Clinical Coding Analyst

2 weeks ago

Cebu City, Central Visayas, Philippines Health Business Solutions LLC Full time

Health Business Solutions, LLC Metro Cebu (On-site)

We are seeking a detail-oriented and analytical Clinical Coding Analyst to join our team and take on the responsibility of reviewing claims denied for coding-related issues. As a Clinical Coding Analyst, you will play a critical role in identifying and resolving coding discrepancies, ensuring accurate and compliant coding practices, and optimizing revenue generation. Your expertise in clinical coding, coding guidelines, and claims processing will be instrumental in analyzing and resolving coding-related denials, thereby enhancing operational efficiency and financial performance.

Company Overview:

For over 20 years, we've been a leading middle market revenue cycle management (RCM) vendor, providing comprehensive financial and operational solutions to health systems, physician groups, or specialty medical practices. Our mission is to improve the overall financial health of our clients by offering customized, data-driven, and tech-enabled recovery of denied claims and aged receivables. We utilize our deep expertise in revenue cycle to help transform our client's revenue cycle processes to achieve sustained reductions in denial rates.

Key Responsibilities:

  1. Review and analyze claims that have been denied due to coding-related issues, including diagnosis codes (ICD-10-CM), procedure codes (CPT/HCPCS), and related modifiers.
  2. Identify coding discrepancies, documentation deficiencies, and other factors contributing to claims denials, utilizing a thorough understanding of coding guidelines, industry standards, and regulatory requirements.
  3. Collaborate with coding teams, healthcare providers, and revenue cycle stakeholders to obtain necessary documentation and information for claims resubmission.
  4. Conduct in-depth coding audits and analysis to validate the accuracy, completeness, and compliance of coding practices, and ensure alignment with payer requirements.
  5. Research and interpret coding guidelines, including updates from coding authorities, to ensure coding accuracy and compliance.
  6. Work closely with coding staff and providers to address and resolve coding-related issues, provide education on coding best practices, and improve coding performance.
  7. Maintain up-to-date knowledge of payer policies, medical necessity criteria, and reimbursement guidelines to accurately evaluate coding denials and appeals.
  8. Compile and prepare detailed reports on coding-related denials, identifying patterns, trends, and opportunities for process improvement.
  9. Collaborate with the revenue cycle team to develop strategies and initiatives aimed at reducing coding-related denials and improving overall revenue cycle performance.
  10. Stay informed about emerging coding trends, changes in coding guidelines, and industry best practices, and provide recommendations for updating coding processes and policies.
  11. Participate in coding-related meetings, committees, and training sessions to share insights, contribute to problem-solving, and promote cross-departmental collaboration.

Qualifications:

  1. Bachelor's degree in Health Information Management, Health Informatics, or a related field. Relevant certifications (e.g., RHIA, RHIT, CCS) are a plus.
  2. Solid experience in clinical coding within a healthcare organization, with a focus on claims denial management and coding-related issues.
  3. Comprehensive knowledge of coding guidelines, including ICD-10-CM, CPT/HCPCS, and related modifiers, as well as proficiency in applying coding conventions and rules.
  4. Familiarity with medical necessity criteria, payer policies, and reimbursement methodologies.
  5. Excellent understanding of revenue cycle processes, claims processing workflows, and denials management.
  6. Proficiency in using coding software, encoders, and electronic health record (EHR) systems.
  7. Detail-oriented mindset with a high level of accuracy and organizational skills.
  8. Effective communication and interpersonal skills to collaborate with coding teams, providers, and other stakeholders.
  9. Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment.
  10. Proficiency in using coding-related software and tools, as well as a high level of computer literacy.

Join our dynamic team as a Clinical Coding Analyst and contribute to the resolution of coding-related denials, ensuring accurate and compliant coding practices that maximize reimbursement and support optimal healthcare delivery.

Health Business Solutions, LLC provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

#J-18808-Ljbffr

  • Senior Clinical Coding Analyst

    2 weeks ago

    Cebu City, Central Visayas, Philippines Health Business Solutions LLC Full time

    Senior Clinical Coding AnalystHealth Business Solutions, LLC Metro Cebu (On-site)We are seeking an experienced and detail-oriented Senior Clinical Coding Analyst to join our team and take on a crucial role in ensuring coding quality within our revenue cycle. As a Senior Clinical Coding Analyst, you will be responsible for analyzing and validating clinical...

