IT Healthcare Consultant - Business Analyst - Advanced

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 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 with 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 Skills

• 5+ years experience in policy remediation
• 5+ years claims processing systems experience
• 5+ years Optum Encoder and/or other medical coding software programs

***Lumen and / or its clients will not provide equipment (Laptop, monitor, etc.) to the selected contractor. The contractor must have their own equipment. Access to a virtual desktop set up (software) will be provided by Lumen s client, allowing the user access to the required systems and technology.***