Clinical Analyst / Medical Coding Specialist

Zohorecruit; New York (NY); Hybrid; USD 90,000 - 130,000; Full time

Benefits offered by this job

Health insurance

Paid vacation

401K match

STD/LTD

AD&D

Job summary

Innosoft is seeking a Clinical Analyst / Medical Coding Specialist to support Medicaid MMIS in Columbia, SC with up to 80% remote work. You will serve as SME for CPT/HCPCS/ICD-10 coding and advise policy staff on coding and process improvements, ensuring accurate code application within the Reference Administration subsystem.

Responsibilities include maintaining code sets, coordinating CMS updates, preparing change listings, and collaborating with Agency personnel.

Qualifications

• Bachelor’s degree in healthcare related field or equivalent
• Must be credentialed as CPC or CCS (or both)

Responsibilities

• Assist with CPT/HCPCS and ICD-10 coding maintenance
• Initiate CMS updates for ICD-10 and CPT/HCPCS changes
• Review coding updates for scope and impact
• Prepare code-change listings for Reference Administration and Medicaid staff
• Conduct meetings with Agency personnel and stakeholders
• Participate in DASH project meetings when SME is required
• Serve as SME in medical coding methodologies and Medicaid policy
• Research business rules and models and provide initial analyses
• Maintain repository with rules and models
• Collaborate to maintain process docs and training content
• Provide backup support for claim escalation research
• Perform other project duties as assigned

Skills

3+ years of healthcare experience

ICD CPT HCPCS knowledge

Anatomy/Physiology knowledge

Business process documentation

Education

Bachelor’s degree in healthcare related field

CPC or CCS certification

Tools

Optum Encoder

Microsoft Office

Job description

Clinical Analyst / Medical Coding Specialist

Columbia, United States | Posted on 09/30/2026

Clinical Analyst / Medical Coding Specialist

Project Identifier

SC

Client

South Carolina

Agency

State of South Carolina

Location

80% Remote; onsite in Columbia, SC for requiredtrainings/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 frommanagement at the resource's expense. Strong preference for resources thatare local to SC, NC, or GA.

Contract Duration

12 Months

Interview Type

Online

The candidate will haveto be on an Innosoft W2.

At least 6 months of valid work authorization

Tentative Start Date

10/27/2026

Deadline

10/06/2026

Project Overview

This projectis a multi-year-old effort which primarily focuses on providing consultingservices to operations and policy staff for the current Medicaid ManagementInformation System (MMIS).

The currentposition’s focus and priority is the continued support of serving as a subjectmatter expert (SME), building knowledge that allows policy and process ownersto make the best recommendations for Medicaid members and providers. It isnecessary to build and sustain a strong staff who understands coding, aidsstaff in understanding CPT/HCPCS and ICD-10 coding and applies the codescorrectly within the Reference Administration sub-system.

Duties/Responsibilities:

• Assist with ongoing CPT/HCPCS and ICD-10 codemaintenance.
• Initiate annual and quarterly CMS updates forICD-10 and CPT/HCPCS coding changes.
• Review coding updates to determine the scope andimpact of changes.
• Prepare code-change listings for ReferenceAdministration 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) formedical coding methodologies, Medicaid policy, and related topics.
• Research business rules, requirements, andmodels and provide initial analysis and recommendations.
• Maintain business rules, requirements, andmodels in the designated repository.
• Collaborate with the team to maintain completeand current process documentation and training content for owners andstakeholders.
• Provide backup support for claim escalationresearch after demonstrating proficiency in the required job functions.
• Perform other project-related duties as assignedor required.

Requirements

Education and Certifications:

• Bachelor’s degree in healthcare related field. Anequivalent combination of experience and education may be considered with priorexperience 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 HCPCStranslation and coding methodologies.
• 3+ years of extensive knowledge of anatomy,physiology, pharmacology, and medical terminology.
• 3+ years of strong knowledge and experience withformal 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 medicalcoding software programs.
• Preference for candidates currently located inSouth Carolina, North Carolina, or Georgia.
• Candidates may reside anywhere in the U.S. butmust be willing to travel onsite to Columbia, SC, when requested by management,at their own expense.

Standard Employee Benefits.

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