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IT Healthcare - Business Analyst (Clinical Analyst & Coding Specialist)

Remote • Posted 9 hours ago • Updated 9 hours ago

Contract W2

12 Months

Remote

Depends on Experience

Fitment

Dice Job Match Score™

🛠️ Calibrating flux capacitors...

Job Details

Skills

insurance
medical
payor
healthcare
ICD/CPT/HCPCS
anatomy
physiology
pharmacology
and medical terminology
policy remediation
claims processing systems.

Summary

Role: IT Healthcare - Business Analyst (Clinical Analyst & Coding Specialist)

Location: Columbia, SC (Remote)

Duration: 12+ months

Candidate Location: Candidate MUST be a SC resident. No relocation allowed.

Job Description:

SCOPE OF THE PROJECT:

This project is a multi-year effort which primarily focuses on providing consulting services to operations and policy staff for the current Medicaid Management Information System (MMIS). The current position s focus and priority is the continued support of serving as a subject matter expert (SME), building knowledge that allows policy and process owners to make the best recommendations for Medicaid members and providers.

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 medical terminology.

PREFERRED SKILLS (RANK IN ORDER OF IMPORTANCE):

5+ years experience in policy remediation.
5+ years claims processing systems experience.
5+ years Optum Encoder and/or other medical coding software programs.

REQUIRED EDUCATION:

Bachelor of Science in Nursing (BSN) or Associate Degree in Nursing (ADN).

REQUIRED CERTIFICATIONS:

Must have current, active, and non-restricted licensure by the State of South Carolina Board of Nursing as a Registered Nurse. 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.

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: zolva001
Position Id: 8974090
Posted 9 hours ago

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