South Carolina Licensed Healthcare Consultant
Job Summary
To support healthcare initiatives, the part-time contract Healthcare Consultant will analyze business processes, collaborate with IT developers, and ensure compliance with coding standards while working in a hybrid environment based in South Carolina.
Key responsibilities
- Analyze and improve healthcare business processes in collaboration with IT teams
- Ensure adherence to medical coding standards and regulations
- Conduct medical reviews and manage appeals related to healthcare insurance
Required qualifications
- Bachelor of Science in Nursing (BSN) or Associate Degree in Nursing (ADN)
- Current, active, and non-restricted South Carolina Registered Nurse licensure
- Credentialed as CPC (Certified Professional Coder) or CCS (Certified Coding Specialist)
- 10+ years of experience in healthcare insurance, medical review, or program integrity
- 5+ years of clinical experience in a healthcare environment
Complete Job Description
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