Healthcare Professional with Coding Expertise

1 day ago

Quezon City, National Capital Region, Philippines beBeeMedicalCoder Full time ₱900,000 - ₱1,200,000
Healthcare Professional with Coding Expertise

The position of Medical Content Analyst requires an individual with in-depth knowledge of medical coding and billing. This role involves conducting research to identify Medicare, Medicaid, and other medical coding and billing documents to determine claim denial or covered criteria for our automated claims editing solution.

This solution is utilized by medical insurance payers across the United States. The clinical content may include additions, deletions or updates to diagnosis codes, procedure codes, age minimums & maximums, quantity limitations, place of service limitations and other clinical content criteria.

The successful candidate will be responsible for:

  • Conducting research and identifying relevant medical coding and billing documents
  • Providing written and oral presentations to senior medical professionals to obtain consensus on proposed denial criteria
  • Supporting customers with clinical content needs
  • Performing data entry of clinical content updates into a database
  • Solving complex problems related to the interpretation of inpatient coding or ICD-10-CM coding conventions/guidelines for inclusion or exclusion within business rules

Required qualifications include:

  • Bachelor's Degree in Nursing
  • 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
  • Denial management or claim review management experience is advantageous
  • Excellent communication skills
  • Proficiency in MS Office Applications
  • Flexibility to work night shifts and remotely

This position offers a challenging opportunity for a skilled professional to utilize their expertise in medical coding and billing to drive business growth and success.

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