Senior Medical Content Analyst | Remote Night Shift

Color Philippines

Taguig

Hybrid

PHP 600,000 - 1,200,000

Full time

13 days ago

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Benefits offered by this job

Sign-on bonus

Healthcare from day one (including 1+/

Dependent coverage

Paid time off with cash conversion

Group life insurance

Performance bonuses

Job summary

MicroSourcing Philippines is hiring a Senior Medical Content Analyst to join our US healthcare payer support team. The role focuses on clinical policy research, denial rule optimization, and complex coding resolution, with data maintenance across JIRA, SharePoint, MS Access, and Excel.

A BSN and active CPC/CCS-P are essential, along with 4+ years of US payer experience. Work from home on a night shift with a sign-on bonus.

Qualifications

BSN required and active professional coding certification: CPC or CCS-P.
4+ years US healthcare payer experience in medical billing, coding, claims processing, chart auditing, or appeals.
Deep understanding of ICD-10-CM, CPT, HCPCS, NCCI edits, LCDs/NCDs, and inpatient coding guidelines.
Proficiency with MS Office, Visio, JIRA, and database tracking systems.

Responsibilities

Analyze Medicare, Medicaid, and commercial billing policies to identify denial criteria and coverage limits.
Maintain and update clinical logic within database platforms for ICD-10-CM, CPT, HCPCS.
Prepare written summaries and presentations for Medical Directors and stakeholders to secure consensus on denial rules.
Interpret ICD-10-CM conventions and coding guidelines to resolve complex business rule requirements.
Data entry of clinical content updates and coding logic using JIRA, SharePoint, MS Access, and Excel.
Provide clinical coding support and rule explanations to US health plan clients and product teams.