> Markdown version of [/jobs/ext/1384467-clinical-systems-analyst](https://www.wearedevelopers.com/jobs/ext/1384467-clinical-systems-analyst). Every page supports `.md` or `Accept: text/markdown`. Links point to the HTML versions so they work for humans too. Agent guide: [/agents.md](https://www.wearedevelopers.com/agents.md). --- # Clinical Systems Analyst - **Company:** The Smart - **Location:** Columbia, SC, United States (Remote available) - **Experience:** Expert - **Contract:** Permanent contract - **Skills:** Microsoft Office, Product Software Implementation Methods - **Published:** July 22, 2026 - **Apply:** https://www.indeed.com/viewjob?jk=1f93d0a5bfc7ce17 ## About the Role * Education: Bachelor of Science in Nursing (BSN) or Associate Degree in Nursing (ADN). * Licensure: Current, active, and unrestricted Registered Nurse (RN) license in the State of South Carolina. * Certification: Active Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) credential. * Certification: ICD-10 Proficiency demonstrated by exam (or the ability to become certified within one year of employment). * 10+ years of experience in healthcare insurance, medical review, program integrity, or appeals. * 5+ years of experience performing medical coding in a payer environment. * 5+ years of experience working directly with IT developers and programmers in a payer environment. * 3+ years of clinical experience in a healthcare setting. * 5+ years of deep foundational knowledge in ICD/CPT/HCPCS translation, coding methodologies, anatomy, physiology, pharmacology, and medical terminology., * 5+ years of experience in policy remediation. * 5+ years of experience working with healthcare claims processing systems. * 5+ years of experience utilizing Optum Encoder and/or other prominent medical coding software programs. * Proficiency with Microsoft Office suite and standard business tools. Core Skills & Attributes * Strong clinical assessment and critical thinking capabilities. * Ability to effectively translate complex clinical and coding rules into actionable IT requirements. * Excellent verbal and written communication skills to engage and guide stakeholders at all levels. * Proven capability to work collaboratively in a fast-paced, change-oriented team environment. Flexible work from home options available. ## Description This dual-functioning IT Healthcare Consultant and Business Analyst role supports medical code change requests by researching, analyzing, and delivering recommendations to policy owners and stakeholders. Acting as a Subject Matter Expert (SME), the successful candidate will facilitate process improvements and system enhancements, bridging the gap between clinical requirements and IT implementation. This role is highly suited for a credentialed Registered Nurse (RN) and Certified Medical Coder who thrives in complex, change-oriented project environments., Medical Coding & Reference Maintenance * Manage and initiate annual and quarterly updates from CMS for all ICD-10 and CPT/HCPCS coding changes. * Perform initial reviews of code modifications to determine the scope of operational and system changes. * Prepare detailed listings of code changes for review and analysis by program and administrative staff. * Serve as the primary Subject Matter Expert (SME) for medical coding methodologies and related healthcare policies. IT Collaboration & System Enhancements * Participate as a core project team member for process improvements and enterprise claims system enhancements. * Provide reference administration expertise for large-scale, future system replacement initiatives. * Research and maintain business rules, technical requirements, and data models within central repositories. * Collaborate continuously with IT developers and programmers to align clinical needs with system capabilities. Stakeholder Engagement & Clinical Support * Facilitate and conduct meetings with cross-functional personnel, stakeholders, and process owners. * Partner with team members to ensure process documentation and training materials are comprehensive and routinely updated. * Serve as a clinical back-up to review patient records against established criteria to determine medical necessity. ## Related Videos - [The weekly developer show: Boosting Python with CUDA, CSS Updates & Navigating New Tech Stacks](https://www.wearedevelopers.com/videos/1293-the-weekly-developer-show-boosting-python-with-cuda-css-updates-navigating-new-tech-stacks) - [Delete the roles, deploy the skills](https://www.wearedevelopers.com/videos/2104-delete-the-roles-deploy-the-skills) - [From Bedside Beeps to Interoperable Bytes – Getting your medical devices ready to talk the IEEE 11073 language](https://www.wearedevelopers.com/videos/771-from-bedside-beeps-to-interoperable-bytes-getting-your-medical-devices-ready-to-talk-the-ieee-11073-language) - [Quality Strategy with a side of Swiss Cheese](https://www.wearedevelopers.com/videos/467-quality-strategy-with-a-side-of-swiss-cheese) - [Grappling With Clunky Old Software? 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