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Executive Order 11246, Section 503 & VEVRAA EOE, including disability/vets
MMIS Medical Coding ICDCPTHCPCS Coding Methodologies Consultant
(Jobs in Columb
 
Requirement id 99520
Job title Consultant
Job location in Columbia, SC
Skills required Written And Verbal Communication Skills, Mapping Business Process Flow, Healthcare Operations, MMIS Medical Coding ICDCPTHCPCS Coding M
Open Date 25-Oct-2019
Close Date
Job type Contract
Duration 12 Months
Compensation DOE
Status requirement ---
Job interview type ---
Apply
   Email Recruiter: coolsoft
Job Description Consultant: Written And Verbal Communication Skills, Mapping Business Process Flow, Healthcare Operations, MMIS Medical Coding ICDCPTHCPCS Coding M

start date:11/28/2019
submission deadline:11/1/2019

client info : Department of Health and Human Services

Description:

This project is a multi-year effort which primarily focuses on providing consulting services to operations and policy staff for the current MMIS while also participating in the planning for a new reference administration approach for the replacement system projects. It is necessary to build and sustain a strong Medical Coding staff who understands coding, aids staff in understanding CPT/HCPCS and ICD-10 coding and applies the codes correctly within the Reference Administration sub-system.

OBJECTIVES TO BE FULFILLED BY CANDIDATE:
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
• 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 and other affected parties
• Participate in Replacement MMIS project meetings as needed where reference administration expertise is required.
• Serves as a team expert on Medical Coding methodologies, Medicaid Policy and related topics.
• Researches business rules, requirements, and models.
• Maintains business rules, requirements, and models in a repository.
• Other project-related duties.

REQUIRED SKILLS (RANK IN ORDER OF IMPORTANCE):

• 15 years experience in healthcare insurance; medical review, program integrity, or appeals.
• 5 years experience working with IT developers/programmers in payer 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 to 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).
 
Call 502-379-4456 Ext 100 for more details. Please provide Requirement id: 99520 while calling.
 
Other jobs in SC: Beaufort (1), Blythewod (2), Blythewood (3), Charleston (17), Columbia (37), Greenville (4), Hartsville (2), North Charleston (2), Overland Park (1), San Francisco (1), SENECA (4), South Carolina (1), Spartanburg (3), Unknown (2),
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(Consultant: Written And Verbal Communication Skills, Mapping Business Process Flow, Healthcare Operations, MMIS Medical Coding ICDCPTHCPCS Coding M in Columbia, SC)
     
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