Clinical Analyst Medical Coding Specialist
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Job Summary
Clinical Analyst / Medical Coding Specialist
Project Identifier | SC |
Client | South Carolina |
Agency | State of South Carolina |
Location | 80% Remote; onsite in Columbia SC for required trainings/meetings Location: 1201 Main Street Suite 600 Columbia SC USA 29201 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. |
Contract Duration | 12 Months |
Interview Type | Online |
Visa Requirements | The candidate will have to be on an Innosoft W2. At least 6 months of valid work authorization (Citizen GC EAD OPT-EAD H4-EAD) |
Tentative Start Date | 10/27/2026 |
Deadline | 10/06/2026 |
Project Overview
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 applies the codes correctly within the Reference Administration sub-system.
Duties/Responsibilities:
Assist with ongoing CPT/HCPCS and ICD-10 code maintenance.
Initiate annual and quarterly CMS updates for ICD-10 and CPT/HCPCS coding changes.
Review coding updates to determine the scope and impact of changes.
Prepare code-change listings for Reference Administration and Medicaid Program staff to review and analyze.
Conduct meetings with Agency personnel stakeholders and process owners.
Participate in future DASH (Replacement MMIS) project meetings when Reference Administration expertise is required.
Serve as a Subject Matter Expert (SME) for medical coding methodologies Medicaid policy and related topics.
Research business rules requirements and models and provide initial analysis and recommendations.
Maintain business rules requirements and models in the designated repository.
Collaborate with the team to maintain complete and current process documentation and training content for owners and stakeholders.
Provide backup support for claim escalation research after demonstrating proficiency in the required job functions.
Perform other project-related duties as assigned or required.
Education and Certifications:
Bachelors degree in healthcare related field. An equivalent combination of experience and education may be considered with prior experience review and approval.
Must be currently credentialed as either a CPC (Certified Professional Coder) or CCS (Certified Coding Specialist).
Required Skills:
3 years of experience in healthcare.
Strong knowledge of ICD CPT and HCPCS translation and coding methodologies.
3 years of extensive knowledge of anatomy physiology pharmacology and medical terminology.
3 years of strong knowledge and experience with formal business process documentation.
Preferred Skills:
3 years of healthcare experience in a hospital medical office or clinical setting.
Knowledge of Microsoft Office including Word Excel and PowerPoint.
Experience with Optum Encoder and other medical coding software programs.
Preference for candidates currently located in South Carolina North Carolina or Georgia.
Candidates may reside anywhere in the U.S. but must be willing to travel onsite to Columbia SC when requested by management at their own expense.
Required Skills:
Required Skills: 3 years of experience in healthcare. Strong knowledge of ICD CPT and HCPCS translation and coding methodologies. 3 years of extensive knowledge of anatomy physiology pharmacology and medical terminology. 3 years of strong knowledge and experience with formal business process documentation. Preferred Skills: 3 years of healthcare experience in a hospital medical office or clinical setting. Knowledge of Microsoft Office including Word Excel and PowerPoint. Experience with Optum Encoder and other medical coding software programs. Preference for candidates currently located in South Carolina North Carolina or Georgia. Candidates may reside anywhere in the U.S. but must be willing to travel onsite to Columbia SC when requested by management at their own expense.
Required Education:
Bachelors degree in a related field. An equivalent combination of experience and education may be considered with prior be currently credentialed as either a CPC (Certified Professional Coder) or CCS (Certified Coding Specialist).
