Senior Medical Coding Content Specialist

Manatal; Taguig; Hybrid; PHP 1,129,000 - 2,257,000; Full time

Job summary

Manatal seeks a Medical Content Analyst 3 to research Medicare/Medicaid coding and denial criteria for automated claims editing used by US payers. You will craft clinical content updates and support customers with complex coding questions, presenting findings to medical directors and clinicians.

Required BS Nursing or BS Pharmacy, 4 years in medical billing/coding, and CCS-P or CPC certification. Strong communication and software skills (Word/Excel/Access/Visio/JIRA/SharePoint) are essential.

Qualifications

• BS Nursing or BS Pharmacy or equivalent required.
• 4 years’ experience in medical billing, coding, claims processing, bill and/or chart review/auditing required.
• Experience working with US health insurance payers in a claims, appeals or coding capacity preferred.
• AHIMA CCS-P or AAPC CPC certification required.

Responsibilities

• Research and identify Medicare, Medicaid, and other medical coding and billing documents to identify claim denial or covered criteria (clinical content).
• Provide written and oral presentations to Medical Director and 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.
• Resolve issues related to interpretation of inpatient coding or ICD-10-CM guidelines for Lyric business rules.

Job description

Manatal seeks a Medical Content Analyst 3 to research Medicare/Medicaid coding and denial criteria for automated claims editing used by US payers. You will craft clinical content updates and support customers with complex coding questions, presenting findings to medical directors and clinicians.

Required BS Nursing or BS Pharmacy, 4 years in medical billing/coding, and CCS-P or CPC certification. Strong communication and software skills (Word/Excel/Access/Visio/JIRA/SharePoint) are essential.