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Remote Rn Government Jobs in Lexington, SC (NOW HIRING)

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What is a Remote RN Government?

A Remote RN Government job is a nursing position that allows registered nurses to work from home or a remote location while serving government agencies. Responsibilities may include telehealth services, case management, utilization review, or public health initiatives. These roles typically support federal, state, or local government healthcare programs such as Veterans Affairs, Medicaid, or public health departments. Remote RNs use technology to assess, educate, and support patients while ensuring compliance with government healthcare regulations.

What does a Remote RN Government do?

Remote RN Government positions often involve supporting diverse patient populations, such as veterans, underserved communities, or individuals enrolled in public health programs. Daily duties include conducting virtual patient assessments, coordinating care plans, providing health education, and ensuring adherence to government health policies. RNs may also collaborate with case managers, social workers, and public health officials remotely. This role demands the ability to manage a varied caseload efficiently while maintaining thorough documentation and clear communication with patients and colleagues.

What are the key skills and qualifications needed for a Remote RN Government?

To thrive as a Remote RN Government, you need an active registered nurse license, thorough clinical knowledge, and experience working within government regulations or public health frameworks. Familiarity with government healthcare systems, secure telemedicine platforms, and compliance standards (such as HIPAA) is essential. Strong self-motivation, clear communication, and time management skills are vital for working independently while collaborating virtually with multidisciplinary teams. These competencies ensure high-quality patient care, regulatory compliance, and effective remote collaboration in a government healthcare setting.

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Remote Rn Government jobs near you

Clinical Analyst & Coding Specialist - Contract - Columbia, SC

SUNSHINE ENTERPRISE USA LLC

Columbia, SC • Remote

Contractor

Re-posted 15 days ago

Job description

Clinical Analyst & Coding Specialist Location: Columbia, SC Hybrid (80% remote, onsite for required trainings and meetings). Interview Process: 1 round, Virtual/Online Duration: 12 Months Employment Type: Contract Experience Required: 10+ Years Candidate location: Candidate MUST be a SC resident. No relocation allowed.

Project Scope: Seeking an experienced Business Analyst (Clinical Analyst & Coding Specialist) to support ongoing Medicaid operations and healthcare system initiatives. The consultant will serve as a Subject Matter Expert (SME) for medical coding, Medicaid policy, and business analysis while collaborating with business and technical teams to support coding updates, policy implementation, and business process improvements. Key Responsibilities: Coordinate annual and quarterly ICD-10, CPT, and HCPCS code updates.

Review and analyze coding changes to determine business and operational impacts. Prepare code change documentation for stakeholder review. Collaborate with business users, stakeholders, and technical teams to implement coding and policy updates.

Participate in meetings related to healthcare systems modernization initiatives. Serve as a Subject Matter Expert (SME) for medical coding methodologies and Medicaid-related processes. Research business rules, requirements, and workflows to develop recommendations.

Maintain business rules, process documentation, and requirements repositories. Support process documentation, knowledge transfer, and training activities. Review medical records against established criteria to determine medical necessity when required.

Assist with additional healthcare and project-related initiatives. Required Skills & Experience: 10+ years of experience in healthcare insurance, medical review, program integrity, or appeals. 5+ years working with IT developers/programmers in a payer environment.

5+ years of medical coding experience in a payer environment. 3+ years of clinical experience in a healthcare environment. Strong knowledge of ICD-10, CPT, and HCPCS coding methodologies.

Strong knowledge of anatomy, physiology, pharmacology, and medical terminology. Experience gathering business requirements and documenting business processes. Excellent analytical, communication, and stakeholder management skills.

Preferred Skills: Experience with healthcare policy remediation. Claims processing systems experience. Microsoft Office Suite proficiency.

Experience with Optum Encoder or other medical coding software. Medicaid and healthcare payer systems experience. Experience supporting healthcare system modernization initiatives.

Education Bachelor of Science in Nursing (BSN) or Associate Degree in Nursing (ADN). Certification: Active, unrestricted Registered Nurse (RN) license. Current CPC (Certified Professional Coder) or CCS (Certified Coding Specialist) certification.

ICD-10 proficiency certification or ability to obtain certification within one year.

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