Business Analyst - Project Lead at Zolon Tech Solutions, Inc.

Columbia, SC

Title : Business Analyst - Project Lead
Location : Columbia SC
Duration : 12 Months

Job Description:

The principal duties of this position are to assist with the CPT/HCPCS and ICD-10 code maintenance.
Specific duties include, but are not limited to:
Initiates annual (and quarterly) updates from CMS of all ICD-10, CPT/HCPCS coding changes.
(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.
Collaborates with team to ensure process documentation is complete, owner and stakeholder, as needed, training content is complete and routinely updated.

Required Skills (Rank In Order Of Importance):

5 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.
3 years’ clinical experience in a healthcare 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.

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:

Required Certifications:

Current nursing license AND 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

Thanks & Regards,
Sai Sree Kuncha
Zolon Tech