Medical Content Analyst

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

## Medical Content AnalystApply: Manila, Philippines: Full time: Posted Today: JR833Lyric is the trusted leader in healthcare decision intelligence. Built on more than 35 years of proven results, Lyric combines responsible AI with clinical, payment, regulatory, and policy expertise to deliver transparent, auditable insights in milliseconds across real-time claims workflows. Lyric augments human decision-making so health plans can make faster, more accurate payments while maintaining full control. Today, Lyric supports 200 million lives, with nine of the top 10 U.S. health plans relying on its platform to reduce waste, improve efficiency, and support accurate payments.**Essential Job Responsibilities & Key Performance Outcomes*** Provide additions, deletions or updates to diagnosis codes, procedure codes, age minimums & 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 database, as needed* Solve problems related to the interpretation of inpatient coding or ICD-10-CM coding conventions/guidelines for inclusion or exclusion within Lyric business rules* Responsible for making recommendations within the software for the denial of diagnosis, age, or other criteria on medical claims based on coding guidelines**Required Skills & Experience*** BS Nursing 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