Healthcare Content Expert

1 week ago

Barcelona, Philippines beBeeContent Full time ₱5,700,000 - ₱8,225,000
Healthcare Content Specialist Role Overview

As a skilled healthcare content professional, you will be responsible for conducting in-depth research and analysis of medical coding and billing documents to inform our automated claims editing solution. This solution is utilized by medical insurance payers across the United States.

Key Responsibilities:
  • Conduct comprehensive research on Medicare, Medicaid, and other medical coding and billing documents to identify claim denial or covered criteria for our automated claims editing solution.
  • Develop and present written and oral presentations to obtain consensus on proposed denial criteria from Medical Directors and clinical colleagues.
  • Provide expert support to customers with clinical content needs as required.
  • Enter clinical content updates into our database as needed.
  • Interpret inpatient coding or ICD-10-CM coding conventions/guidelines for inclusion or exclusion within our business rules.
Required Qualifications
  • Bachelor's Degree in Nursing, including an Active RN (PRC) license.
  • AHIMA Certified Coding Specialist - Physician (CCS-P) or AAPC Certified Professional Coder (CPC), with 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.
  • Denial management or claim review management experience is advantageous.
  • Excellent Communication Skills, enabling effective communication with all areas of the organization.
  • Proficient in using MS Office applications.
  • Able to work night shifts.
About Our Organization

We are a pioneer and leading provider of managed services, with a culture that celebrates authentic selves and fosters growth and opportunity for every team member.

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