HCPCS Analyst

HCPCS Analyst (Jobs in Columbia, SC) Requirement id 158239 Job title Analyst Job location in Columbia, SC Skills required Healthcare Insurance, IT Developer, Critical Thinking, HCPCS Open Date 18-May-2026 Close Date Job type Contract Duration 12 Months Compensation DOE Status requirement

• Job interview type

•

Email Recruiter:

coolsoft

Job Description Analyst:

Healthcare Insurance, IT Developer, Critical Thinking, HCPCS Start date :6/23/2026

End Date :

12 Months from projected start date Submission deadline :05/27 at 5:00 PM EST.

Client Info :

SCDHHS Note:

Interview Process:

1 round, Virtual/Online

• Duration of the

Contract:

12 months

Work Location:

Fully Remote

Candidate Location:

Candidate MUST be a SC resident. No relocation allowed.

Description:

OBJECTIVES TO BE FULFILLED BY CANDIDATE

The principal duties of this position are to assist with the CPT/HCPCS and ICD-10 code maintenance. As the IT Healthcare Consultant

• Business Analyst
• Advanced (Clinical Analyst and Coding Specialist): 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, 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.
• Research 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.
• May serve as a back-up to review patient records against established criteria to determine medical necessity.
• Other project-related duties.
• 5+ years written and oral communications skills, strong proficiency in English.
• Knowledge of Microsoft Office Suite

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 State of South Carolina 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. Call502-379-4456 Ext 100for more details.

Please provide Requirement id:

158239 while calling. EOE Protected Veterans/Disability