Business Analyst

DPP is seeking a Business Analyst for an opportunity with our client in Columbia SC.

Work Location: Hybrid in Columbia SC; 80% remote
Duration: 12 months with possibility of extension
Terms: W2 Contract
Candidate Location: Can reside anywhere in the US; must be willing to travel onsite to Columbia SC. Strong preference for candidates local to SC NC or GA.

Position Summary:

• This project is a multi-year-old effort which primarily focuses on providing consulting services to operations and policy staff for the current Medicaid Management Information System (MMIS).
• The current positions focus and priority is the continued support of serving as a subject matter expert (SME) building knowledge that allows policy and process owners to make the best recommendations for Medicaid members and providers.
• It is necessary to build and sustain a strong staff who understands coding aids staff in understanding CPT/HCPCS and ICD-10 coding and apply the codes correctly within the Reference Administration sub-system.
• The principal duties of this position are to assist with the CPT/HCPCS and ICD-10 code maintenance.

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.
• Conduct 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.
• Collaborate 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.

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

Required Education:

• Bachelors degree in healthcare related field.
• An equivalent combination of experience and education may be considered with prior Agency hiring team review and approval.

Required Certifications:

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

Preferred Qualifications:

• 3 years experience healthcare hospital office and clinic setting.
• Knowledge of Microsoft Office (Word Excel PowerPoint Optum Encoder and other medical coding software programs).

Authorized US Worker - US Citizens and those authorized to work in the US are encouraged to apply. We are unable to sponsor at this time.

Interested Learn more:
Click the apply button to learn more about this position (#26-01218).

DP Professionals (DPP) offers a range of compensation and benefits packages to our employees and their eligible dependents. DPP is a certified Woman-owned Small Business Enterprise (WBE and WOSB) with more than 25 years in the staffing industry. EOE/AA/V/D

Required Experience:

IC