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Clinical Data Specialist

1 week ago


Manila, National Capital Region, Philippines MicroSourcing Full time

As a Medical Content Analyst 3, you will be responsible for researching and identifying Medicare, Medicaid, and other medical coding and billing documents to develop claim denial or covered criteria for our automated claims editing solution.

Primary Responsibilities

This role involves:

Key Accountabilities
  • Conduct thorough analysis of medical coding and billing documents to identify claim denial or covered criteria.
  • Prepare and present written and oral reports to Medical Director (physicians) and other clinical colleagues.
  • Collaborate with customers to provide clinical content support as needed.
  • Maintain accurate records of clinical content updates in database.
Requirements
  • Bachelor's degree in Nursing, Pharmacy, or equivalent required.
  • Four years' experience in medical billing, coding, claims processing, bill and/or chart review/auditing, is required.
  • Strong analytical and communication skills are essential.