Senior Medical Content Analyst

Lyric Ai; Manila; On-site; PHP 600,000 - 900,000; Full time

Job summary

Lyric in Manila is seeking a Senior Medical Content Analyst to support clinical content updates, coding interpretation and denial decision workflows. You will work with Medical Directors and clinicians to align on criteria and provide customer-facing content support.

Ideal candidates have 5+ years in medical billing/coding with strong communication, MS Office and workflow tools, and familiarity with ICD-10-CM guidelines. Clinical content roles suit those who thrive in agile, fast-paced teams.

Qualifications

• BS Nursing or BS Pharmacy (or equivalent) is required.

Responsibilities

• Update diagnosis, procedure codes and clinical content criteria.
• Present denial criteria to medical leadership to gain consensus.
• Provide clinical content support to customers as needed.
• Enter clinical content updates into the database as needed.
• Resolve inpatient coding interpretation issues per ICD-10-CM guidelines for Lyric rules.
• Recommend software-denial criteria based on coding guidelines.

Skills

Communication

Analytical thinking

Verbal communication

Documentation

Education

BS Nursing

BS Pharmacy

Tools

MS Word

MS Excel

MS Access

Visio

JIRA

SharePoint

MS Project

Job description

Senior Medical Content Analyst page is loaded## Senior Medical Content Analystlocations: Manila, Philippinestime type: Full timeposted on: Posted Yesterdayjob requisition id: JR880Lyric 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 guidelinesRequired Qualifications* BS Nursing, BS Pharmacy or equivalent required* 5 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 requiredPreferred Qualifications* Master's degree in business or healthcare related field* Previous ClaimsXten experience* Previous experience using AI tools in a professional environment* Previous experience at CMS (Medicare or Medicaid) or at a Health Insurance plan* Ability to convey complex technical information across various formats (written, verbal, visual)* Comfortable working in agile, fast-paced, and collaborative environments* Willing to participate in target AI training programs* Self-motivated and proactive, with the ability to work independently and with minimal supervision* Strong analytical and critical thinking skillslocations: Manila, Philippinestime type: Full timeposted on: Posted Yesterday