IT - SCDHHS - IT Healthcare Consultant - Business Analyst - Advanced - Clinical Analyst

Interview Process: 1 round, Virtual/Online

Duration of the Contract: 12 months Possibility for Extension: Yes

Work Location: 80% remote, resources will need to come onsite in Columbia, SC to certain trainings/meetings

Candidate Location: Resource can reside anywhere in the US - must be willing to travel onsite to Columbia, SC within notice from management at the resources expense.

Strong preference for resources that are local to SC, NC, or GA.

Objectives to Be Fulfilled by Candidate:

The principal duties of this position are to assist with the CPT/HCPCS and ICD-10 code maintenance. As the IT Healthcare Consultant Business Analyst Advanced (Clinical Analyst and Coding Specialist):

Specific duties include, but are not limited to:

• 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

Preferred Skills (rank in order of Importance):

• 3+ years' experience healthcare hospital, office and clinic setting
• Knowledge of Microsoft Office (Word, Excel, PowerPoint, Optum Encoder and other medical coding software programs)
• Other: preference for resources that are local to SC, NC, or GA. Resources can reside anywhere in the US but must be willing to travel onsite to Columbia, SC within notice from management at the resources expense.

Required Certifications:

Currently credentialed as CPC (Certified Professional Coder) or as CCS (Certified Coding Specialist).

Schedule Interview: How soon can you schedule an interview (date / times)?

Once qualified resumes and candidates have been received.

ADDITIONAL SKILLS / Notes:

• Written and oral communications skills, strong proficiency in English
• Ability to effectively communicate with executive management, line management, project management, and team members