Clinical Data Analyst

3 days ago

Mandaue City, Central Visayas, Philippines beBeeCoding Full time ₱400,000 - ₱550,000
Medical Coding Professional

We are seeking a Medical Coding Professional to join our team. This individual 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.

Key Responsibilities
  • Conduct research and identify Medicare, Medicaid, and other medical coding and billing documents to identify claim denial or covered criteria (clinical content)
  • Provide written and oral presentations to clinical colleagues to obtain consensus on proposed denial criteria
  • Provide clinical content support to 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

Required Qualifications:

  • Bachelor's Degree in Nursing
  • Active RN (PRC) License
  • AHIMA Certified Coding Specialist - Physician (CCS-P) or AAPC Certified Professional Coder (CPC)
  • At least 5 years of experience in the areas of 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
  • Experience in denial management or claim review management is a plus/advantage
  • Excellent Communication Skills (verbal and written) enabling effective communication with all areas of the business
  • Proficient in using MS Office Applications
  • Amenable to Work on Night Shift
  • Amenable to Work From Home Set-Up

Seniority Level: Mid-Senior level
Employment Type: Full-time
Job Function: Health Care Provider
Industries: Outsourcing and Offshoring Consulting

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