Remote Clinical Coding Analyst & SME: CPT/HCPCS ICD-10

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

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.