  • Sr Clinical Coding Analyst

    2 weeks ago

    Cebu City, Central Visayas, Philippines Health Business Solutions LLC Full time

    Senior Clinical Coding AnalystHealth Business Solutions, LLC Metro Cebu (On-site)We are seeking an experienced and detail-oriented Senior Clinical Coding Analyst to join our team and take on a crucial role in ensuring coding quality within our revenue cycle. As a Senior Clinical Coding Analyst, you will be responsible for analyzing and validating clinical...

  • Clinical Analyst

    5 days ago

    Cebu City, Central Visayas, Philippines Stark Asia Solutions Inc. Full time

    On-site - Cebu 1-3 Yrs Exp Bachelor Full-timeJob DescriptionDescriptionA Clinical Analyst optimizes healthcare information systems to enhance patient care and operational efficiency.They collaborate with medical staff to implement and maintain electronic health records (EHRs), analyze clinical data to identify trends, and provide training to ensure effective...

  • Clinical Documentation Specialist

    5 days ago

    Cebu City, Central Visayas, Philippines Stark Asia Solutions Inc. Full time

    At Stark Asia Solutions Inc., we are seeking a skilled Clinical Documentation Specialist to join our team. As a Clinical Auditor, you will be responsible for ensuring the accuracy and quality of clinical documentation within healthcare organizations. Your primary role will be to conduct systematic reviews of medical records, billing codes, and clinical...

  • Quality Assurance Analyst

    5 days ago

    Cebu City, Central Visayas, Philippines Stark Asia Solutions Inc. Full time

    Quality Assurance RoleAs a Quality Assurance Analyst at Stark Asia Solutions Inc., you will play a key role in maintaining the quality and integrity of clinical documentation and processes within healthcare organizations. Your responsibilities will include conducting systematic reviews of medical records and clinical procedures to verify adherence to...

  • Clinical Documentation Reviewer

    4 days ago

    Cebu City, Central Visayas, Philippines Health Business Solutions Full time

    Responsibilities and Requirements:The Coding Auditor will be responsible for reviewing and auditing medical records to ensure accurate coding and compliance with regulatory requirements.You will work closely with our coding teams, providers, and clinical staff to educate on coding practices and provide feedback on regulatory compliance.Your expertise in...

  • Clinical Appeals Nurse

    17 hours ago

    Cebu City, Central Visayas, Philippines Health Business Solutions Full time

    Join our dedicated team at HBiz where we strive to provide outstanding care and service excellence. We are currently seeking a highly skilled Clinical Appeals Nurse to play a crucial role in managing medical denials by providing clinical expertise in the appeals process. This position is ideal for those who excel in analytical thinking and have a strong...

  • Coding Compliance Specialist

    4 days ago

    Cebu City, Central Visayas, Philippines Health Business Solutions Full time

    About the Role:We are seeking an experienced Coding Auditor to join our team at Health Business Solutions. As a key member of our revenue cycle management team, you will be responsible for ensuring the accuracy and compliance of medical coding practices.Your expertise in medical coding, including ICD-10, CPT, and HCPCS, will be essential in identifying...

  • Medical Coding Expert

    4 days ago

    Cebu City, Central Visayas, Philippines Health Business Solutions Full time

    Job Description:The Coding Auditor will play a critical role in ensuring the accuracy and compliance of medical coding practices within our organization. This individual will perform detailed reviews of medical documentation and coding, guaranteeing adherence to regulatory standards such as ICD-10, CPT, and HCPCS.This position requires strong analytical...

  • Medical Information Systems Analyst

    5 days ago

    Cebu City, Central Visayas, Philippines Stark Asia Solutions Inc. Full time

    We are seeking a Medical Information Systems Analyst to join our team at Stark Asia Solutions Inc.About the RoleThis analyst will collaborate with medical staff to implement and maintain electronic health records (EHRs), analyze clinical data to identify trends, and provide training to ensure effective system use.The ideal candidate will be responsible for...

