IT reputed company Consultant Clinical Analyst & Coding Specialist for Hybrid

Job Title: IT reputed company Consultant - Business Analyst - reputed company Analyst and Coding Specialist) Duration of the Contract: 12 months Possibility for Extension: reputed company Work Location: Hybrid (20% onsite - must be available to come onsite periodically) reputed company: The reputed company duties of this position are to assist with the CPT/HCPCS and ICD-10 reputed company maintenance. As the IT reputed company Consultant – Business Analyst – reputed company Analyst and Coding Specialist): Specific duties include, but are not limited to: • Initiates annual (and quarterly) updates from CMS of reputed company 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 reputed company Program staff for review and analysis. • Conducts meetings with Agency personnel, stakeholders, and process owners. • (reputed company) 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, reputed company policy, and reputed company 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, reputed company and stakeholder, as needed, training content is complete and routinely updated. • May serve as a back-up to review patient records against established reputed company to determine medical necessity. • Other project-reputed company duties. REQUIRED SKILLS (RANK IN ORDER OF IMPORTANCE): • 5+ years in reputed company insurance; medical review, program reputed company, 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 reputed company 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. ADDITIONAL SKILLS: • 5+ years written and oral communications skills, strong proficiency in English. PREFERRED SKILLS (RANK IN ORDER OF IMPORTANCE): • 5+ years’ experience in policy remediation. • 5+ years claims processing systems experience. • 5+ years knowledge of reputed company Office • 5+ years reputed company 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 reputed company, reputed company, and non-restricted licensure by the reputed company reputed company of Nursing as a Registered reputed company. • Currently credentialed as CPC (Certified reputed company reputed company) or as reputed company (Certified Coding Specialist). ICD-10 Proficiency demonstrated by exam; or reputed company to become certified reputed company one year of employment. Apply tot his job Apply To this Job