Senior Clinical Coding & Business Analysis Expert

Intellibee; Columbia (SC); On-site; USD 85,000 - 110,000; Full time

Benefits offered by this job

Long-Term Stability

Comprehensive Health Coverage

Future Planning (401k)

Green Card assistance

Job summary

IntelliBee in Columbia, SC seeks an IT Healthcare Consultant – Business Analyst – Advanced (Clinical Analyst and Coding Specialist) to support CPT/HCPCS and ICD-10 code maintenance, lead annual and quarterly CMS updates, and act as SME for medical coding and Medicaid policy.

The role requires 3+ years in healthcare, strong coding methodologies, and solid experience with business process documentation; travel to onsite in Columbia may be required.

Qualifications

• 3+ years’ experience in healthcare.
• Strong knowledge of ICD/CPT/HCPCS translation and coding methodologies.
• 3+ years extensive knowledge of anatomy, physiology, pharmacology, and medical terminology.
• 3+ years of strong knowledge of 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 Agency personnel, stakeholders, and process owners.
• (Future) Participates in DASH (Replacement MMIS) project meetings, as needed, where reference administration expertise is required.
• Serves as an agency 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 with team to ensure process documentation is complete, owner and stakeholder, as needed, training content is complete and routinely updated.
• May serve as a back-up to other roles within the bureau to support claim escalations research, once the person has demonstrated full proficiency in the job functions required for their new role
• Other project-related duties, as assigned or required

Skills

Healthcare experience

Coding methodologies

Anatomy knowledge

Business process documentation

Education

Bachelor's degree in healthcare-related field

Tools

Microsoft Office

Optum Encoder

Medical coding software

Job description

IntelliBee in Columbia, SC seeks an IT Healthcare Consultant – Business Analyst – Advanced (Clinical Analyst and Coding Specialist) to support CPT/HCPCS and ICD-10 code maintenance, lead annual and quarterly CMS updates, and act as SME for medical coding and Medicaid policy.

The role requires 3+ years in healthcare, strong coding methodologies, and solid experience with business process documentation; travel to onsite in Columbia may be required.