BGC

Medical Coder

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Medical Coder

  • Picadilly Star Buliding, Bonifacio Avenue, Taguig, Metro Manila, Philippines

  • 25 Openings

  • All Tenure

  • 35k/Month

  • 35000/Month

  • Confidential

Job Pitch

Be part of our IT Healthcare Team!

Job Description

The Medical Content Specialist researches, analyzes and creates clinical content for the business rules for Change Healthcare’s Clinical Claims Management (CCM). The CCM Product Line is a fast-paced environment with contractually driven quarterly and monthly deliverables. The CCM products are utilized by payer organizations to augment claims management systems, by electronically auditing medical claims, for accurate processing of both professional and facility claims. The role of the Content Specialist is to provide comprehensive and in-depth research, analysis, and content development of new and revised content to be offered in existing or new business rules, to expand the CCM content offerings. Clinical content also includes but is not limited to CPT codes, ICD-10-CM diagnosis codes, HCPCS codes, POS codes, DRG’s, APC’s and other code sets and the translation of written clinical information into deniable clinical content. Content development is defined as the identification of a clinical term or medical condition and translating it into a procedure code, diagnosis code or any other code set element as appropriate. Qualifications: - Bachelor of Nursing or healthcare degree from an accredited University e.g., Registered Nurse (Philippines or US) equivalent is required; a Master’s degree is preferred. - American Academy of Professional Coders / CPC certification is required. - Knowledge in Pharmaceutical data informatics. - Sound knowledge in US healthcare and Clinical Pharmacy. - Ability to perform Pharmacy benefit analysis, research, quality reviewing, and implementing the same. - Strong working knowledge of HCPCS codes & guidelines, current ICD-10-CM codes, and guidelines as well as current medical coding and billing guideline expertise are strongly preferred - HIPAA compliance.

Skill Required

  • Attention to Detail
  • Empathetic to Customers
  • Positive Attitude

Qualification Required

  • College Graduate
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