Clinical Coding Specialist – CPC/CPCA, US Payers

ManpowerGroup; Taguig; On-site; PHP 360,000 - 600,000; Full time

Job summary

ManpowerGroup Philippines is seeking a Medical Billing and Coding Specialist to review diagnosis and procedure codes, age limits, and other clinical content criteria for accuracy and compliance. The role focuses on ensuring coding accuracy and payer conformity in line with client requirements.

You will present written and oral recommendations to the Medical Director and clinical colleagues to achieve consensus on denial criteria, and provide ongoing clinical content support to clients.

Qualifications

• Experience in medical billing, coding, claims processing, bill and/or chart review/auditing.
• Experience working with US health insurance payers in a claims, appeals or coding capacity is required.

Responsibilities

• Provide additions, deletions or updates to diagnosis codes, procedure codes, age minimums & maximums, quantity limitations and other clinical content criteria.
• Provide written and oral presentations to Medical Director and other clinical colleagues to obtain consensus on proposed denial criteria.
• Provide clinical content support to our customers as needed.

Skills

Medical coding experience

US payer experience

Education

BS Nursing or equivalent

Job description

ManpowerGroup Philippines is seeking a Medical Billing and Coding Specialist to review diagnosis and procedure codes, age limits, and other clinical content criteria for accuracy and compliance. The role focuses on ensuring coding accuracy and payer conformity in line with client requirements.

You will present written and oral recommendations to the Medical Director and clinical colleagues to achieve consensus on denial criteria, and provide ongoing clinical content support to clients.