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Healthcare Business Analyst (Remote MUST be a SC resident)

Job

Elegant Enterprise Wide Solutions

Full-Time

Posted 6 days ago (Updated 5 hours ago) • Actively hiring

Expires 6/25/2026

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Job Description

REQUIRED SKILLS
(RANK
IN ORDER OF IMPORTANCE
): 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 SKILLS
(RANK
IN ORDER OF IMPORTANCE
): 5+ years' experience in policy remediation. 5+ years claims processing systems experience. 5+ years Optum Encoder and/or other medical coding software programs
REQUIRED EDUCATION
Bachelor of Science in Nursing (BSN) or Associate Degree in Nursing (ADN)
REQUIRED CERTIFICATIONS
Must have current, active, and non-restricted licensure by the SC 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.