Medical Content Expert

5 days ago


Taguig, National Capital Region, Philippines Manpower Core Group Inc. Full time
Job Description

We are seeking a Medical Content Analyst to join our team at Manpower Core Group Inc. As a key member of our healthcare team, you will be responsible for conducting research and identifying Medicare, Medicaid, and other medical coding and billing documents to identify claim denial or covered criteria (clinical content) for our automated claims editing solution.

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

Key Responsibilities:

  • Research and identify Medicare, Medicaid, and other medical coding and billing documents to identify claim denial or covered criteria (clinical content) for our automated claims editing solution.
  • Provide written and oral presentations to Medical Director (physicians) and other clinical colleagues to obtain consensus on proposed denial criteria.
  • Provide clinical content support to our customers as needed.
  • Perform data entry of clinical content updates into database, as needed.
  • Solve problems related to the interpretation of inpatient coding or ICD-10-CM coding conventions/guidelines for inclusion or exclusion within Lyric business rules.


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