Medical Records Specialist HCA Healthcare IncMedical Records SpecialistCharleston, SCSubmit your application for the opportunity below: Medical Records Specialist Job Summary and Qualifications As a Medical Records Specialist, you would be responsible for assisting the HIM Director by routinely performing duties in support of the management of the Horizon Patient Folder (HPF)/McKesson Patient Folder (MPF) workflow queues, working applicable worklists within 3M 360 Encompass, the resolution of unbilled accounts, and the processing of physician suspensions. Facilitates the retrieval and printing of medical records from storage, as well as the storage, archival and record retention of documents and/or other Alternate Media that cannot be scanned into HPF/MPF (e.g., fetal monitor strips).May assist with the physician suspension process by evaluating if a physician should be put on suspension, creating the list of recommended suspensions for approval, sending out notice letters, making reminder calls, etc.
Medical Review Nurse -UM/Post Appeals (Michigan RN license req) Molina Healthcare IncMedical Review Nurse -UM/Post Appeals (Michigan RN license req)North Charleston, SCREQUIRED QUALIFICATIONS: At least 2 years clinical nursing experience, including at least 1 year of utilization review (prospective, retrospective and concurrent clinical review), medical claims review, long-term services and supports (LTSS), claims auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and experience. Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level of care utilizing MCG/InterQual, state/federal guidelines, billing and coding regulations, and Molina policies; validates the medical record and claim submitted support correct coding to ensure appropriate reimbursement to providers.
Medical Records Coder III Outpatient (REMOTE) BayCare Health SystemMedical Records Coder III Outpatient (REMOTE)Charleston, SCRemoteResponsibilities: The Medical Records Outpatient Coder III reviews short stay focused encounters to accurately assign diagnosis and procedural codes-using ICD-10-CM and CPT-4 coding systems. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians.
Medical Review Officer (MRO) - Bid MaximusMedical Review Officer (MRO) - BidCharleston, SCFull timeMaximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. - After completing all research, the physician must write a case rationale in the correct format that introduces the question at hand, summarizes the correct guideline, analyses the pertinent case details related to the guideline, and then make a final determination as to the medical necessity of the requested service.
Medical Records Assistant: OIDD - Coastal State of South CarolinaMedical Records Assistant: OIDD - CoastalDorchester County, SC$37,200–$48,300 / yearEmployment Contingency: Employment is contingent upon our receipt of the following required pre-employment screenings: medical screening - to include a drug screening; background record checks (to include fingerprinting), South Carolina Department of Social Services' Child Abuse and Neglect Central Registry screening, U.S. Department of Health and Human Services Office of Inspector General "List of Excluded Individuals/Entities" screening; South Carolina Department of Motor Vehicles Driving Record check; and a review of transcripts verifying educational credentials. State Disaster Plan: In accordance with the States Disaster Plan, which includes hazardous weather, employees of The South Carolina Department of Behavioral Health and Developmental Disabilities, Office of Intellectual and Developmental Disabilities may be required to work in times of an emergency or disaster.
Clinical Quality Review Team Lead TriWest Healthcare AllianceClinical Quality Review Team LeadCharleston, SCRemoteFull timeThe team lead supports clinical and non-clinical staff supporting CQM programs by providing training and onboarding of new staff; determining work assignments; performing audits for clinical records and/or work accuracy; and ensuring effective, consistent and accurate workflow. Technical Skills: Comprehensive knowledge of research methodology; proficient applying appropriate data analysis processes; knowledge of managed care principles and methods; knowledge in the application of clinical criteria; proficient with Microsoft Word, Excel, and PowerPoint.
Lead Reviewing Physician Consultant (Bid) MaximusLead Reviewing Physician Consultant (Bid)Charleston, SCFull timeAfter completing all research, the physician must write a case rationale in the correct format that introduces the question at hand, summarizes the correct guideline, analyses the pertinent case details related to the guideline, and then make a final determination as to the medical necessity of the requested service. Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment.
Mental Health Reviewing Consultant (Bid) MaximusMental Health Reviewing Consultant (Bid)Charleston, SCFull timeMaximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. - After completing all research, the physician must write a case rationale in the correct format that introduces the question at hand, summarizes the correct guideline, analyses the pertinent case details related to the guideline, and then make a final determination as to the medical necessity of the requested service.
Alternate Vision Reviewing Physician Consultant (BID) MaximusAlternate Vision Reviewing Physician Consultant (BID)Charleston, SCFull timeMaximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. - Maintain working knowledge of Office of Personnel Management (OPM) medical and suitability policies and ensure all consultations reflect current clinical best practices, regulatory requirements, and program objectives.
