Remote Healthcare IT Consultant & Coding Specialist

VIVA USA Inc; Columbia (SC); Hybrid; USD 80,000 - 120,000; Full time

Benefits offered by this job

Remote work

Onsite trainings

Equal opportunity employer

Job summary

VIVA USA Inc. seeks an IT Healthcare Consultant - Business Analyst - Advanced (Clinical Analyst and Coding Specialist) to support Medicaid MMIS coding and policy work, focusing on CPT/HCPCS and ICD-10 updates. Remote work is available 80% with onsite trainings in Columbia, SC.

The role requires healthcare experience, coding proficiency, and strong documentation skills; you will liaison with CMS and internal teams, maintain coding rules, and prepare change listings for review.

Qualifications

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

Responsibilities

• Initiates annual (and quarterly) updates from CMS of all ICD-10, CPT/HCPCS coding changes.
• Performs initial review of codes to determine scope of changes.
• Prepares listings of codes changes to Reference Administration staff and Medicaid Program staff for review and analysis.
• Conducts meetings with client personnel, stakeholders, and process owners.
• May participate in DASH project meetings where reference administration expertise is required.
• Serves as an client subject matter expert (SME) for medical coding methodologies, Medicaid policy, and related topics.
• Research business rules, requirements, and models to complete initial analysis and recommendations.
• Maintains business rules, requirements, and models in a repository.
• Collaborates to ensure process documentation is complete, owner and stakeholder training content is complete and routinely updated.
• May serve as a back-up to other roles within the bureau to support claim escalations research.
• Other project-related duties, as assigned or required

Skills

Healthcare experience

CPT/HCPCS coding

Anatomy knowledge

Business process docs

Education

Bachelor’s degree in healthcare

Tools

Microsoft Office

Optum Encoder

Medical coding software

Job description

VIVA USA Inc. seeks an IT Healthcare Consultant - Business Analyst - Advanced (Clinical Analyst and Coding Specialist) to support Medicaid MMIS coding and policy work, focusing on CPT/HCPCS and ICD-10 updates. Remote work is available 80% with onsite trainings in Columbia, SC.

The role requires healthcare experience, coding proficiency, and strong documentation skills; you will liaison with CMS and internal teams, maintain coding rules, and prepare change listings for review.