MMIS Reference Administrator

Remote • Posted 10 hours ago • Updated 8 hours ago
Contract W2
Contract Independent
Contract Corp To Corp
No Travel Required
Remote
Depends on Experience
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Fitment

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Job Details

Skills

  • MMIS
  • Medicaid
  • Medical Coding
  • CPT
  • HCPCS
  • ICD-10
  • Claims Adjudication
  • Claims Processing
  • Business Requirements
  • Functional Requirements
  • Payor Environment
  • Optum Encoder
  • Policy Remediation
  • Clinical Assessment
  • Reference Administration
  • CMS Updates

Summary

Requirements
  • 5 or more years of experience in medical coding and claims adjudication within a payor environment.
  • Proficiency in MMIS and CPT, HCPCS, and ICD-10 coding methodologies.
  • Experience in translating clinical policies into technical business and functional requirements.
  • Experience with Optum Encoder and specialized medical coding software programs.
  • Experience in collaborating with software developers on technical claims processing system updates.
  • Experience with supervising staff responsible for reference administration and system record updates.
  • Excellent verbal and written communication skills.
 
Responsibilities
  • Investigate and resolve complex Medicaid Management Information System issues and pricing errors.
  • Execute annual and quarterly CMS updates for ICD-10 and CPT/HCPCS coding changes.
  • Lead technical meetings with stakeholders to align Medicaid policy with system functionality.
  • Manage technical repositories for business rules, system requirements, and claims models.
  • Facilitate the initial analysis of federal medical coding requirements and agency initiatives.
  • Oversee the development of technical documentation for claims adjudication outcomes.
  • Establish project milestones and assign responsibilities for MMIS reference administration updates.
 
Founded in 1999, Resourcesoft, Inc. is a leading Technology Consulting and Professional Services organization. Headquartered in Marlborough, MA, the company serves the technology needs of its clients nationwide. Resourcesoft has often been recognized by prominent rating agencies for its exemplary growth and stability. With over two decades of industry experience, the Company has evolved as a front runner in enabling project optimization. We partner with leading organizations to provide technology solutions within the financial, insurance, education, government, publishing, healthcare and pharmaceutical domains. We take pride in mentoring a workforce that is well positioned to respond to the emerging IT trends and needs. With the employees at the crux of every business endeavor, our success is driven by our expertise in pairing the right talent with the best jobs in the technology sector. We forge long term, personalized relationships with our employees to advance their career to the next level. We engage them in technology centric client projects that provide opportunities for them to evolve, innovate and deliver world class products and services. Our career opportunities offer challenging assignments and exposure to emerging and cutting edge technologies. We are committed to providing our employees with the tools necessary to accelerate their career progression, while maintaining a healthy, work-life balance. We are deeply committed to providing a workplace ambience that is both challenging and fulfilling.
 
Resourcesoft is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.
 
For more information about Resourcesoft and our services, please visit our website.
Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.
  • Dice Id: 10117734
  • Position Id: 21120-27990-
  • Posted 10 hours ago

Company Info

About Resourcesoft, Inc.

Founded in 1999, Resourcesoft, Inc. is a leading Technology Consulting and Professional Services organization. Headquartered in Marlborough, MA, the company serves the technology needs of its clients nationwide. Resourcesoft has often been recognized by prominent rating agencies for its exemplary growth and stability. With over two decades of industry experience, the company has evolved as a front runner in enabling project optimization. We partner with leading organizations to provide technology solutions within the financial, insurance, education, government, publishing, healthcare and pharmaceutical domains. We take pride in mentoring a workforce that is well positioned to respond to the emerging IT trends and needs. With the employees at the crux of every business endeavor, our success is driven by our expertise in pairing the right talent with the best jobs in the technology sector. We forge long term, personalized relationships with our employees to advance their career to the next level. We engage them in technology centric client projects that provide opportunities for them to evolve, innovate and deliver world class products and services. Our career opportunities offer challenging assignments and exposure to emerging and cutting edge technologies. We are committed to providing our employees with the tools necessary to accelerate their career progression, while maintaining a healthy, work-life balance. We are deeply committed to providing a workplace ambience that is both challenging and fulfilling.

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