Medicare Coding Content & Denial Analyst

Color Employer, LLC; Manila; Hybrid; PHP 446,400 - 669,600; Full time

Job summary

Color Employer, LLC is looking for a Medical Content Analyst in Manila, Philippines. This role involves researching Medicare and Medicaid documents to determine claim denial criteria. Analysts will provide presentations and clinical support and perform data entry for updates.

The ideal candidate should possess a BS in Nursing, at least 4 years of experience in medical billing, and hold coding certifications (CCS-P or CPC). Communication skills and proficiency in various software are essential.

Qualifications

• BS Nursing or equivalent required.
• Minimum of 4 years' experience in medical billing, coding, claims processing, or auditing.
• Previous experience with U.S. health insurance payers is required.
• Experience in denial management is a plus.
• Excellent communication skills for internal and external communication.
• Proficiency with software applications is necessary.

Responsibilities

• Provide written and oral presentations to reach consensus on proposed denial criteria.
• Offer clinical content support to customers as needed.
• Perform data entry of clinical content updates.
• Solve issues related to inpatient coding or ICD-10-CM guidelines.
• Make recommendations for denial of medical claims based on guidelines.

Skills

Strong verbal and written communication skills

Proficiency with MS Word

Proficiency with MS Excel

Proficiency with MS Access

Experience with JIRA

Experience with SharePoint

Experience with MS Project

Education

Bachelor of Science in Nursing or equivalent

AHIMA Certified Coding Specialist – Physician (CCS-P) or AAPC Certified Professional Coder (CPC)

Tools

MS Word

MS Excel

MS Access

Visio

JIRA

SharePoint

MS Project

Job description

Color Employer, LLC is looking for a Medical Content Analyst in Manila, Philippines. This role involves researching Medicare and Medicaid documents to determine claim denial criteria. Analysts will provide presentations and clinical support and perform data entry for updates.

The ideal candidate should possess a BS in Nursing, at least 4 years of experience in medical billing, and hold coding certifications (CCS-P or CPC). Communication skills and proficiency in various software are essential.