Medical Coding Specialist

13 hours ago


Ayala Alabang, National Capital Region, Philippines beBeeCoding Full time $72,000 - $84,000

Job Title: Medical Coding Specialist

About the Position
  • The ideal candidate will conduct thorough research and analyze Medicare, Medicaid, and other medical coding and billing documents to identify claim denials or covered criteria for our automated claims editing solution.
Key Responsibilities
  • Research and identify relevant medical coding and billing documents to determine claim denial or covered criteria.
  • Provide clear and concise written and oral presentations to physicians and clinical colleagues to obtain consensus on proposed denial criteria.
  • Offer clinical content support to customers as needed.
  • Enter data into our database for clinical content updates.
  • Analyze inpatient coding and ICD-10-CM coding conventions/guidelines for inclusion or exclusion within our business rules.
Requirements
  • Bachelor's Degree in Nursing or related field.
  • Active RN License required.
  • AHIMA Certified Coding Specialist - Physician (CCS-P) or AAPC Certified Professional Coder (CPC).
  • At least 5 years of experience in areas of CPT Coding, HCPCS, Medical Billing, Claims Denials, and/or Chart Review/Auditing.
  • Previous experience working with US health insurance payers in claims, appeals or coding capacity.
  • Denial management or claim review management experience is a plus.
  • Excellent Communication Skills enabling effective communication with all areas of the organization.
  • Proficient in using MS Office Applications.
  • Able to work night shifts and from home.


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