01Overview
Employer Industry: Healthcare IT Consulting
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Hybrid work model, requiring only 20% on-site presence
- Engaging work on complex, change-oriented projects
- Competitive salary with potential for bonuses
- Work with a motivated team and contribute to meaningful healthcare improvements
- Supportive employer committed to diversity and inclusion
What to Expect (Job Responsibilities):
- Assist with CPT/HCPCS and ICD-10 code maintenance and updates from CMS
- Conduct meetings with agency personnel, stakeholders, and process owners
- Serve as a subject matter expert (SME) for medical coding methodologies and Medicaid policy
- Research business rules, requirements, and models to provide analysis and recommendations
- Collaborate with the team to ensure process documentation and training content are complete and updated
What is Required (Qualifications):
- Minimum of 5 years in healthcare insurance; medical review, program integrity, or appeals
- Minimum of 5 years working with IT developers/programmers in a payor environment
- Minimum of 5 years in medical coding in a payer environment
- Minimum of 3 years clinical experience in a healthcare environment with strong assessment skills
- Current, active licensure by the State of South Carolina Board of Nursing as a Registered Nurse and CPC or CCS certification
How to Stand Out (Preferred Qualifications):
- 5+ years' experience in policy remediation
- 5+ years claims processing systems experience
- 5+ years knowledge of Microsoft Office
- 5+ years experience with Optum Encoder or other medical coding software programs
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Company : Remote Jobs
Salary : Work from home .