Medical Scribe CVS Health CorpMedical ScribeNorth Charleston, SC$17–$25.65 / hourScribes receive extensive on-the-job training in clinical workflows, value-based medicine, preventative care for chronic conditions, accurate and specific documentation, population health data streams, and team based care. This is an excellent opportunity for pre-med track individuals looking to gain practical, paid experience in a clinical setting before applying to an MD/DO/PA/NP program, as well as those pursuing careers in Health Informatics, Public Health, Healthcare Administration, Medical Coding, and other related fields.
Medical Assistant Clinical Coordinator OneOncology IncMedical Assistant Clinical CoordinatorNorth Charleston, SCJob Description: The Certified Medical Assistant Clinical Coordinator at the LOA Osteoporosis Center is responsible for gathering and documenting patient screening data, obtaining vitals, preparing charts, drawing labs, maintaining their area, assisting providers, managing referrals, preparing patient charts, and other various activities needed to ensure patient care is prioritized. Coordinate and assist with new patient referral processes for the LOA Osteoporosis Center, including obtaining and reviewing medical records, communicating with referring providers and patients, scheduling appointments, and ensuring timely and seamless continuity of care.
Medical Assistant Clinical Coordinator Lowcountry Oncology AssociatesMedical Assistant Clinical CoordinatorNorth Charleston, South CarolinaThe Certified Medical Assistant Clinical Coordinator at the LOA Osteoporosis Center is responsible for gathering and documenting patient screening data, obtaining vitals, preparing charts, drawing labs, maintaining their area, assisting providers, managing referrals, preparing patient charts, and other various activities needed to ensure patient care is prioritized. Coordinate and assist with new patient referral processes for the LOA Osteoporosis Center, including obtaining and reviewing medical records, communicating with referring providers and patients, scheduling appointments, and ensuring timely and seamless continuity of care .
Physician Associate Director of Medical Operations Concentra Inc.Physician Associate Director of Medical OperationsNorth Charleston, SCExcellent communication skills including speaking, presentation, listening, telephone, negotiation, business and medical writing skills necessary to convey information to supervisors, peers, or customers. All these services together make achieving health easier and more accessible for our patients, clients, colleagues, and all provide you with unmatched support, education, career advancement opportunities, and benefits.
Certified Medical Assistant OneOncology IncCertified Medical AssistantNorth Charleston, SCJob Description: The Certified Medical Assistant is responsible for gathering and documenting patient screening data, obtaining vitals, preparing charts, drawing labs, maintaining their area, assisting providers, and other various activities needed to ensure patient care is prioritized. Additional responsibilities may be assigned to help drive our mission of delivering high-quality and compassionate cancer care in our community, for our community, and by oncologists who live in our community.
NewCertified Medical Assistant Lowcountry Oncology AssociatesCertified Medical AssistantMount Pleasant, South CarolinaThe Certified Medical Assistant is responsible for gathering and documenting patient screening data, obtaining vitals, preparing charts, drawing labs, maintaining their area, assisting providers, and other various activities needed to ensure patient care is prioritized. Additional responsibilities may be assigned to help drive our mission of delivering high-quality and compassionate cancer care in our community, for our community, and by oncologists who live in our community.
UNIV - Clinical Risk Manager (Registered Nurse) - Insurance Services MUSCUNIV - Clinical Risk Manager (Registered Nurse) - Insurance ServicesCharleston, South CarolinaThe Insurance Services Clinical Risk Manager supports the Insurance Services Director of Clinical Risk Management by conducting frontline discovery, evaluation, and documentation of clinical events involving healthcare providers across MUSC and the MUSC Health System including the RHN, MUSCP and affiliates, and MUSC Health Affiliates (collectively call the MUSC Enterprise). The Clinical Risk Manager collaborates with hospital risk and quality teams, internal counsel, and clinical departments to promote patient safety, reduce clinical risk exposure, and improve system wide learning.
UNIV - Clinical Risk Manager (Registered Nurse) - Insurance Services Medical University of South CarolinaUNIV - Clinical Risk Manager (Registered Nurse) - Insurance ServicesCharleston, South CarolinaThe Insurance Services Clinical Risk Manager supports the Insurance Services Director of Clinical Risk Management by conducting frontline discovery, evaluation, and documentation of clinical events involving healthcare providers across MUSC and the MUSC Health System including the RHN, MUSCP and affiliates, and MUSC Health Affiliates (collectively call the MUSC Enterprise). The Clinical Risk Manager collaborates with hospital risk and quality teams, internal counsel, and clinical departments to promote patient safety, reduce clinical risk exposure, and improve system wide learning.