Medical Coder | RN with CPC | WFH | Night Shift

2 days ago

Cebu City, Philippines MicroSourcing Full time

Medical Coder | RN with CPC | WFH | Night Shift Join MicroSourcing as a Medical Coder | RN with CPC and work from home during the night shift. Position Summary The Medical Content Analyst will research Medicare, Medicaid, and other medical coding documents to identify claim denial or covered criteria for our automated claims editing solution. This solution is used by medical insurance payers across the United States. Clinical content may include additions, deletions, or updates to diagnosis codes, procedure codes, age minimums and maximums, quantity limitations, place of service limitations, and other criteria. Duties and Responsibilities Research and identify Medicare, Medicaid, and other medical coding and billing documents to determine claim denial or covered criteria. Provide written and oral presentations to the Medical Director and other clinical colleagues for consensus on proposed denial criteria. Provide clinical content support to customers as needed. Perform data entry of clinical content updates into the database. Solve problems related to the interpretation of inpatient coding or ICD‑10‑CM coding conventions/guidelines for inclusion or exclusion within Lyric business rules. Required Qualifications Bachelor's Degree in Nursing. Active RN (PRC) License. AHIMA Certified Coding Specialist – Physician (CCS‑P) or AAPC Certified Professional Coder (CPC). At least 5 years of experience in CPT Coding, HCPCS, Medical Billing, Claims Denials, and/or Chart Review/Auditing. Experience working with US health insurance payers in a claims, appeals, or coding capacity. Denial management or claim review management experience is a plus. Excellent verbal and written communication skills. Proficient in MS Office applications. Amenable to work the night shift. Amenable to work from home. Additional Information Referrals increase your chances of interviewing by 2x. Work set‑up: Work from home, night shift. Location: GSC Tower, BGC, Taguig City (office available if needed). #J-18808-Ljbffr

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