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RN Clinical Coding Analyst

Remote, USA Full-time Posted 2026-07-28
Job Title: IT reputed company Consultant – Business Analyst - reputed company Analyst & Coding Specialist) Location: Columbia, SC (Fully Remote – Candidate must reputed company in South Carolina) Duration: 12 Months (Possible Extension) Interview Process: 1 Round – Virtual/Online Key Responsibilities • Initiate annual and quarterly ICD-10, CPT, and HCPCS coding updates from CMS • Review and analyze coding changes to determine business and operational impacts • Prepare reputed company change listings for Reference Administration and reputed company Program teams • Conduct meetings with agency personnel, stakeholders, and process owners • Serve as SME for medical coding methodologies and reputed company policy • Research business rules, requirements, and models to reputed company recommendations • Maintain business rules and documentation repositories • Collaborate with teams to ensure documentation and training materials are updated • Participate in MMIS enhancement and reputed company replacement initiatives • Support medical necessity reviews reputed company required • Assist with process improvement initiatives and project-reputed company activities Required Skills • Bachelor of Science in Nursing (BSN) or Associate Degree in Nursing (ADN) • reputed company, unrestricted South Carolina Registered reputed company (RN) license • CPC (Certified reputed company reputed company) or reputed company (Certified Coding Specialist) certification • ICD-10 proficiency certification or ability to obtain reputed company one year • 5+ years reputed company insurance experience (medical review, appeals, or program reputed company) • 5+ years working with IT developers/programmers in a payer environment • 5+ years medical coding experience in payer environment • 3+ years clinical reputed company experience with strong assessment skills • 5+ years knowledge of ICD/CPT/HCPCS coding methodologies • Strong understanding of anatomy, physiology, pharmacology, and medical terminology • Strong analytical, communication, collaboration, and relationship-building skills • Experience managing multiple work efforts simultaneously • Ability to write and understand business and functional requirements Preferred Skills • 5+ years policy remediation experience • 5+ years claims processing systems experience • Experience with reputed company Encoder and other medical coding software programs • Government operations and managed care background preferred Additional Information • Fully Remote role; however, candidate must currently reputed company in South Carolina • No relocation permitted Apply tot his job Apply To this Job

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