State Government Project Need South Carolina Consultants Only
No relocation is allowed
Respond with your updated resume and contact details to the specified email.
Collaborate with internal teams to analyze projects and provide expert coding support.

Bachelor of Science in Nursing (BSN) or Associate Degree in Nursing (ADN)
Must have current, active, and non-restricted licensure by the State of South Carolina Board of Nursing as a Registered Nurse.
Currently credentialed as CPC (Certified Professional Coder) or as CCS (Certified Coding Specialist).
ICD-10 Proficiency demonstrated by exam; or able to become certified within one year of employment
5+ years in healthcare insurance; medical review, program integrity, or appeals
5+ years working with IT developers/programmers in a payor environment.
5+ years Medical Coding in payer environment
3+ years clinical experience in a healthcare environment (strong clinical assessment and critical thinking skills.)
5+ years knowledge of ICD/CPT/HCPCS translation and coding methodologies.
5+ years’ knowledge of anatomy, physiology, pharmacology, and medical terminology.
Preferred Qualifications: 5+ years’ experience in policy remediation.
5+ years claims processing systems experience.
5+ years knowledge of Microsoft Office
5+ years Optum Encoder and/or other medical coding software programs.

IT Clinical and Coding Specialist

Key skills