Junior Medical Content Analyst

Location: Manila, Philippines

Company

Healthcare decision intelligence platform combining responsible AI with clinical, payment, regulatory, and policy expertise to support transparent and auditable claims decisions.

What you will do

• Research Medicare, Medicaid, specialty society, and other medical coding authority publications to identify covered and non-covered guideline language.
• Enter clinical content into claims-editing software accurately and follow established review processes.
• Compare coding authority documentation with existing clinical content to identify code set and guideline updates.
• Monitor routine code set changes, guideline revisions, and medical coding requirements with support from senior analysts.
• Share researched coding and billing information with cross-functional teams and escalate complex questions to senior analysts or subject matter experts.
• Validate and maintain source documentation used for claims editing.

Requirements

• Bachelor’s degree in health information management, nursing, or another healthcare-related field.
• AAPC CPC, AHIMA CCS-P, or CCS certification required; apprentice status is acceptable.
• At least one year of relevant healthcare or health insurance payer experience, such as medical claims processing, billing, chart review, payment analysis, or clinical editing.
• Working knowledge of pre-payment editing, payment policies, payment integrity, medical coding, and medical billing.
• Understanding of U.S. health insurance payers, including Commercial, Medicare, Medicaid FFS and MCOs, and paper and EDI claims processing.
• Strong communication, analytical, critical-thinking, self-direction, and Microsoft application skills.