Clinical Coding Content Specialist (Denials & Claims)

Lyric Ai; Manila; On-site; PHP 350,000 - 550,000; Full time

Job summary

Lyric AI is seeking a Medical Content Analyst in Manila, Philippines. You will update clinical content, support denial criteria, and liaise with clinical leadership to ensure accurate coding decisions in real-time claims workflows.

The role requires a BA/BS in Nursing or equivalent and 4 years of billing/coding experience with US health payers, plus strong communication and data-entry skills. Knowledge of ICD-10-CM is essential.

Qualifications

• BS Nursing or equivalent required.
• 4 years’ experience in medical billing, coding, claims processing, bill and/or chart review/auditing.
• Experience with US health insurance payers in claims, appeals or coding is required.
• Experience in denial management or claim review is a plus.
• AHIMA CCS-P or AAPC CPC certification is required.

Responsibilities

• Provide additions, deletions or updates to diagnosis/codes and other clinical content criteria.
• Present to Medical Director and clinicians to obtain consensus on denial criteria.
• Provide clinical content support to customers as needed.
• Data entry of clinical content updates into database.
• Interpret inpatient coding and ICD-10-CM guidelines for Lyric rules.
• Recommend software-denial decisions based on coding guidelines.

Skills

Communication

Data entry

MS Excel

MS Word

MS Access

JIRA

SharePoint

Clinical content interpretation

Education

BS Nursing or equivalent

Tools

Visio

MS Project

JIRA

SharePoint

Job description

Lyric AI is seeking a Medical Content Analyst in Manila, Philippines. You will update clinical content, support denial criteria, and liaise with clinical leadership to ensure accurate coding decisions in real-time claims workflows.

The role requires a BA/BS in Nursing or equivalent and 4 years of billing/coding experience with US health payers, plus strong communication and data-entry skills. Knowledge of ICD-10-CM is essential.