Healthcare Coding Expert

1 week ago

Biñan, Calabarzon, Philippines beBeeCoding Full time $60,000 - $90,000
Medical Coding Specialist

We are seeking an experienced Medical Coding Specialist to conduct research and identify Medicare, Medicaid, and other medical coding and billing documents to determine claim denial or covered criteria for our automated claims editing solution.

Main Responsibilities:
  • Conduct in-depth research of medical coding and billing documents to identify claim denial or covered criteria for our automated claims editing solution.
  • Provide written and oral presentations to physicians and clinical colleagues to obtain consensus on proposed denial criteria.
  • Support customers by providing clinical content updates as needed.
  • Enter data into a database, updating clinical content as required.
  • Analyze and solve problems related to the interpretation of inpatient coding or ICD-10-CM coding conventions/guidelines for inclusion or exclusion within our business rules.
Required Skills and Qualifications:
  • 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 CPT Coding, HCPCS, Medical Billing, Claims Denials, and Chart Review/Auditing.
  • Previous experience working with US health insurance payers in claims, appeals, or coding capacity.
  • Denial management or claim review management experience is advantageous.
  • Excellent Communication Skills (verbal and written) enabling effective communication across all areas of the business.
  • Proficient in MS Office Applications.
  • Able to work flexible hours and remotely.
Preferred Attributes:
  • Proven track record of delivering results in a fast-paced environment.
  • Demonstrated ability to analyze complex information and provide actionable insights.
  • Strong problem-solving skills, with a focus on quality and accuracy.

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