  • Clinical Support Specialist

    4 days ago

    Cebu City, Central Visayas, Philippines Wipro Technologies Full time

    Wipro Technologies is committed to creating an accessible, supportive, and inclusive workplace. We are looking for a Clinical Support Specialist to join our team.Job DescriptionThe Clinical Support Specialist will provide effective technical support and actively resolve client issues directly or through timely escalation to meet process...

  • Clinical Data Associate

    2 days ago

    Cebu City, Central Visayas, Philippines Tahche Careers Full time

    Job Role:Tahche Careers is looking for a skilled Clinical Data Associate to join our team in Cebu, Philippines. As a key member of our team, you will be responsible for managing clinical data and ensuring accurate communication between medical doctors' offices and our facilities.Key Responsibilities:Monitor Radiology Worklist/Press route buckets daily.Sort...

  • Clinical Documentation Improvement Quality Assurance

    17 hours ago

    Cebu City, Central Visayas, Philippines Shearwatercpo Full time

    Clinical Documentation Improvement Quality Assurance (CDI QA Specialist)Join to apply for the Clinical Documentation Improvement Quality Assurance (CDI QA Specialist) role at Shearwater CPO - Home of Clinicians.Physical Sites: Taguig, Pampanga, and CebuOur Clinicians and Associates advocate for better patient care while enjoying these benefits:Work from Home...

  • Clinical Process Improvement Lead

    5 days ago

    Cebu City, Central Visayas, Philippines Stark Asia Solutions Inc. Full time

    We are looking for a Clinical Process Improvement Lead to join our team at Stark Asia Solutions Inc.About the RoleThis lead will work closely with medical staff to implement and maintain electronic health records (EHRs), analyze clinical data to identify trends, and provide training to ensure effective system use.The ideal candidate will be responsible for...

  • Clinical Coding Professional

    3 days ago

    Iloilo City, Western Visayas, Philippines TMDPH INC Full time

    QualificationsThe ideal candidate should possess a Bachelor's degree in any field but with coding experience. Fresh graduates from any medical related course are welcome to apply. Experience with electronic health record (EHR) systems and coding software is an advantage. Excellent analytical skills and attention to detail are essential for this role.

  • Healthcare Data Auditor

    4 days ago

    Cebu City, Central Visayas, Philippines Health Business Solutions Full time

    Job Summary:We are looking for a skilled Coding Auditor to join our team at Health Business Solutions. As a Coding Auditor, you will be responsible for reviewing and auditing medical records to ensure accurate coding and compliance with regulatory requirements.You will work closely with our coding teams, providers, and clinical staff to educate on coding...

  • Medical Imaging Pre-Authorization Specialist

    6 days ago

    Cebu City, Central Visayas, Philippines Tahche Careers Full time

    Tahche Careers is seeking a highly skilled Medical Imaging Pre-Authorization Specialist to join our team. In this role, you will be responsible for obtaining pre-certifications and pre-authorizations for procedures and medications, scheduling appointments for outpatient testing with other providers, transcribing and triaging patient calls to physicians, and...

  • Quality Analyst

    3 weeks ago

    Cebu City, Central Visayas, Philippines PRIVATE ADVERTISER Full time

    Responsibilities:-Review and audit clinical documentation, patient interactions, and healthcare processes for compliance with policies, procedures, and regulatory standards.-Analyze trends and patterns in quality metrics to recommend data-driven solutions.-Ensure adherence to healthcare regulations such as HIPAA, CMS guidelines, and other applicable...

  • Medical Records Reviewer

    5 days ago

    Cebu City, Central Visayas, Philippines Stark Asia Solutions Inc. Full time

    We are seeking a Medical Records Reviewer to join our team at Stark Asia Solutions Inc. As a Clinical Auditor, you will be responsible for evaluating and ensuring the accuracy of clinical documentation and processes within healthcare organizations. Your primary role will be to conduct systematic reviews of medical records, billing codes, and clinical...

  • Healthcare Compliance Officer

    5 days ago

    Cebu City, Central Visayas, Philippines Stark Asia Solutions Inc. Full time

    Job OverviewAs a Healthcare Compliance Officer at Stark Asia Solutions Inc., you will play a vital role in maintaining the integrity of clinical data and ensuring accurate billing practices. Your responsibilities will include conducting systematic reviews of medical records and clinical procedures to verify adherence to established standards and regulatory...