Why is this position open: The workload and complexities of the reference administration responsibilities requires additional support to maintain efficiency and to achieve defined deliverable dates. The additional position will allow us to finalize succession planning for team members that may consider retirement within the next 12 18 months.
Will close to submissions on 02/23 at 5:00PM EST.
Interview Process: 1 round, Virtual/Online
Duration of the Contract: 12 months
Possibility for Extension: Yes
Work Location: Hybrid (20% onsite - must be available to come onsite periodically)
Candidate Location: Candidate MUST be a SC resident. No relocation allowed.
Full job description attached & required/preferred skills are stated below.
Education
Bachelor of Science in Nursing (BSN) or Associate Degree in Nursing (ADN)
License
Must have current, active, and non-restricted licensure by the State of South Carolina Board of Nursing as a Registered Nurse.
Certification
Currently credentialed as CPC (Certified Professional Coder) or as CCS (Certified Coding Specialist). ICD-10 Proficiency demonstrated by exam; or able to become certified within one year of employment.
Required Skills
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 medical terminology.
Preferred Skills
5+ years' experience in policy remediation.
5+ years claims processing systems experience.
5+ years knowledge of Microsoft Office
5+ years Optum Encoder and/or other medical coding software programs
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