Please let me know your Interest and rate for this position.
Phone/Skype Hire. Upto 80% remote for SC/NC/GA candidates
Work Location: 80% remote, resources will need to come onsite in Columbia, SC to certain trainings/meetings
Location: Columbia, SC / Remote
Duration: 12+ months
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 (Replacement MMIS) project meetings, as needed, where reference administration expertise is required.
• Serves as an agency subject matter expert (SME) for medical coding methodologies, Medicaid policy, and related topics.
• Research business rules, requirements, and models to complete initial analysis and recommendations.
• Maintains business rules, requirements, and models in a repository.
• Collaborates with team to ensure process documentation is complete, owner and stakeholder, as needed, training content is complete and routinely updated.
• May serve as a back-up to other roles within the bureau to support claim escalations research, once the person has demonstrated full proficiency in the job functions required for their new role
Skills Needed
• 3+ years’ experience in healthcare
• Strong knowledge of ICD/CPT/HCPCS translation and coding methodologies
• 3+ years extensive knowledge of anatomy, physiology, pharmacology, and medical terminology
• 3+ years of strong knowledge of formal business process documentation
• 3+ years’ experience healthcare hospital, office and clinic setting
• Knowledge of Microsoft Office (Word, Excel, PowerPoint, Optum Encoder and other medical coding software programs)
REQUIRED EDUCATION:
Bachelor’s degree in healthcare related field. An equivalent combination of experience and education may be considered with prior SCDHHS hiring team review and approval.
Required CERTIFICATIONS:
Currently credentialed as CPC (Certified Professional Coder) or as CCS (Certified Coding Specialist).
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