Senior Medical Coding Specialist

2 weeks ago

Porac, Philippines beBeeMedicalCoding Full time ₱600,000 - ₱800,000
Medical Coding Specialist Opportunity

We are seeking a highly skilled Medical Coding Specialist to join our team. As a Medical Coding Specialist, you 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.

Responsibilities:
  • Conduct thorough research on Medicare, Medicaid, and other medical coding and billing documents to identify claim denial or covered criteria (clinical content).
  • Provide written and oral presentations to medical directors and other clinical colleagues to obtain consensus on proposed denial criteria.
  • Offer clinical content support to customers as needed.
  • Enter data into a database for clinical content updates, as required.
  • Solve problems related to the interpretation of 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 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 advantageous.
  • Excellent Communication Skills (verbal and written) enabling effective communication with all areas of the business.
  • Proficient in using MS Office Applications.
  • Able to work on Night Shift.
  • Able to work From Home Set-up.
Benefits:
  • Mid-Senior level position.
  • Full-time employment.
  • Health Care Provider job function.
  • Outsourcing and Offshoring Consulting industry.

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