Clinical Content Specialist

7 days ago

Sorsogon, Bicol, Philippines beBeeMedicalCoding Full time $90,000 - $120,000
Job Description

We are seeking a Medical Coding Specialist to join our team. The successful candidate will be responsible for conducting research and identifying medical coding and billing documents to identify claim denial or covered criteria for our automated claims editing solution.

This solution is utilized by medical insurance payers across the United States. 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.

Duties and Responsibilities
  • Conduct research and identify 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 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.

 

Requirements

To be successful in this role, you will need to have:

  • 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.
  • Excellent Communication Skills, enabling effective communication with all areas of the business.
  • Proficient in using MS Office applications.
  • Amenable to work on Night Shift.
About This Opportunity

This is a remote opportunity that offers flexibility and autonomy. As a Medical Coding Specialist, you will play a critical role in supporting our customers and ensuring the accuracy of their medical records.

You will have the opportunity to work with a talented team of professionals who are passionate about delivering high-quality results.

The ideal candidate will be highly organized, detail-oriented, and able to work independently with minimal supervision.

This is an excellent opportunity for someone looking to take their career to the next level and make a real impact in the healthcare industry.

What We Offer

We offer a competitive salary and benefits package, including:

  • Health Insurance
  • Dental Insurance
  • Vision Insurance
  • 401(k) Plan
  • Flexible Work Arrangements

We are an equal opportunities employer and welcome applications from diverse candidates. If you are a motivated and talented individual who is passionate about delivering exceptional results, we encourage you to apply.

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