About the role
Discover your 100% YOU with MicroSourcing!
Position: Medical Content Analyst (Junior)
Work setup & shift: Work From Home| Night Shift
Why join MicroSourcing?
You'll have:
Competitive Rewards: Enjoy above-market compensation, healthcare coverage on day one, plus one or more dependents, paid time-off with cash conversion, group life insurance, and performance bonuses
A Collaborative Spirit: Contribute to a positive and engaging work environment by participating in company-sponsored events and activities.
Work-Life Harmony: Enjoy the balance between work and life that suits you with flexible work arrangements.
Career Growth: Take advantage of opportunities for continuous learning and career advancement.
Inclusive Teamwork: Be part of a team that celebrates diversity and fosters an inclusive culture.
Responsibilities:
Review Medicare, Medicaid, Specialty Society, and alternative medical coding authority publications to identify covered and non-covered guideline updates.
Enter researched clinical content into Lyric software accurately, adhering to established claim outcome processes and review guidelines.
Compare current coding authority documentation against existing software logic to identify out-of-date code sets and rules.
Share researched coding and billing data with internal teams and escalate complex technical questions to senior subject matter experts.
Validate, organize, and maintain source documentation to justify current and future claims editing packages.
Maintain up-to-date knowledge of national code sets, reimbursement requirements, and medical policy updates under the guidance of senior staff.
Qualifications:
Bachelor's degree in Health Information Management, Nursing, or a closely related healthcare field.
Valid AAPC CPC, AHIMA CCS-P, or AHIMA CCS credential (Apprentice status is acceptable).
Minimum of 1 year of experience in healthcare or insurance payer environments, such as medical claims processing, chart auditing, billing, or clinical editing.
Solid understanding of US health insurance frameworks, including Commercial, Medicare, and Medicaid (FFS and MCO) billing protocols.
Direct working knowledge of pre-payment claims editing, payment integrity, and formal reimbursement policies.
Proven ability to synthesize and present highly complex regulatory or medical coding structures clearly.
About MicroSourcing
With over 9,000 professionals across 13 delivery centers, MicroSourcing is the pioneer and largest offshore provider of managed services in the Philippines.
Our commitment to 100% YOU
MicroSourcing firmly believes that our company's strength lies in our people's diversity and talent. We are proud to foster an inclusive culture that embraces individuals of all races, genders, ethnicities, abilities, and backgrounds. We provide space for everyone, embracing different perspectives, and making room for opportunities for each individual to thrive.
At MicroSourcing, equality is not merely a slogan – it's our commitment. Our way of life. Here, we don't just accept your unique authentic self - we celebrate it, valuing every individual's contribution to our collective success and growth. Join us in celebrating YOU and your 100%!
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Originally posted on Himalayas