Hansen Talent Group is hiring a Business Analyst to work with a large enterprise in Columbia, SC. Government experience preferred.
What You'll Do: - 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.
- Conducts 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.
- Researches business rules, requirements, and models to complete initial analysis and recommendations.
- Maintains business rules, requirements, and models in a repository.
- Collaborates with team to ensure process documentation is complete, owner and stakeholder, as needed, training content is complete and routinely updated.
- Other project-related duties.
Required Skills (rank in order of Importance):- 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.
- trong knowledge of formal business process documentation.
- Ability to effectively communicate with executive management, line management, project management, and team members.
Work Experience:
- 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.
Required Education:
RN or LPN/Medical Coding Certification