Required Skills (rank in order of Importance):
- Five years’ experience in healthcare insurance; medical review, program integrity, or appeals.
- 5 years’ experience working with IT developers/programmers in a payor environment.
- 5 years’ experience Medical Coding in payer environment.
- Strong knowledge of ICD/CPT/HCPCS translation.
- Strong knowledge of ICD/CPT/HCPCS coding methodologies.
- Extensive knowledge of anatomy, physiology, pharmacology, and medical terminology.
- Superb written and oral communications skills, strong proficiency in English is required.
- Strong knowledge of formal business process documentation.
- Ability to effectively communicate with executive management, line management, project management, and team members.
Preferred Skills (rank in order of Importance):
- Experience in policy remediation.
- Claims processing systems experience.
- Knowledge of Microsoft Office (Word, Excel, PowerPoint, Optum Encoder and or other medical coding software programs).
Required Education:
RN or LPN in South Carolina and Medical Coding Certification
Required Certifications:
Current nursing license in South Carolina. Currently credentialed as CPC (Certified Professional Coder) or as CCS (Certified Coding Specialist). ICD-10 Proficiency demonstrated by exam.
Job Types: Full-time, Contract
Pay: $110.00 - $115.00 per hour
License/Certification:
- Current nursing license in South Carolina (Preferred)
- Currently credentialed as CPC or as CCS (Preferred)
- ICD-10 Proficiency demonstrated by exam (Preferred)
- RN or LPN in South Carolina (Preferred)
Work Location: Remote
