обновлено 1 месяц назад
Medical Content Analyst
Вакансия из Hirify Global, списка международных tech-компанийДля мэтча и отклика нужен Plus
Мэтч & Сопровод
Для мэтча с этой вакансией нужен Plus
Описание вакансии
Текст:
TL;DR
Medical Content Analyst (Healthcare Coding): Developing and maintaining clinical content criteria for medical claims, including diagnosis and procedure codes, age limits, quantity limitations, and place-of-service rules, with an accent on ICD-10-CM coding conventions and denial criteria. Focus on interpreting inpatient coding guidelines, presenting recommendations to physicians, and supporting clinical content updates in healthcare software.
Location: Manila, Philippines
Company
is an AI-first healthcare technology company developing a platform for improving pre-payment accuracy and reducing waste in the healthcare ecosystem.
What you will do
- Maintain diagnosis codes, procedure codes, age limits, quantity limits, place-of-service limits, and other clinical content criteria.
- Present proposed denial criteria to Medical Directors and clinical colleagues to reach consensus.
- Provide clinical content support to customers.
- Enter clinical content updates into the database as needed.
- Interpret inpatient and ICD-10-CM coding conventions and recommend denial criteria for medical claims.
Requirements
- BS in Nursing or an equivalent qualification.
- Four years of experience in medical billing, coding, claims processing, bill or chart review, or auditing.
- Previous experience with US health insurance payers in claims, appeals, or coding is required.
- AHIMA Certified Coding Specialist–Physician (CCS-P) or AAPC Certified Professional Coder (CPC) certification.
- Excellent written and verbal communication skills.
- Proficiency with MS Word, MS Excel, MS Access, Visio, JIRA, and SharePoint.
Nice to have
- Experience in denial management or claim review management.
- Experience with MS Project.
Culture & Benefits
- Work in an AI-first healthcare technology environment.
- Contribute to software designed to improve payment accuracy and reduce healthcare waste.
- Collaborate with physicians, clinical colleagues, customers, and business teams.
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