Clinical Content Specialist

7 days ago

Dasmariñas, Calabarzon, Philippines beBeeContent Full time $60,000 - $96,000
Job Title: Clinical Content Specialist

We are seeking a skilled Clinical Content Specialist to join our team.

Role Overview:

  • The Clinical Content Specialist will conduct research and identify relevant medical coding and billing documents to enhance our automated claims editing solution.
  • The ideal candidate will collaborate with medical professionals to obtain consensus on proposed denial criteria.
  • This role involves providing clinical content support to customers as needed.
  • Data entry of clinical content updates into a database is a critical aspect of this position.
  • The Clinical Content Specialist will analyze and solve problems related to inpatient coding or ICD-10-CM coding conventions/guidelines for inclusion or exclusion within business rules.

Required Skills and Qualifications:

  • Bachelor's Degree in Nursing with an 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 is preferred.
  • Denial management or claim review management experience is a plus.
  • Excellent communication skills enabling effective collaboration with all areas of the business.
  • Proficient in using MS Office applications.

Benefits:

  • Opportunity to work with a dynamic team.
  • Professional growth and development opportunities.

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