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Clinical Analyst/Medical Coding Specialist

SYSTEMTEC

Clinical Analyst / Medical Coding Specialist

SYSTEMTEC is seeking a Clinical Analyst / Medical Coding Specialist for a remote opportunity for candidates working EST hours. Candidate will provide clinical coding and business analysis expertise within a complex healthcare environment, supporting the review, interpretation, and implementation of ICD-10, CPT, and HCPCS updates. The role will partner with healthcare, policy, operations, and technology stakeholders to document requirements, evaluate business impacts, and support ongoing healthcare system improvements.

Required Qualifications of the Clinical Analyst/Medical Coding Specialist:

  • Applicants must be authorized to work for any employer in the U.S. We are unable to provide sponsorship or work with Third-Party agencies.
  • Bachelor's degree in a healthcare-related field.
  • Current CPC (Certified Professional Coder) or CCS (Certified Coding Specialist) certification.
  • 3+ years of professional experience in healthcare.
  • 3+ years of experience with ICD-10, CPT, and HCPCS coding methodologies and code translation.
  • 3+ years of knowledge and practical application of anatomy, physiology, pharmacology, and medical terminology.
  • 3+ years of experience developing and maintaining formal business process documentation.
  • Strong analytical, research, communication, and stakeholder collaboration skills.
  • Ability to translate complex healthcare and coding requirements into clear business rules, processes, and recommendations.
  • Ability to travel to Columbia, South Carolina, for required onsite meetings and training at the candidate's own expense.

Preferred Skills/Experience of the Clinical Analyst/Medical Coding Specialist:

  • Experience in hospital, physician office, and/or clinical healthcare settings.
  • Familiarity with Microsoft Word, Excel, and PowerPoint.
  • Experience with Optum Encoder or comparable medical coding software.
  • Experience supporting Medicaid, healthcare claims, or healthcare information systems.
  • Experience with system modernization, process improvement, or business analysis initiatives.
  • Candidates located in South Carolina, North Carolina, or Georgia are strongly preferred.

Responsibilities of the Clinical Analyst/Medical Coding Specialist:

  • Coordinate and review annual and quarterly updates to ICD-10, CPT, and HCPCS coding standards, assessing changes and their potential business impact.
  • Prepare code-change reports and recommendations for policy, operations, administrative, and other stakeholder groups.
  • Conduct research and analysis of business rules, requirements, workflows, and processes related to healthcare coding and system functionality.
  • Serve as a subject matter expert on medical coding methodologies, healthcare terminology, and related Medicaid processes.
  • Maintain business requirements, process documentation, models, training materials, and related information within established repositories.
  • Participate in stakeholder meetings, system enhancement initiatives, process improvement efforts, and future healthcare technology modernization activities.

Work Location: Remote. EST hours.

Compensation / Benefits: Full-Time Employment with SYSTEMTEC means competitive compensation, access to health, dental, disability, and life coverage, and 401(k) with match. ***Please note: SYSTEMTEC is not set up to employ workers in the states of California, New York, and New Jersey.***

SYSTEMTEC
Vacancy posted 3 days ago
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