Medical Coding Specialist

2 days ago

Taguig, National Capital Region, Philippines beBeeCoder Full time ₱1,200,000 - ₱1,500,000
Medical Coder Opportunity

This role focuses on applying expertise in medical coding and billing to identify claim denials or covered criteria for an automated claims editing solution.

Job Summary
  • The ideal candidate will possess strong research skills, allowing them to effectively review medical documents and provide written and oral presentations to obtain consensus on proposed denial criteria.
Responsibilities
  • Conduct thorough research of Medicare, Medicaid, and other medical coding and billing documents to identify claim denial or covered criteria for our automated claims editing solution.
  • Provide high-quality clinical content support to customers as needed, ensuring timely and accurate solutions.
  • Collaborate with Medical Director (physicians) and other clinical colleagues to ensure seamless communication and achieve consensus on proposed denial criteria.
  • Enter data accurately into the database, maintaining a high level of quality and efficiency.
  • Analyze and interpret inpatient coding or ICD-10-CM coding conventions/guidelines for inclusion or exclusion within Lyric business rules.
Requirements
  • 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 the areas of 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 position.
  • Full-time employment type.
  • Health Care Provider job function.
  • Outsourcing and Offshoring Consulting industries.

This opportunity provides the chance to work remotely, promoting flexibility and work-life balance.

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