Looking for Clinical Analyst & Coding Specialist- W2 Only (SC Resident) - 100% Remote

Job Title: Medical Coder/ReviewerDuration: 12 Months (With possible extension)Location: 100% Remote Responsibilities: Initiates annual (and quarterly) updates from CMS of all ICD-10, CPT/HCPCS coding changes. Performs initial review of codes to determine scope of changes. Prepares listings of codes changes to Reference Administration staff and Medicaid Program staff for review and analysis. Conducts meetings with Agency personnel, stakeholders, and process owners. (Future) Participates in DASH (

Required Skills (rank in order of Importance): 5+ years in healthcare insurance; medical review, program integrity, or appeals. 5+ years working with IT developers/programmers in a payor environment. 5+ years Medical Coding in payer environment. 3+ years clinical experience in a healthcare environment (strong clinical assessment and critical thinking skills.) 5+ years knowledge of ICD/CPT/HCPCS translation and coding methodologies.5+ years knowledge of anatomy, physiology, pharmacology, and m

Job Summary: - On-site position; applicants must be local. - Requires BSN or ADN degree. - Must have an active, non-restricted South Carolina RN license. - Must hold current CPC or CCS certification (or obtain within one year); ICD-10 proficiency required. - Minimum 5 years experience in healthcare insurance (medical review, program integrity, or appeals). - At least 5 years working with IT developers/programmers in a payer environment. - At least 5 years experience with medical coding

We are seeking an Advanced Business Analyst / Clinical Analyst & Coding Specialist for a long-term contract role. This is a unique opportunity for a Registered Nurse (RN) with strong medical coding expertise to act as a Subject Matter Expert (SME), bridging the gap between clinical policy and IT systems. Note: There is NO actual medical billing or coding in this role. You will be researching code data changes (CMS/ICD-10/CPT) and translating them into business rules and system requirements. Lo