Business Analyst(LLocal to SC)

Required Skills

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

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.

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 Optum Encoder and/or other medical coding software programs