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Healthcare Insurance Medical Coding Analyst
(Jobs in Columbia, SC)
 
Requirement id 149807
Job title Analyst
Job location in Columbia, SC
Skills required Verbal Communication, Written Communication Skills, Technical Peers, Healthcare Insurance Medical Coding
Open Date 02-Oct-2024
Close Date
Job type Contract
Duration 12 Months
Compensation DOE
Status requirement ---
Job interview type ---
   Email Recruiter: coolsoft
Job Description Analyst: Verbal Communication, Written Communication Skills, Technical Peers, Healthcare Insurance Medical Coding

Position Title: Reference Administration Business Analyst And Coding Specialist - Lead-11401-1

start date :11/12/2024

submission deadline : 10/10/2024

client info : Department of Health and Human Services

Note:

Q) INTERVIEW PROCESS (who will conduct i/v, phone or in-person, how many rounds of i/v)?

A) Phone for the initial interview. In-person or video may be used for secondary interview(s)

Q) SCHEDULE INTERVIEW: How soon can you schedule an interview (date / times)?

A) Once qualified resumes and candidates have been received.



Description :


***Please see the education and certification that is needed**
This is very specific and candidates submitted must have these requirements.

SCOPE OF THE PROJECT:
This project is a multi-year effort which primarily focuses on providing consulting services to operations and policy staff for the current MMIS.

The current positions focus and priority is the continued support of serving as a subject matter expert (SME), building knowledge that allows policy and process owners to make the best recommendations for Medicaid members and providers. A long-term plan includes participating and providing guidance in the administrative approach for the replacement management system. It is necessary to build and sustain a strong Medical Coding staff who understands coding, aids staff in understanding CPT/HCPCS and ICD-10 coding and applies the codes correctly within the Reference Administration sub-system.

OBJECTIVES TO BE FULFILLED BY CANDIDATE:
The principal duties of this position are to assist with the CPT/HCPCS and ICD-10 code maintenance.

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.
• 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.
• Researches 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.
• Other project-related duties.

REQUIRED SKILLS (RANK IN ORDER OF IMPORTANCE):
• Five 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 translation.

• Strong knowledge of ICD/CPT/HCPCS coding methodologies.

• Extensive knowledge of anatomy, physiology, pharmacology, and medical terminology.

• Superb written and oral communications skills, strong proficiency in English is required.

• Strong knowledge of formal business process documentation.

• Ability to effectively communicate with executive management, line management, project management, and team members.


PREFERRED SKILLS (RANK IN ORDER OF IMPORTANCE):
• Experience in policy remediation.

• Claims processing systems experience.

• Knowledge of Microsoft Office (Word, Excel, PowerPoint, Optum Encoder and or other medical
 
Call 502-379-4456 Ext 100 for more details. Please provide Requirement id: 149807 while calling.
 
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(Analyst: Verbal Communication, Written Communication Skills, Technical Peers, Healthcare Insurance Medical Coding in Columbia, SC)
     
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