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.***