Clinical Content Analyst

1 week ago

Hagonoy, Central Luzon, Philippines beBeeCoding Full time ₱1,500,000 - ₱1,800,000

Job Title: Medical Coding Specialist

">About the Role">

The ideal candidate 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.

">
  • We are seeking a skilled Medical Coding Specialist to join our team.
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This role involves researching 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.

">Responsibilities">
  • Conduct 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 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 business rules.
">Required Qualifications">
  • Bachelor's Degree in Nursing. Active RN license required.
  • 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 (verbal and written), enabling effective communication with all areas of the business.
  • Proficient in using MS Office applications.
  • Able to work Night Shift.
">

Why Join Our Team?

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We are committed to fostering growth and opportunity for every team member. Our inclusive culture embraces individuals of all races, genders, ethnicities, abilities, and backgrounds.

">

About Us

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We provide managed services to clients worldwide. With over 9,000 professionals across 13 delivery centers, we strive to deliver exceptional results.

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