Medical Content Expert

1 day ago

Angeles City, Central Luzon, Philippines beBeeClinicalContentSpecialist Full time ₱5,760,000 - ₱8,640,000

Job Description:

  • We are seeking a skilled Clinical Content Specialist to join our team. The ideal candidate will have experience in medical coding and billing, with a strong understanding of Medicare and Medicaid policies.

Responsibilities:

  • Conduct research and identify claim denial or covered criteria for our automated claims editing solution.
  • Provide written and oral presentations to obtain consensus on proposed denial criteria.
  • Support customers by providing clinical content expertise as needed.
  • Perform data entry of clinical content updates into database.
  • Solve problems related to interpretation of 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.
  • Excellent Communication Skills enabling effective communication with all areas of the business.
  • Proficient in using MS Office applications.
  • Amenable to work on Night Shift.

About Our Company:

Our company is committed to fostering growth and opportunity for every team member. We celebrate authentic selves and strive to create an inclusive culture that embraces individuals of all backgrounds.

Additional Details:

  • Seniority level: Mid-Senior level
  • Employment type: Full-time
  • Job function: Health Care Provider and Information Technology
  • Industries: Outsourcing and Offshoring Consulting
  • Location: Remote / Night Shift available

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