Position: Business Analyst and Medical Coding Specialist
Location: Columbia, SC 29210 (mostly remote)
Duration: 1+ year
REQUIRED EDUCATION:
RN or LPN (SC)
Medical Coding Certification (CPC, CSS)
ICD/CPT/HCPCS
Specific duties include, but are not limited to:
• 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.
• Serves as an agency subject matter expert (SME) for medical coding methodologies, Medicaid policy, and related topics.
REQUIRED:
• 5 years’ experience in healthcare insurance; medical review, program integrity, or appeals.
• 5 years’ experience working with IT developers/programmers in a payor environment.
• 5 years’ experience Medical Coding in payer environment.
• Strong knowledge of ICD/CPT/HCPCS coding methodologies.
• Extensive knowledge of anatomy, physiology, pharmacology, and medical terminology.
