What are the responsibilities and job description for the Auditor, Quality Medical position at Hornet Staffing, Inc, a GEE Group company?
Greetings!
Hope you're doing well. We are excited to announce an opening for an Auditor, Quality Medical to join our team onsite in Columbia, SC.
If you have strong expertise in DRG/APC validation, medical record auditing, and HIPAA compliance, this is an excellent opportunity to advance your career in a high-impact healthcare role.
About the Role:
The Auditor, Quality Medical plays a key role in ensuring accuracy in medical coding, reducing medical costs, and improving documentation integrity. This position involves reviewing complex medical records, validating DRG/APC outcomes, analyzing trends, and supporting legal/HIPAA compliance activities.
Key Responsibilities
✔ 75% – Validation & Reporting
- Perform validation reviews for DRG, APC, and Never Events across all lines of business
- Identify methodology for case selection and coordinate rate adjustments with claims teams
- Prepare monthly & quarterly trend reports outlining outcomes, savings, and coding accuracy insights
✔ 15% – Records Management & HIPAA
- Manage records retrieval, release, and document control
- Ensure full compliance with HIPAA regulations
✔ 10% – Subject Matter Expertise
- Serve as a resource for coding methodology, medical record processes, and documentation issues
What We’re Looking For
- Experience in medical record management, coding, and validation review
- Strong understanding of DRG/APC guidelines, coding accuracy, and healthcare documentation
- Ability to analyze large volumes of clinical data and identify trends
- Knowledge of HIPAA, compliance standards, and claims processes
- Excellent communication and organizational skills