Clinical Content Analyst: Denials & Coding Expert

Lyric; Manila; On-site; PHP 670,000 - 1,004,000; Full time

Job summary

Lyric, a leader in healthcare decision intelligence, is seeking a qualified clinician with expertise in medical billing, coding, and claims processing. The role requires collaboration with physicians and clinical colleagues to adjudicate denial criteria and update software with policy rules.

The candidate will support clients and ensure accurate coding and billing practices. Candidates should have 5 years of relevant experience, strong communication skills, and proficiency with common MS Office

Qualifications

• BS Nursing or BS Pharmacy or equivalent is required.
• 5 years of medical billing/coding/claims processing experience is required.
• Experience with US health insurance payers in claims, appeals or coding is required.
• Excellent written and verbal communication skills.
• Proficiency with MS Word, Excel, Access, Visio, JIRA, and SharePoint.

Responsibilities

• Provide updates to diagnosis/coding content criteria.
• Present criteria to Medical Director and clinical colleagues for consensus.
• 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.
• Make recommendations for denial of criteria based on coding guidelines.

Skills

Medical billing

Medical coding

Claims processing

Communication

Documentation

Education

BS Nursing

BS Pharmacy

Tools

MS Word

MS Excel

MS Access

Visio

JIRA

SharePoint

Job description

Lyric, a leader in healthcare decision intelligence, is seeking a qualified clinician with expertise in medical billing, coding, and claims processing. The role requires collaboration with physicians and clinical colleagues to adjudicate denial criteria and update software with policy rules.

The candidate will support clients and ensure accurate coding and billing practices. Candidates should have 5 years of relevant experience, strong communication skills, and proficiency with common MS Office