Remote Medical Coding Specialist

1 day ago

Iloilo City, Western Visayas, Philippines beBeeCoder Full time $60,000 - $70,000
Job Title: Medical Coder | RN and CPC | WFH | Night Shift

We are seeking an experienced medical coder to join our team. In this role, you will be responsible for conducting research and identifying Medicare, Medicaid, and other medical coding and billing documents to identify claim denial or covered criteria for our automated claims editing solution.

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.

  • Key Responsibilities:
  • Conduct research and identify Medicare, Medicaid, and other medical coding and billing documents to identify claim denial or covered criteria.
  • Provide written and oral presentations to obtain consensus on proposed denial criteria.
  • Provide clinical content support to customers as needed.
  • Perform data entry of clinical content updates into database.
  • Solve problems related to the interpretation of inpatient coding or ICD-10-CM coding conventions/guidelines for inclusion or exclusion within 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.
  • Previous experience working with US health insurance payers in a claims, appeals or coding capacity.
  • Experience in denial management or claim review management is a plus/advantage.
  • Excellent Communication Skills 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.
Work Environment:
  • Mid-Senior level
  • Full-time
  • Health Care Provider
  • Outsourcing and Offshoring Consulting

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