Clinical Healthcare Analyst

2 days ago

Taguig, National Capital Region, Philippines beBeeCoding Full time $72,000 - $86,400
Medical Coding Specialist

Key Responsibilities:

  • Conduct research and identify Medicare, Medicaid, and other medical coding and billing documents to identify claim denial or covered criteria for automated claims editing solutions.
  • Provide written and oral presentations to physicians and clinical colleagues to obtain consensus on proposed denial criteria.
  • Support customers with clinical content needs.
  • Perform data entry of clinical content updates into databases as required.
  • Solve problems related to the interpretation of inpatient coding or ICD-10-CM coding conventions/guidelines for inclusion or exclusion within business rules.

Requirements:

  • 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 CPT Coding, HCPCS, Medical Billing, Claims Denials and/or Chart Review/Auditing are required.
  • Previous experience working with US 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 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.

Benefits:

Full-time employment type. Mid-senior level position. Health Care Provider job function. Outsourcing and Offshoring Consulting industry.

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