Clinical Content Researcher

3 days ago

Manila, National Capital Region, Philippines beBeeAnalyst Full time ₱900,000 - ₱1,200,000
Medical Content Analyst

This is a challenging role that involves analyzing medical content to identify new claims editing opportunities.

  • Evaluate analytics reports and medical claims to identify new claims editing opportunities
  • Contribute to the content topics backlog for editing consideration
  • Function as a subject matter expert for current claims auditing and medical coding scenarios to expand editing outcomes
  • Provide knowledge transfer to colleagues for rule development
  • Solve problems related to the interpretation of inpatient coding or ICD-10-CM coding conventions/guidelines for inclusion or exclusion with business rules

Required:

  • BS Nursing, BS Pharmacy, or equivalent required
  • 4 years' experience in medical billing, coding, claims processing, bill and/or chart review/auditing, is required. Previous experience working with health insurance payers in a claims, appeals, or coding capacity is also required
  • Experience in denial management or claim review management is a plus
  • Excellent communication skills (verbal and written) enabling effective communication both internally with all areas of the business and externally
  • Demonstrated proficiency with various software applications, including but not limited to: MS Word; MS Excel; MS Access; Visio; JIRA; SharePoint with MS project a plus

The ideal candidate will possess excellent analytical skills, be able to work independently, and have strong communication skills. They must be able to analyze complex data, make recommendations, and communicate these recommendations effectively to stakeholders.

General Competencies:

  • Ability to influence and direct thoughts and actions to successfully reach goals
  • Embraces challenges, persists in the face of setbacks, and finds inspiration in the success of others
  • Proven ability to engender trust and build relationships through partnering with clients for innovation and providing high-quality products and services
  • Can provide clear, balanced advice/counsel on a range of strategic and complex management, product, and market issues
  • Results-oriented style with a high degree of analytical ability and proven problem-solving skills
  • Ability to thrive and quickly adapt to change, leading others through change in a dynamic, fast-paced industry and work environment
  • Ability to manage a team in a matrix environment to recruit and retain top talent, build consensus, and rally members to achieve results
  • Effectively builds strong relationships and partnerships within and outside of the company. Able to navigate within a matrixed corporate structure

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