Medical Coding Analyst

4 weeks ago

Taguig, National Capital Region, Philippines MicroSourcing Full time

Discover your 100% YOU with MicroSourcing

Position: Medical Content Analyst
Location: GSC Tower, BGC, Taguig City
Work Set-up & Shift: Work From Home

Position Summary:
The Medical Content Analyst will be responsible for conducting research and identifying Medicare, Medicaid, and other medical coding and billing documents to identify claim denial or covered criteria (clinical content) for our automated claims editing solution.

This solution is utilized by medical insurance payers across the United States. The clinical content could include additions, deletions or updates to diagnosis codes, procedure codes, age-minimums & maximums, quantity limitations, place of service limitations and other clinical content criteria.

Duties and Responsibilities:

  • Research and identify Medicare, Medicaid, and other medical coding and billing documents to identify claim denial or covered criteria (clinical content) for our automated claims editing solution.

  • Provide written and oral presentations to Medical Director (physicians) and other clinical colleagues to obtain consensus on proposed denial criteria.

  • Provide clinical content support to our customers as needed.

  • Perform data entry of clinical content updates into database, as needed.

  • 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.

  • Must have an Active RN (PRC) License.

  • Must be an AHIMA Certified Coding Specialist - Physician (CCS-P) or AAPC Certified Professional Coder (CPC).

  • At least 5 years of experience in the areas of CPT Coding, HCPCS, Medical Billing, Claims Processing and Chart Review/Auditing are required.

  • Previous experience working with US health insurance payers in a claims, appeals or coding capacity is also required.

  • Experience in denial management or claim review management is a plus/advantage.

  • Excellent Communication Skills (verbal and written) enabling effective communication with all areas of the business.

  • Proficient in using MS Office Applications.

  • Amenable to Work on Night Shift.

  • Amenable to Work From Home Set-Up.

About MicroSourcing

With over 9,000 professionals across 13 delivery centers, MicroSourcing is the pioneer and largest offshore provider of managed services in the Philippines.

Our commitment to 100% YOU

MicroSourcing firmly believes that our company's strength lies in our people's diversity and talent. We are proud to foster an inclusive culture that embraces individuals of all races, genders, ethnicities, abilities, and backgrounds. We provide space for everyone, embracing different perspectives, and making room for opportunities for each individual to thrive.

At MicroSourcing, equality is not merely a slogan – it's our commitment. Our way of life. Here, we don't just accept your unique authentic self - we celebrate it, valuing every individual's contribution to our collective success and growth. Join us in celebrating YOU and your 100%

For more information, visit https://www.microsourcing.com/

*Terms & conditions apply

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