Employer Industry: Healthcare Consulting

Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Work as a subject matter expert in medical coding and Medicaid policy
- Engage in a multi-year project with a focus on consulting services
- Collaborative work environment with team-based responsibilities
- Contribute to important updates and changes in healthcare coding

What to Expect (Job Responsibilities):
- Assist with the maintenance of CPT/HCPCS and ICD-10 codes
- Initiate updates from CMS for coding changes and perform initial reviews
- Prepare code change listings for review and conduct meetings with stakeholders
- Serve as a subject matter expert for medical coding methodologies and Medicaid policy
- Collaborate with the team to ensure complete documentation and training content

What is Required (Qualifications):
- Current nursing license in South Carolina and/or multi-State license
- Credentialed as CPC (Certified Professional Coder) or CCS (Certified Coding Specialist)
- Minimum of 5 years' experience in healthcare insurance, medical review, or appeals
- Minimum of 3 years' clinical experience in a healthcare environment
- Strong knowledge of ICD, CPT, and HCPCS coding methodologies

How to Stand Out (Preferred Qualifications):
- Experience in policy remediation
- Familiarity with claims processing systems
- Knowledge of Microsoft Office (Word, Excel, PowerPoint, Optum Encoder)
- Experience working with IT developers/programmers in a payer environment

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