Medical Content Analyst-Research

Lyric; Hyderabad; Hybrid; INR 1,200,000 - 1,800,000; Full time

Job summary

Lyric is seeking a healthcare coder to support AI-driven healthcare solutions, bridging clinical coding with AI outputs. The role emphasizes accuracy, regulatory alignment, and improvement of AI models for claims editing.

Required background includes MBBS/BAMS/BHMS/BDS/BPT with internship and 2+ years US healthcare experience, with CPT/ICD-10-CM/HCPCS proficiency and familiarity with payer processing.

Qualifications

• Minimum of 2 years of relevant US healthcare experience.
• Proficiency in CPT, ICD-10-CM, HCPCS coding conventions.
• Understanding of US payer types and claims processing (Commercial, Medicare, Medicaid).

Responsibilities

• Verify coding or billing guidelines and data extracts from AI for accuracy.
• Review Medicare/Medicaid/Commercial guidelines and create/maintain policies.
• Provide accurate and timely feedback to AI to improve model performance.
• Stay updated on medical coding and billing regulatory changes to improve AI tools.
• Participate in development of coding guidelines for AI-assisted workflows.
• Validate criteria for policy or rule suitability.

Skills

CPC/CCS-P

US healthcare

Coding standards

Medical terminology

MS Office

Education

MBBS/BAMS/BHMS/BDS/BPT with internship

Tools

AAPC CPC

AHIMA CCS-P

Job description

JOB SUMMARY

The Content Innovation team is integral to the success of the content development process of Lyric and the expansion of our claims editing solutions. This team member will support development and optimization of AI-driven healthcare solutions. This role bridges clinical coding expertise with artificial intelligence, ensuring that model outputs are accurate, compliant and aligned with claims editing.

ESSENTIAL JOB RESPONSIBILITIES & KEY PERFORMANCE OUTCOMES

• Verify coding or billing guidelines and other data extracts from AI to confirm accuracy in accordance with coding parameters.
• Review Medicare/Medicaid/Commercial guidelines and create/maintain policies
• Provide accurate and timely feedback to AI to improve model performance.
• Remain informed with medical coding and billing regulatory changes to contribute continuous improvement of AI tools.
• Participate in the development of coding guidelines for AI-assisted workflows.
• Validate criteria for policy or rule suitability.

REQUIRED QUALIFICATIONS

• Bachelors degree in MBBS/BAMS/BHMS/BDS/BPT with completed internship
• Active American Academy of Professional Coders (AAPC) Certified Professional Coders (CPC) certification or American Health Information Management Association (AHIMA) Certified Coding Specialist-Physician (CCS-P)
• Minimum of 2 years of relevant US healthcare experience, must demonstrate proficiency in applying CPT, ICD-10-CM, and HCPCS coding conventions, including translating clinical documentation into appropriate codes.
• Understanding of US health insurance payers including Commercial, Medicare, Medicaid (FFS and MCOs), third-party claims processing (including paper & EDI processes)
• Strong grasp of medical terminology and human anatomy
• Proficiency in Microsoft applications

PREFERRED QUALIFICATIONS

• Bachelor’s degree in healthcare related field
• Previous US Healthcare in Payer/Provider specific experience
• Previous experience in Medicaid/Commercial policy reimbursement guidelines
• Previous experience at CMS (Medicare or Medicaid) or at a Health Insurance plan
• Comfortable working in agile, fast-paced, and collaborative environments
• Self-motivated and proactive, with the ability to work independently and with minimal supervision
• Strong analytical and critical thinking skills