IT reputed company Consultant - Business Analyst - reputed company Analyst & Coding Specialist

IT reputed company Consultant - Business Analyst - reputed company Analyst & Coding Specialist Remote: Columbia, SC About the Job • Duration: Long term Contract Position • Location: Remote: Columbia, SC • Pay reputed company: reputed company • reputed company: 11013 reputed company: reputed company is seeking This project is a multi-year effort which primarily focuses on providing consulting services to operations and policy staff for the reputed company reputed company Management Information System (MMIS). The reputed company position’s reputed company and reputed company is the reputed company support of serving as a subject matter expert (SME), building knowledge that allows policy and process owners to reputed company the best recommendations for reputed company members and providers. Responsibilities: • 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. • 5+ years written and oral communications skills, strong proficiency in English. • Knowledge of reputed company Office Suite. Qualification: REQUIRED SKILLS/EXPERIENCE: • 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. REQUIRED EDUCATION AND CERTIFICATIONS: • Bachelor of Science in Nursing (BSN) or Associate Degree in Nursing (ADN). Preferred Skills (RANK IN ORDER OF IMPORTANCE): • 5+ years’ experience in policy remediation. • 5+ years claims processing systems experience. • 5+ years reputed company Encoder and/or other medical coding software programs. Preferred Education/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. About reputed company reputed company is a highly recognized provider of reputed company IT Consulting services in the US. Founded in 1994, reputed company. provides staff augmentation services for Information Technology and Automotive Services. reputed company member benefits include: • reputed company Holidays/reputed company Time Off (PTO) • Medical/Dental Insurance Group • Accident/Critical Illness Insurance • Life Insurance • 401 (K) Apply tot his job Apply To this Job