Medical Content Analyst

MicroSourcing; Manila; Sur place; PHP 669 600 - 1 004 400; Plein temps

Avantages offerts par ce poste

Healthcare coverage on day one

Paid time-off with cash conversion

Group life insurance

Performance bonuses

Résumé du poste

MicroSourcing is hiring a Medical Content Analyst 3 for a remote role in Metro Manila, Philippines. The analyst will research Medicare/Medicaid documents to identify denial or coverage criteria and present conclusions to the Medical Director and clinical colleagues.

The role requires 4 years in medical billing/coding and CCS-P or CPC certification, with strong communication and MS Office skills. Night shift, full-time position with work-from-home setup.

Qualifications

• BS Nursing or BS Pharmacy or equivalent required.
• 4 years’ experience in medical billing, coding, claims processing or related.
• AHIMA CCS-P or AAPC CPC certification required.
• Excellent verbal and written communication skills.
• Proficiency with MS Word, MS Excel, Visio, JIRA, SharePoint and MS Project.
• Experience in denial management or claim review is a plus.

Responsabilités

• Research Medicare/Medicaid and other coding documents to identify denial or coverage criteria.
• Present findings to Medical Director and clinicians to gain consensus on denial criteria.
• Provide clinical content support to customers as needed.
• Enter clinical content updates into the database.
• Resolve inpatient coding interpretation issues per ICD-10-CM guidelines for Lyric rules.

Connaissances

Verbal communication

Written communication

Attention to detail

Formation

BS Nursing or BS Pharmacy

CCS-P or CPC certification

Outils

MS Word

MS Excel

MS Access

Visio

JIRA

SharePoint

MS Project

Description du poste

Position

Medical Content Analyst 3

Location & Employment

Location: Metro Manila, Philippines
Employment type: Full‑time
Work setup: Work‑from‑home, Night Shift

Summary

The Medical Content Analyst 3 will research and identify Medicare, Medicaid, and other medical coding and billing documents to identify claim denial or covered criteria for our automated claims editing solution. The analyst will provide written and oral presentations to Medical Director and other clinical colleagues to obtain consensus on proposed denial criteria, support customers as needed, and perform data entry of clinical content updates into the database.

Responsibilities

• Research and identify Medicare, Medicaid, and other medical coding and billing documents to identify claim denial or covered 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 customers as needed.
• Perform data entry of clinical content updates into database.
• Resolve problems related to the interpretation 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, and experience working with U.S. health insurance payers in a claims, appeals or coding capacity required.
• Experience in denial management or claim review management is a plus.
• Excellent verbal and written communication skills.
• Proficiency with MS Word, MS Excel, MS Access, Visio, JIRA, SharePoint and MS Project a plus.
• AHIMA Certified Coding Specialist – Physician (CCS‑P) or AAPC Certified Professional Coder (CPC) required.

Why Join MicroSourcing?

Competitive rewards, healthcare coverage on day one, paid time‑off with cash conversion, group life insurance, performance bonuses. Collaborative spirit, work‑life harmony, career growth opportunities, inclusive teamwork.