Business Analyst

DP Professionals

🇺🇸 United States

Hybrid

Staff / Principal

4 days ago

CPT
HCPCS
ICD-10
CMS
medical coding
medical terminology
Certified Coding Specialist
Excel
PowerPoint

4 days ago

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DPPis seeking aBusiness Analystfor 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:

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.

Responsibilities:

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.

Required Qualifications:

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

Required Education:

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.

Required Certifications:

Currently credentialed as CPC (Certified Professional Coder) or as CCS (Certified Coding Specialist).

Preferred Qualifications:

3+ years’ experience healthcare hospital, office and clinic setting.
Knowledge of Microsoft Office (Word, Excel, PowerPoint, Optum Encoder and other medical coding software programs).

Authorized US Worker- US Citizens and those authorized to work in the US are encouraged to apply. We are unable to sponsor at this time.

Interested? Learn more:
Click theapplybutton to learn more about this position(#26-01218).

DP Professionals (DPP) offers a range of compensation and benefits packages to our employees and their eligible dependents.DPP is a certified Woman-owned Small Business Enterprise (WBE and WOSB) with more than 25 years in the staffing industry.EOE/AA/V/D

Business Analyst · DP Professionals

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