IT Healthcare Consultant Business Analyst Advanced (Clinical Analyst and

Employer Industry: Healthcare IT Consulting Why consider this job opportunity: - Opportunity for career advancement and growth within the organization - Hybrid work model, requiring only 20% on-site presence - Engaging work on complex, change-oriented projects - Competitive salary with potential for bonuses - Work with a motivated team and contribute to meaningful healthcare improvements - Supportive employer committed to diversity and inclusion What to Expect (Job Responsibilities): - Assist with CPT/HCPCS and ICD-10 code maintenance and updates from CMS - Conduct meetings with agency personnel, stakeholders, and process owners - Serve as a subject matter expert (SME) for medical coding methodologies and Medicaid policy - Research business rules, requirements, and models to provide analysis and recommendations - Collaborate with the team to ensure process documentation and training content are complete and updated What is Required (Qualifications): - Minimum of 5 years in healthcare insurance; medical review, program integrity, or appeals - Minimum of 5 years working with IT developers/programmers in a payor environment - Minimum of 5 years in medical coding in a payer environment - Minimum of 3 years clinical experience in a healthcare environment with strong assessment skills - Current, active licensure by the State of South Carolina Board of Nursing as a Registered Nurse and CPC or CCS certification How to Stand Out (Preferred Qualifications): - 5+ years' experience in policy remediation - 5+ years claims processing systems experience - 5+ years knowledge of Microsoft Office - 5+ years experience with Optum Encoder or other medical coding software programs #HealthcareIT #MedicalCoding #ConsultingServices #CareerOpportunity #HybridWork "We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately. We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer." Apply To this Job Company : Remote Jobs Salary : Work from home .