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Full-time

Medical Coding Specialist

Posted by Confidential • Columbia, South Carolina, United States

📍 Columbia, South Carolina 🕒 March 01, 2026
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About the Role


Duties

Reviews medical documentation to perform a variety of coding validations for multiple lines of business under Medicare/TRICARE to determine accuracy of billing and payment. Reassigns and sequences diagnostic and procedural codes using universally recognized coding system as appropriate.

Compiles and analyzes statistics to determine focus areas for targeted medical review activities where there is the greatest potential for inappropriate Medicare/TRICARE payments.

  • Determines methodology to identify cases for DRG, HIPPS, HCPCS, RUG, and APC validation. Conducts targeted coding, documentation reviews, and validation reviews coordinating rate adjustments and adjudication of corresponding claims. Utilizes Grouper, Rover, MDS QC tool or other appropriate software for code validation.

  • Compiles/analyzes statistics to determine focus areas for targeted medical review activities where there is the greatest potential for inappropriate Medicare/TRICARE paymen...

    • Job Details

    • Location Columbia, South Carolina
    • Job Type Full-time
    • Category Health Technologists and Technicians
    • Posted March 01, 2026
    • Deadline April 10, 2026

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