Medical Content Analyst, Automation

2 days ago

Manila, Philippines lyric.ai Full time

Medical Content Analyst, Automation page is loaded## Medical Content Analyst, Automationlocations: Manila, Philippinestime type: Full timeposted on: Posted 3 Days Agojob requisition id: JR536and drive innovation with #YouToThePowerOfAI.Essential Job Responsibilities & Key Performance Outcomes* Review and validate AI generated CPT, HCPCS, ICD10CM and other claim data set elements.* Verify coding or billing guidelines and other data extracts from AI to confirm accuracy in accordance with coding parameters.* Identify any AI data extract anomalies or defects.* Provide accurate and timely feedback to AI to improve model performance.* Remain informed with medical coding and billing regulatory changes to contribute continuous improvement of AI tools.* Participate in the development of coding guidelines for AI-assisted workflows.* Validate criteria for policy or rule suitability.* Serve as a subject matter expert (SME) in cross-functional team with Clinical, technical, and product stakeholders.Required Qualifications* Bachelor’s degree in health information management, Nursing or other Healthcare related degree required* Active American Academy of Professional Coders (AAPC) Certified Professional Coders (CPC) certification or American Health Information Management Association (AHIMA) Certified Coding Specialist-Physician (CCS-P) or Certified Coding Specialist (CCS)* Minimum of 5 years of relevant healthcare experience, including at least 3 years in medical coding, chart review, auditing, or abstraction. Must demonstrate proficiency in applying CPT, ICD-10-CM, and HCPCS coding conventions, including translating clinical documentation into appropriate codes.* Understanding of US health insurance payers including Commercial, Medicare, Medicaid (FFS and MCOs), third-party claims processing (including paper & EDI processes)* Strong grasp of medical terminology and human anatomy* Familiarity with AI-driven tools such as Computer-Assisted Coding (CAC) or Natural Language Process (NLP) platforms* Proficiency in Microsoft applicationsPreferred Qualifications* Master’s degree in business or healthcare related field* Previous ClaimsXten experience* Previous experience using AI tools in a professional environment* Previous experience at CMS (Medicare or Medicaid) or at a Health Insurance plan* Ability to convey complex technical information across various formats (written, verbal, visual)* Comfortable working in agile, fast-paced, and collaborative environments* Willing to participate in target AI training programs* Self-motivated and proactive, with the ability to work independently and with minimal supervision* Strong analytical and critical thinking skills#J-18808-Ljbffr

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