Role Description
Candidate will provide clinical coding and business analysis expertise within a complex healthcare environment, supporting the review, interpretation, and implementation of ICD-10, CPT, and HCPCS updates. The role will partner with healthcare, policy, operations, and technology stakeholders to document requirements, evaluate business impacts, and support ongoing healthcare system improvements.
Qualifications
-
Applicants must be authorized to work for any employer in the U.S. We are unable to provide sponsorship or work with Third-Party agencies.
-
Bachelorโs degree in a healthcare-related field.
-
Current CPC (Certified Professional Coder) or CCS (Certified Coding Specialist) certification.
-
3+ years of professional experience in healthcare.
-
3+ years of experience with ICD-10, CPT, and HCPCS coding methodologies and code translation.
-
3+ years of knowledge and practical application of anatomy, physiology, pharmacology, and medical terminology.
-
3+ years of experience developing and maintaining formal business process documentation.
-
Strong analytical, research, communication, and stakeholder collaboration skills.
-
Ability to translate complex healthcare and coding requirements into clear business rules, processes, and recommendations.
-
Ability to travel to Columbia, South Carolina, for required onsite meetings and training at the candidateโs own expense.
Requirements
-
Experience in hospital, physician office, and/or clinical healthcare settings.
-
Familiarity with Microsoft Word, Excel, and PowerPoint.
-
Experience with Optum Encoder or comparable medical coding software.
-
Experience supporting Medicaid, healthcare claims, or healthcare information systems.
-
Experience with system modernization, process improvement, or business analysis initiatives.
-
Candidates located in South Carolina, North Carolina, or Georgia are strongly preferred.
Responsibilities
-
Coordinate and review annual and quarterly updates to ICD-10, CPT, and HCPCS coding standards, assessing changes and their potential business impact.
-
Prepare code-change reports and recommendations for policy, operations, administrative, and other stakeholder groups.
-
Conduct research and analysis of business rules, requirements, workflows, and processes related to healthcare coding and system functionality.
-
Serve as a subject matter expert on medical coding methodologies, healthcare terminology, and related Medicaid processes.
-
Maintain business requirements, process documentation, models, training materials, and related information within established repositories.
-
Participate in stakeholder meetings, system enhancement initiatives, process improvement efforts, and future healthcare technology modernization activities.
Work Location
Remote. EST hours.
Compensation / Benefits
-
Full-Time Employment with SYSTEMTEC means competitive compensation.
-
Access to health, dental, disability, and life coverage.
-
401(k) with match.
Please note:
SYSTEMTEC is not set up to employ workers in the states of California, New York, and New Jersey.