Expert Healthcare Coding Professional

16 hours ago

Las Piñas, National Capital Region, Philippines beBeeClinical Full time ₱60,000 - ₱80,000
Job Overview

Our company seeks a highly skilled Clinical Coder to conduct thorough research and identify Medicare, Medicaid, and other medical coding and billing documents to ensure accurate claim denials or covered criteria for automated claims editing solutions.

The successful candidate will collaborate with Medical Directors and clinical colleagues to provide written and oral presentations on proposed denial criteria and obtain consensus.

Additionally, the selected individual will provide clinical content support to customers as needed and perform data entry of updates into databases.

With expertise in ICD-10-CM coding conventions/guidelines, this professional will solve problems related to interpretation and inclusion/exclusion within business rules.

Key Responsibilities:
  • Conduct comprehensive research and identify relevant Medicare, Medicaid, and other medical coding and billing documents to ensure accurate claim denials or covered criteria.
  • Develop and present written and oral reports to Medical Directors and clinical colleagues on proposed denial criteria.
  • Provide expert clinical content guidance to customers and perform data entry tasks as required.
  • Apply knowledge of ICD-10-CM coding conventions/guidelines to resolve issues related to interpretation and inclusion/exclusion within business rules.
Required Qualifications:
  • Bachelor's Degree in Nursing.
  • Active RN (PRC) License.
  • AHIMA Certified Coding Specialist - Physician (CCS-P) or AAPC Certified Professional Coder (CPC) certification.
  • At least 5 years of experience in areas such as 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 required.
  • Experience in denial management or claim review management is an advantage.
  • Excellent communication skills for effective collaboration with all business areas.
  • Proficient in using MS Office Applications.
  • Ability to work on night shifts and flexible work arrangements.
Benefits:

This role offers a competitive compensation package, including benefits and opportunities for professional growth and development.

Our company values diversity and inclusion and is an equal opportunity employer.

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