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Medical Coder
2 weeks ago
Discover your 100% YOU with MicroSourcing
Position: Medical Coder
Location: GSC Tower, BGC, Taguig City
Work Set-up & Shift: Work From Home and Night Shift
Position Summary:
The Medical Coder will be responsible in 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, minimums & maximums, quantity limitations, place of service limitations, and other clinical content criteria.
Duties and 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.
Required Qualifications:
- Bachelor's Degree in Nursing.
- Must have anActive RN (PRC) License.
- Must be an 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 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/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.
About MicroSourcing
With over 9,000 professionals across 13 delivery centers, MicroSourcing is the pioneer and largest offshore provider of managed services in the Philippines.
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