Medical Coder

MicroSourcing International; Taguig; Remote; PHP 400,000 - 700,000; Full time

Benefits offered by this job

Healthcare coverage on day one

Paid time-off with cash conversion

Group life insurance

Performance bonuses

Job summary

MicroSourcing is seeking a Medical Content Analyst to work from home in a night-shift role, focusing on Medicare/Medicaid and clinical coding criteria for automated claims editing.

The role requires a BS Nursing or BS Pharmacy and 4 years in medical billing or coding, with strong communication and proficiency in MS Office and coding standards. Healthcare from day one and performance bonuses are among the rewards.

Qualifications

• BS Nursing or Pharmacy degree required; US health payer experience in claims/denials is required.
• 4 years of medical billing/coding/claims processing experience; experience with US health payers is required.
• Strong communication skills (verbal and written) across internal/external stakeholders.
• Proficiency with software: MS Word, MS Excel, MS Access, Visio, JIRA, SharePoint; MS Project is a plus.

Responsibilities

• Research and identify Medicare, Medicaid, and other medical coding and billing documents to identify claim denial or covered criteria (clinical content) for automated claims editing.
• Present findings to Medical Director and clinical colleagues to obtain consensus on denial criteria.
• Provide clinical content support to customers as needed.
• Perform data entry of clinical content updates into database, as needed.
• Resolve interpretation issues of inpatient coding or ICD-10-CM conventions for Lyric business rules.

Skills

Excellent communication

MS Word

MS Excel

MS Access

Visio

JIRA

SharePoint with MS Project

Education

BS Nursing or BS Pharmacy

AHIMA CCS-P or CPC

Tools

MS Word

MS Excel

MS Access

Visio

JIRA

SharePoint

MS Project

Job description

Job Description

Discover your 100% YOU with MicroSourcing!

Position

Medical Content Analyst

Work setup & shift

Work From Home| Night Shift

Why join MicroSourcing?

Competitive Rewards

Enjoy above-market compensation, healthcare coverage on day one, plus one or more dependents, paid time-off with cash conversion, group life insurance, and performance bonuses

A Collaborative Spirit

Contribute to a positive and engaging work environment by participating in company-sponsored events and activities.

Work-Life Harmony

Enjoy the balance between work and life that suits you with flexible work arrangements.

Career Growth

Take advantage of opportunities for continuous learning and career advancement.

Inclusive Teamwork

Be part of a team that celebrates diversity and fosters an inclusive culture.

Responsibilities

• Research and identify Medicare, Medicaid, and other medical coding and billing documents to identify claim denial or covered criteria (clinical content) for our automated claims editing solution. The clinical content could include additions, deletions or updates to diagnosis codes, procedure codes, age minimums and maximums, quantity limitations, place of service limitations and other clinical content criteria
• Provide written and oral presentations to Medical Director (physicians) and other clinical colleagues to obtain consensus on proposed denial criteria.
• Provide clinical content support to our customers as needed
• Perform data entry of clinical content updates into databse, as needed
• Solve problems related to the interpration of inpatient coding or ICD-10-CM coding conventions/guidelines for inclusion or exclusion within Lyric business rules.

Qualifications

• BS Nursing, BS Pharmacy or equivalent required.
• 4 years experience in medical billing, coding, claims processing, bill and/or chart review/auditing, is required. Previous experience working with US health insurance payers in a claims, appeals or coding capacity is also required
• Experience in denial management or claim review management is a plus. Excellent communication skills (verbal and written) enabling effective communication both internally with all areas of the business and externally.
• Demonstrated proficiency with various software applications, including but not limited to: MS Word, MS Excel, MS Access, Visio, JIRA, Sharepoint with MS project a plus
• AHIMA Certified Coding Specialist - Physician (CCS-P) or AAPC Certified Professional Coder (CPC) is required

About MicroSourcing

With over 9,000 professionals across 13 delivery centers, MicroSourcing is the pioneer and largest offshore provider of managed services in the Philippines.

Our commitment to 100% YOU

MicroSourcing firmly believes that our company's strength lies in our people's diversity and talent. We are proud to foster an inclusive culture that embraces individuals of all races, genders, ethnicities, abilities, and backgrounds. We provide space for everyone, embracing different perspectives, and making room for opportunities for each individual to thrive.

At MicroSourcing, equality is not merely a slogan – it's our commitment. Our way of life. Here, we don't just accept your unique authentic self - we celebrate it, valuing every individual's contribution to our collective success and growth. Join us in celebrating YOU and your 100%!

For more information, visit https://www.microsourcing.com/

• Terms & conditions apply