring timely and consistent responses to members and providers; you will focus on prior authorization cases and consultation cases.
Hospice Medical Coder Your Health OrganizationHospice Medical CoderColumbia, SCWe are a leading physician group serving South Carolina and Georgia, dedicated to delivering quality healthcare directly to patients in care facilities, homes, clinics, and virtual visits. Provide support to the team by performing general administrative tasks, utilizing software systems effectively, and assisting other staff members as needed to enhance patient care and staff efficiency.
Medicare Pricing Analyst Wisconsin Physicians Service Insurance CorpMedicare Pricing AnalystSCRemoteThe Medicare Pricing Procedures Analyst also researches and responds to interdepartmental requests, reviews Medicare pricing guidance, supports system testing and validation, maintains internal documentation, and assists the Technical Claims team with projects that improve the accuracy and efficiency of Medicare pricing operations. This role supports the implementation and validation of CMS pricing updates, maintains pricing information within Medicare systems, and collaborates with CMS, Shared System Maintainers, and other Medicare Administrative Contractors (MACs) to ensure accurate and timely claims payment.
Customer Service Representative Medical University of South CarolinaCustomer Service RepresentativeColumbia, SCHours Per Week: Job Description/Summary: The Surgery Scheduler schedules all surgical procedures and assures that appropriate clinical and insurance coding information is collected. Maintains accuracy in the upcoming surgical schedule, speaking directly with Physician offices, and fostering a close working relationship with all the departments involved.
Physician - Critical Care/Pulmonology (temp/locums) TDY Medical StaffingPhysician - Critical Care/Pulmonology (temp/locums)Columbia, South CarolinaPerform specialty specific procedures including but not limited to: Arterial/venous blood sampling, thoracentesis, arterial and venous catheter placement, placement of central venous lines/acute dialysis catheters/PA catheters, intubation, fiberoptic bronchoscopy, lumbar puncture, joint aspiration, placement of NG/feeding tubes, aspiration of subcutaneous fluid collections, bladder catheterizations, and performing portable ultrasound. The contract physician is required to make physician-to-physician contact calls with private and client physicians regarding referral of patients and to make telephone arrangements with appropriate physicians at tertiary care medical centers to arrange for referral of patients to other medical centers.
Medicare Risk Adjustment Manager (Southeast) CVS Health CorpMedicare Risk Adjustment Manager (Southeast)SC$54,300–$119,340 / yearThe role drives, in collaboration with the national and local risk adjustment teams, risk coding improvement activities within the region, medical record collection, provider collaboration and data sharing, general coding education and related activities, as well as other activities as assigned. 7+ years of experience in risk adjustment, clinical quality, or healthcare quality improvement required; experience supporting provider‑based or value‑based initiatives preferred.
NewLead Statisical Programmer Computer Enterprises IncLead Statisical ProgrammerColumbia, SCInitiates, designs, codes, and executes complex statistical analysis programming and sophisticated statistical interpretation, compilation, and verifications to guide departmental efforts. This role involves leading efforts in designing, coding, maintaining, and executing database programs for data extraction, analysis, and presentation.
Clinician (Advanced Practice Nurse or Certified Nurse Midwife) Planned Parenthood South AtlanticClinician (Advanced Practice Nurse or Certified Nurse Midwife)Columbia, SC$57.60–$72 / hourPerform physical examinations with special emphasis on the reproductive system, including breast examination, pelvic examination, cancer screening tests, diagnosis of sexually transmitted infections (STIs), and other types of more specialized procedures such as endometrial biopsies and colposcopies, as may be indicated by medical protocols and clinical privileging. In centers providing abortion, provide client and physician support, including but not limited to lab testing, sonography, informed consent, POC evaluation, medication administration, recovery oversight and discharge for clients, post abortion follow up communications and office visits.
CDI Specialist RN Lexington Medical CenterCDI Specialist RNWest Columbia, SCAble to conduct thorough medical record review on initial and extended-stay concurrent reviews on all selected inpatient admission and documents findings to identify MCCs/CCs, PSI, HAC, mortality second-level review, and patient length of stay that supports patient's severity of illness and risk of mortality denoting all key information utilized in the tracking process. Lexington Health is a comprehensive network of care that includes six community medical and urgent care centers, nearly 80 physician practices, more than 9,000 health care professionals and Lexington Medical Center, a 607-bed teaching hospital in West Columbia, South Carolina.
Clinical Director LifeStance Health IncClinical Directorcayce, SCLifeStance is a national provider of mental healthcare services focused on evidenced-based, medically driven treatment services for children, adolescents and adults suffering from a variety of mental health issues in an outpatient care setting, both in-person at its 550+ clinics nationwide and through its digital health telemedicine offering. Duties/Responsibilities: Clinician Education & Engagement: Partners with Practice Group Manager and other team leaders to support new clinicians through provision of clinically focused regional onboarding training, promoting caseload ramp, and engaging in new employee orientation.
Physical Therapist Center Director Concentra Inc.Physical Therapist Center DirectorColumbia, SCMasters use of clinical systems to ensure efficient and excellent supportive documentation, appropriate and optimal coding levels, charge capture, and follow-through on all patient care orders. Actively participates in CLT meetings with COD and CMD to improve quality, patient safety, outlier management, and ensures the ongoing development and growth of the center's business.
Clinical Director LifeStance HealthClinical DirectorColumbia, South CarolinaPartners with Practice Group Manager and other team leaders to support new clinicians through provision of clinically focused regional onboarding training, promoting caseload ramp, and engaging in new employee orientation. The Clinical Director will provide oversight and support for psychotherapy clinicians, engaging through coaching and education of new and tenured clinicians and enhancing ongoing clinician professional growth and development.
Health Information Management Inpatient Coder, FT, Days, - Remote Prisma HealthHealth Information Management Inpatient Coder, FT, Days, - RemoteColumbia, SCRemotePerforms Inpatient coding including major traumas and Neonatal Intensive Care Unit (NICU) records by assigning International Classification of Diseases (ICD) and International Classification of Diseases-Procedure Coding System (ICD-PCS) codes as well as the Diagnosis Related Groups (DRG) assignment. Verifies assignment of DRGs, MCC/CCs, Hospital Acquired Conditions (HACs) and Patient Safety Indicators (PSIs) that most appropriately reflect documentation of the occurrence of events, severity of illness, and resources utilized during the inpatient encounter and in compliance with department policies and procedures.
Health Information Management Inpatient Coder, FT, Days, Prisma HealthHealth Information Management Inpatient Coder, FT, Days,Columbia, South CarolinaPerforms Inpatient coding including major traumas and Neonatal Intensive Care Unit (NICU) records by assigning International Classification of Diseases (ICD) and International Classification of Diseases-Procedure Coding System (ICD-PCS) codes as well as the Diagnosis Related Groups (DRG) assignment. Verifies assignment of DRGs, MCC/CCs, Hospital Acquired Conditions (HACs) and Patient Safety Indicators (PSIs) that most appropriately reflect documentation of the occurrence of events, severity of illness, and resources utilized during the inpatient encounter and in compliance with department policies and procedures.
Medical Billing & Payroll Specialist — BrightStar Care BrightStar CareMedical Billing & Payroll Specialist — BrightStar CareLexington, South CarolinaThe right person will not simply process invoices or payroll when instructed—they will actively monitor accounts every day, identify what needs attention, follow up on unpaid invoices, and make sure payments and payroll are on track. This position will be responsible for managing the billing and payroll process, submitting client invoices, monitoring payments, and handling accounts receivable collections.