IT Healthcare Consultant - Business Analyst - Advanced (Clinical Analyst and Coding Specialist)

Remote Full-time
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

#HealthcareIT #MedicalCoding #ConsultingServices #CareerOpportunity #HybridWork

"We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately. We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer."

Apply Now

Apply Now
Apply Now →

Similar Jobs

Experienced Registered Behavior Technician for In-Home ABA Therapy - Atlanta, GA

Remote

Immediate Hiring: Experienced Registered Behavioral Technician (RBT) for Clinic-Based ABA Therapy Services

Remote

Experienced Registered Behavioral Technician (RBT) - ABA Therapy for Children with Autism Spectrum Disorder

Remote

Experienced Registered Nurse - Telehealth: Providing Remote Care Coordination and Patient Support

Remote

Experienced Substitute Teacher for Riverside County Schools - Join Scoot Education's Innovative Team

Remote

Experienced Substitute Teacher for San Bernardino County - Flexible Schedules & Competitive Pay

Remote

Experienced School Year Instructional Coach for High-Dosage Tutoring Programs in Edgewater Park, NJ

Remote

Experienced School Year Tutor for K-8 Students in Math and Literacy - Mickleton, NJ

Remote

Experienced Secondary Social Studies Teacher for Kansas - Flexible Hybrid Remote Arrangement

Remote

USPS Office Helper

Remote

Data Entry Remote Jobs-JetBlue Airline At Home ...

Remote

Senior Director, External Manufacturing Procurement

Remote

HubSpot CRM Specialist

Remote

**Experienced Customer Service Representative – Part-Time Opportunity at arenaflex**

Remote

Online Member Support Representative - No Experience Required

Remote

[FULL TIME Remote] Territory Sales Manager - Womens Health

Remote

Brand Designer

Remote

Représentant.e du service à la clientèle, Indemnisation

Remote

Member Support Specialist

Remote

Sales Director - West Coast, Atlanta or Chicago

Remote
← Back