Healthcare Data Analyst Position

2 weeks ago

Porac, Philippines beBeeContent Full time ₱800,000 - ₱1,200,000
Job Title: Healthcare Content Specialist

This is a unique opportunity to leverage research and analytical skills in the field of healthcare content development. The successful candidate will be responsible for identifying Medicare, Medicaid, and other medical coding and billing documents that contain claim denial or covered criteria for our automated claims editing solution.

The ideal candidate will have a strong background in CPT Coding, HCPCS, Medical Billing, Claims Denials, and/or Chart Review/Auditing, with at least 5 years of experience in a similar role. A Bachelor's Degree in Nursing and an Active RN license are mandatory, along with relevant certifications such as CCS-P or CPC.

Key responsibilities include:

  • Conducting research to identify claim denial or covered criteria for our automated claims editing solution.
  • Providing written and oral presentations to Medical Director (physicians) and other clinical colleagues to obtain consensus on proposed denial criteria.
  • Offering clinical content support to customers as needed.
  • Entering data into a database for clinical content updates, as required.
  • Solving problems related to the interpretation of inpatient coding or ICD-10-CM coding conventions/guidelines for inclusion or exclusion within Lyric business rules.

Strong communication and teamwork skills are essential for effective collaboration with cross-functional teams. Proficiency in using MS Office applications is expected, and a willingness to work night shifts is preferred.

Join us in this exciting opportunity to make a meaningful contribution to the healthcare industry.

Required Qualifications:

  • Bachelor's Degree in Nursing with Active RN License.
  • At least 5 years of experience in CPT Coding, HCPCS, Medical Billing, Claims Denials, and/or Chart Review/Auditing.
  • AHIMA Certified Coding Specialist - Physician (CCS-P) or AAPC Certified Professional Coder (CPC) certification.
  • Experience working with US health insurance payers in a claims, appeals, or coding capacity.

Preferred Qualifications:

  • Experience in denial management or claim review management.
  • Excellent Communication Skills (verbal and written).
  • Proficiency in using MS Office applications.

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