Healthcare Content Expert

1 day ago

Pulong Santa Cruz, Calabarzon, Philippines beBeeClinical Full time $80,000 - $100,000

We are seeking a skilled professional to fill the role of Clinical Content Specialist.

This individual will be responsible for conducting in-depth research and identifying relevant medical coding and billing documents. Their expertise will be instrumental in developing denial criteria for our automated claims editing solution, which is utilized by medical insurance payers across the United States.

Key Responsibilities
  • Conduct thorough research on Medicare, Medicaid, and other medical coding and billing documents to identify claim denial or covered criteria.
  • Develop written and oral presentations to obtain consensus from physicians and clinical colleagues on proposed denial criteria.
  • Provide timely support to customers as needed, ensuring their needs are met with professionalism and expertise.
  • Perform data entry of clinical content updates into our database, maintaining accuracy and efficiency.
  • Solve complex problems related to the interpretation of inpatient coding or ICD-10-CM coding conventions/guidelines for inclusion or exclusion within our business rules.
Requirements
  • Bachelor's Degree in Nursing and active RN license.
  • AHIMA Certified Coding Specialist - Physician (CCS-P) or AAPC Certified Professional Coder (CPC), with at least 5 years of experience in CPT Coding, HCPCS, Medical Billing, Claims Denials, and/or Chart Review/Auditing.
  • Previous experience working with US health insurance payers in a claims, appeals, or coding capacity.
  • Experience in denial management or claim review management is highly desirable.
  • Excellent Communication Skills (verbal and written), enabling effective collaboration with all areas of the business.
  • Proficient in using MS Office applications.
  • Able to work on Night Shift, if required.
About Our Organization

Our organization values inclusivity and diversity, embracing individuals of all backgrounds and abilities. We strive to create an environment that fosters growth, opportunity, and authentic expression.

Additional Information

The ideal candidate will possess strong analytical skills, attention to detail, and excellent communication skills. This position requires a self-motivated individual who can work independently and collaboratively as part of a team.

Candidates should have a passion for delivering high-quality results, meeting deadlines, and exceeding expectations. We offer a competitive compensation package, comprehensive benefits, and opportunities for professional development and growth.

This is an exciting opportunity for an experienced professional to join our team and contribute to our mission of delivering exceptional healthcare services.

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