IT Business Analyst II (Medical Coding Analyst) / 61070479

The Agency's mission is to be boldly innovative in improving the health and quality of life for South Carolinians.
This position is located inBureau of Provider & Support Services, Richland County.
This is an in-office role and not a telecommute or remote position.
Are you the One? We are looking for anIT Business Analyst II (Medical Coding Analyst)who is responsible for monitoring, interpreting, and implementing updates to ICD 10 CM, CPT, and HCPCS code sets, as well as related regulatory and payer specific guidelines.

This role ensures the organization’s coding practices remain current and compliant by analyzing coding changes, updating internal reference materials, and supporting stakeholders and clinical staff through education and clarification.

In collaboration with the Program Manager, the Medical Coding Analyst also evaluates documentation and coding trends to identify opportunities for improvement and maintain the accuracy and integrity of coded data across SCDHHS.

• Monitor incoming tickets to ensure proper procedures and timeliness standards are followed. Conduct data analysis and prepare reports regarding adherence to procedures and timeliness standards. Ensure that any issues that cannot be resolved by frontline staff are escalated as needed. Learn the business processes that govern issue resolution and monitor appropriate implementation within the service management tool.
• Responsible for reviewing, interpreting, and implementing updates to ICD-10-CM, CPT, HCPCS, and related coding guidelines within organizational systems and workflows. Ensures all coding tools, reference materials, and internal processes reflect current standards by coordinating updates across encoders, EHR platforms, and internal documentation. Conducts quality reviews to validate the accuracy and completeness of coding changes, identifies discrepancies or system issues, and collaborates with coding staff, IT teams, and compliance personnel to resolve them. Monitors coding trends post-updates, provides clarification and education as needed, and maintains thorough documentation of all changes to support consistency, compliance, and continuous improvement.
• Responsible for reviewing, updating, and maintaining all medical coding reference policies and procedures to ensure alignment with current ICD-10-CM, CPT, HCPCS, and regulatory guidelines. Evaluates coding standards and organizational practices to identify required revisions, drafts and updates policy documents, and ensures timely distribution to coding staff and stakeholders. Collaborates with compliance, auditing, and operational teams to validate accuracy, incorporate regulatory changes, and support consistent application of coding policies across the organization. Maintains clear documentation of updates and provides clarification or education as needed to support adherence and coding quality.
• Engages in ongoing professional development to maintain current knowledge of medical coding guidelines, regulatory changes, and industry best practices. Actively participates in training, continuing education, and skill building opportunities, and applies new knowledge to support coding accuracy, compliance, and continuous improvement within the organization.
• Other duties may be added and/or assigned as needed.
  
  

The South Carolina Department of Health and Human Services offers an exceptional benefits package for FTE and TGE positions that includes:

• Health, Dental, Vision, Long Term Disability, and Life Insurance for Employee, Spouse, and Children.
• 15 days annual (vacation) leave per year.
• 15 days sick leave per year.
• 13 paid holidays.
• State Retirement Plan and Deferred Compensation Programs.

A high school diploma and experience in computer system development and modification.

A bachelor's degree in a related area may substitute for the required work experience.

An equivalent combination of experience and education may be considered with prior State Human Resources approval.

PREFERRED: Experience in information technology related business analysis, including process development, compliance monitoring, and quality improvement efforts.

Additional Requirements:

• Valid driver's license.
• Sitting or standing for long periods of time.
• In-office role.

• Ability to work with stakeholders to document business processes and ensure those processes are compliant with applicable regulations and policies.
• Ability to identify opportunities for improved efficiencies.
• Ability to design, implement, and maintain workflows within an IT service management tool to meet business needs.
• Knowledge of data analysis.
• Ability to prepare and present reports communicating the results of data analysis.
• Strong customer service and troubleshooting skills.
• Ability to communicate technical information, both verbally and in writing, to a wide range of end-users.

Please complete the State application to include all current and previous work history and education.A resume will not be accepted nor reviewed to determine if an applicant has met the qualifications for the position. Supplemental questions are considered part of your official application for qualification purposes. All applicants must apply online. All correspondence from the Office of Human Resources will be through electronic mail.

The South Carolina Department of Health and Human Services is committed to providing equal employment opportunities to all applicants and does not discriminate on the basis of race, color, religion, sex (including pregnancy, childbirth or related medical conditions, including, but not limited, to lactation), national origin, age (40 or older), disability or genetic information.