IT Clinical and Coding Specialist - Only for South Carolina Residents

Job Description

Job DescriptionPosition - Contract - Hybrid (Columbia- SC) - State Government Project
Need South Carolina Consultants Only - No relocation is allowed
Required Skills

• 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.

If this opportunity aligns with your background and career goals, please respond with your updated resume and contact details to sivarajan.s@zirlen.com. You may also feel free to reach out at 972-433-6033, Ext. 1005.