Medicaid Coding SME & Clinical Analyst (Remote)

Innosoft Corp.; Columbia (SC); Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

50% Health Insurance Paid by Innosoft

Paid Vacation

401K Match

STD/LTD and AD&D

Job summary

Innosoft Corp. seeks a Clinical Analyst / Medical Coding Specialist to support MMIS-related coding and policy analysis from a mainly remote position with required onsite trainings in Columbia, SC.

The role requires current CPC or CCS credentials and at least 3 years of healthcare coding experience. The candidate will serve as SME for CPT/HCPCS/ICD-10 coding, support CMS updates, and collaborate with Agency staff.

Qualifications

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

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 scope and impact of changes.
• Prepare code-change listings for Reference Administration and Medicaid staff to review.
• Conduct meetings with Agency personnel, stakeholders, and process owners.
• Participate in future DASH project meetings when SME expertise is required.
• Serve as SME for medical coding methodologies and Medicaid policy.
• Research business rules and models and provide initial analysis and recommendations.
• Maintain documentation and training content for owners and stakeholders.
• Provide backup support for claim escalation research.

Skills

Healthcare experience

ICD/CPT/HCPCS coding

Anatomy & physiology

Business process documentation

Education

Bachelor's degree in healthcare

CPC or CCS certification

Tools

Microsoft Office

Optum Encoder

Job description

Innosoft Corp. seeks a Clinical Analyst / Medical Coding Specialist to support MMIS-related coding and policy analysis from a mainly remote position with required onsite trainings in Columbia, SC.

The role requires current CPC or CCS credentials and at least 3 years of healthcare coding experience. The candidate will serve as SME for CPT/HCPCS/ICD-10 coding, support CMS updates, and collaborate with Agency staff.