Medical Content Developer

16 hours ago


Paranaque City, Calabarzon, Philippines beBeeClinicalContent Full time $60,000 - $95,000
Healthcare Content Specialist Role Overview

This position involves conducting research to identify Medicare, Medicaid, and other medical coding and billing documents for claim denial or covered criteria in our automated claims editing solution.

The role requires a thorough understanding of clinical content, including diagnosis codes, procedure codes, age minimums & maximums, quantity limitations, place of service limitations, and other clinical content criteria.

Key Responsibilities
  • Conduct research on medical coding and billing documents to identify claim denial or covered criteria.
  • Collaborate with Medical Director (physicians) and 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.
  • Analyze and interpret inpatient coding or ICD-10-CM coding conventions/guidelines for inclusion or exclusion within Lyric business rules.
Required Skills and Qualifications
  • Bachelor's Degree in Nursing with an Active RN license.
  • AHIMA Certified Coding Specialist - Physician (CCS-P) or AAPC Certified Professional Coder (CPC) certification.
  • At least 5 years of experience in 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.
  • Excellent communication skills and proficiency in MS Office applications.
About the Opportunity

This is a mid-senior level position that requires strong analytical and problem-solving skills. The ideal candidate will have a passion for delivering high-quality clinical content solutions.

Benefits

This role offers a competitive salary and comprehensive benefits package, including remote work options and flexible scheduling.

Additional Information

Seniority level: Mid-Senior level

Employment type: Full-time

Job function: Health Care Provider and Information Technology

Industries: Outsourcing and Offshoring Consulting

Location: Remote

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