Clinical Analyst / Medical Coding Specialist

Innosoft Corporation; Columbia (SC); Hybrid; USD 70,000 - 90,000; Full time

Benefits offered by this job

50% Health Insurance Paid by Innosoft

Paid Vacation

401K Match

STD LTD and AD&D paid by Innosoft

Job summary

Innosoft Corporation seeks a Clinical Analyst / Medical Coding Specialist to support Medicaid MMIS efforts. The role emphasizes SME-level coding accuracy, CPT/HCPCS and ICD-10 updates, and stakeholder engagement.

You will review CMS changes and assist with annual coding updates in a dynamic project environment. Ideal candidates have 3+ years in healthcare, credentials CPC or CCS, and strong command of medical terminology and documentation practices.

Qualifications

• Bachelor’s degree in a healthcare-related field or equivalent experience.
• Must hold CPC or CCS credentialed status.
• 3+ years in healthcare with CPT/HCPCS and ICD-10 coding knowledge.

Responsibilities

• Maintenance of CPT/HCPCS and ICD-10 codes and CMS updates.
• Prepare code-change listings and review changes with stakeholders.
• Serve as SME for medical coding methodologies and Medicaid policy.
• Collaborate to maintain documentation and training content.

Skills

CPT/HCPCS coding

Medical terminology

Anatomy knowledge

CMS updates handling

Documentation of process

Education

Bachelor’s degree in healthcare

Equivalent experience considered

Tools

Optum Encoder

Microsoft Word

Excel

PowerPoint

Job description

Clinical Analyst / Medical Coding Specialist

Project Identifier

SC

Client

South Carolina

Agency

State of South Carolina

Location

80% Remote; onsite in Columbia, SC for required
trainings/meetings

Location: 1201 Main Street Suite 600, Columbia, SC, USA,
29201

Candidate location: Resource can reside anywhere in the US
- must be willing to travel onsite to Columbia, SC within notice from
management at the resource's expense. Strong preference for resources that
are local to SC, NC, or GA.

Contract Duration

12 Months

Interview Type

Online

Visa Requirements

The candidate will have
to be on an Innosoft W2.
At least 6 months of valid work authorization
(Citizen, GC, EAD, OPT-EAD, H4-EAD)

Tentative Start Date

10/27/2026

Deadline

10/06/2026

Project Overview

This project
is a multi-year-old effort which primarily focuses on providing consulting
services to operations and policy staff for the current Medicaid Management
Information System (MMIS).

The current
position’s 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. It is
necessary to build and sustain a strong 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.

Duties/Responsibilities:

• Assist with ongoing CPT/HCPCS and ICD-10 code maintenance.
• Initiate annual and quarterly CMS updates for ICD-10 and CPT/HCPCS coding changes.
• Review coding updates to determine the scope and impact of changes.
• Prepare code-change listings for Reference Administration and Medicaid Program staff to review and analyze.
• Conduct meetings with Agency personnel, stakeholders, and process owners.
• Participate in future DASH (Replacement MMIS) project meetings when Reference Administration expertise is required.
• Serve as a Subject Matter Expert (SME) for medical coding methodologies, Medicaid policy, and related topics.
• Research business rules, requirements, and models and provide initial analysis and recommendations.
• Maintain business rules, requirements, and models in the designated repository.
• Collaborate with the team to maintain complete and current process documentation and training content for owners and stakeholders.
• Provide backup support for claim escalation research after demonstrating proficiency in the required job functions.
• Perform other project-related duties as assigned or required.

Requirements

Education and Certifications:

• Bachelor’s degree in healthcare related field. An equivalent combination of experience and education may be considered with prior experience review and approval.
• Must be currently credentialed as either a CPC (Certified Professional Coder) or CCS (Certified Coding Specialist).

Required Skills:

• 3+ years of experience in healthcare.
• Strong knowledge of ICD, CPT, and HCPCS translation and coding methodologies.
• 3+ years of extensive knowledge of anatomy, physiology, pharmacology, and medical terminology.
• 3+ years of strong knowledge and experience with formal business process documentation.

Preferred Skills:

• 3+ years of healthcare experience in a hospital, medical office, or clinical setting.
• Knowledge of Microsoft Office, including Word, Excel, and PowerPoint.
• Experience with Optum Encoder and other medical coding software programs.
• Preference for candidates currently located in South Carolina, North Carolina, or Georgia.
• Candidates may reside anywhere in the U.S. but must be willing to travel onsite to Columbia, SC, when requested by management, at their own expense.

Benefits

Standard Employee Benefits.
50% Health Insurance Paid by Innosoft, Paid Vacation, 401K Match, STD LTD and AD&D paid by Innosoft.