Clinical IT Business Analyst & Coding SME (Healthcare)

Zohorecruit; West Columbia (TX); On-site; USD 85,000 - 110,000; Full time

Job summary

South Carolina Department of Health & Human Services (SCDHHS) seeks an IT Healthcare Consultant – Business Analyst – Advanced (Clinical Analyst and Coding Specialist) to support CPT/HCPCS and ICD-10 code maintenance and MMIS-related initiatives. The role requires healthcare experience, coding expertise and strong collaboration with policy and operations teams.

The position emphasizes serving as SME for coding methodologies, engaging with stakeholders, and guiding process improvements within the

Qualifications

• 3+ years’ experience in healthcare settings.
• Strong ICD/CPT/HCPCS translation knowledge.
• 3+ years anatomy, physiology, pharmacology and medical terminology.
• 3+ years writing formal business process documentation.

Responsibilities

• Initiates annual (and quarterly) ICD-10, CPT/HCPCS coding updates.
• Reviews codes to determine scope of changes.
• Prepares code change listings for staff review and analysis.
• Conducts meetings with agency personnel and stakeholders.
• Participates in DASH/MMIS project meetings as needed.
• Serves as SME for medical coding, Medicaid policy and related topics.
• Maintains business rules and models in a repository.
• Ensures training content is complete and up-to-date.

Skills

Healthcare experience

ICD/CPT/HCPCS knowledge

Anatomy & medical terminology

Business process documentation

Education

Bachelor’s degree in healthcare related field

CPC or CCS certification

Tools

Microsoft Office

Optum Encoder

Medical coding software

Job description

South Carolina Department of Health & Human Services (SCDHHS) seeks an IT Healthcare Consultant – Business Analyst – Advanced (Clinical Analyst and Coding Specialist) to support CPT/HCPCS and ICD-10 code maintenance and MMIS-related initiatives. The role requires healthcare experience, coding expertise and strong collaboration with policy and operations teams.

The position emphasizes serving as SME for coding methodologies, engaging with stakeholders, and guiding process improvements within the