Junior Medical Content Analyst - Coding & Claims Insight

TBC Corporation; Manila; On-site; PHP 3,466,000 - 4,726,000; Full time

Job summary

Lyric, a leader in healthcare decision intelligence, is seeking a qualified professional to support Medicare/Medicaid coding research and accurate claims editing. You will enter clinical content into Lyric software, review guidelines, and identify updates to ensure correct outcomes.

Ideal candidates have a HIM/health-related degree, relevant payer experience, and CPC/CCS credentials, with strong communication and analytical abilities to navigate complex coding challenges.

Qualifications

• Education: Bachelor's degree in health information management, Nursing or other Healthcare related degree required.
• AAPC CPC certification or AHIMA CCS-P/CCS required; apprentice status acceptable.
• Minimum of one year or more relevant healthcare experience in payer/payment/medical policy analysis or related roles.
• Working knowledge of pre-payment editing, payment policies and payment integrity.
• Must be initiative-taking, self-directed, able to work independently.
• Understanding of US health insurance payers incl. Commercial, Medicare, Medicaid, third-party claims processing (paper & EDI).
• Strong communication skills: able to present complex material via all mediums.
• Analytical skills: ability to analyze complex data, identify trends and assess vulnerabilities.
• Superior critical thinking skills.
• Proficiency in Microsoft applications.

Responsibilities

• Assist with researching Medicare, Medicaid, Specialty Society, and other medical coding authority publications to locate covered and non-covered guideline language.
• Enter clinical content into Lyric software accurately, following established processes and review guidance to support correct claim outcomes.
• Help identify code set and guideline updates by comparing coding authority documentation against existing clinical content.
• Stay informed about routine code set updates, guideline changes, and medical coding requirements with guidance from senior team members.
• Support cross-functional teams by sharing researched coding and billing information and escalating complex subject matter questions to senior analysts or subject matter experts.
• Validate and maintain source documentation for claims editing.

Skills

Healthcare analytics

US payer knowledge

Communication skills

Analytical thinking

Independence

Microsoft Office

Education

Bachelor’s in HIM/Health

Nursing or healthcare degree

Job description

Lyric, a leader in healthcare decision intelligence, is seeking a qualified professional to support Medicare/Medicaid coding research and accurate claims editing. You will enter clinical content into Lyric software, review guidelines, and identify updates to ensure correct outcomes.

Ideal candidates have a HIM/health-related degree, relevant payer experience, and CPC/CCS credentials, with strong communication and analytical abilities to navigate complex coding challenges.