Medical Coding Specialist

17 hours ago

Mabalacat, Central Luzon, Philippines beBeeCoding Full time $45,000 - $60,000
Medical Coding Specialist

Job Description:

We are seeking a skilled Medical Coding Specialist to perform complex coding tasks, ensuring accurate and efficient coding practices. The ideal candidate will have a strong background in medical coding and billing, with experience working with Medicare, Medicaid, and other medical coding and billing documents.

Key Responsibilities:

  • Conduct research and identify claim denial or covered criteria (clinical content) for automated claims editing solutions.
  • Collaborate with clinical teams to obtain consensus on proposed denial criteria through written and oral presentations.
  • Provide clinical content support to customers as needed.
  • Enter data into databases related to clinical content updates, as required.
  • Address interpretation-related issues regarding inpatient coding or ICD-10-CM coding conventions/guidelines for inclusion/exclusion within business rules.

Requirements:

  • Bachelor's Degree in Nursing.
  • Active RN 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 beneficial.
  • Excellent Communication Skills enabling effective communication across all business areas.
  • Proficient in using MS Office Applications.
  • Flexible work schedule, including night shifts and remote work arrangements.

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