Quick Overview
Seniority
Mid Senior
Work mode
On Site
Location
Columbia, SC, United States
Posted
Yesterday
Microsoft Office
Job Description
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:
Interested? Learn more:
Click the apply button to learn more about this position (#26-01218).
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 position’s 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.
- 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.
- 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
- Bachelor’s degree in healthcare related field.
- An equivalent combination of experience and education may be considered with prior Agency hiring team review and approval.
- Currently credentialed as CPC (Certified Professional Coder) or as CCS (Certified Coding Specialist).
- 3+ years’ experience healthcare hospital, office and clinic setting.
- Knowledge of Microsoft Office (Word, Excel, PowerPoint, Optum Encoder and other medical coding software programs).
Interested? Learn more:
Click the apply button to learn more about this position (#26-01218).
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