Medical Content Analyst
At a glance
Mid-level Content Creation role at Tbc. Manila · full-time.
Pay not stated Content Creation salary
Growth Roles summary, based on the employer's posting.
What you'll do
- You'll revise diagnosis, procedure, age, quantity, place-of-service, and related clinical rules
- You'll explain proposed denial criteria to physicians and clinical teams to build agreement
- You'll answer customer needs involving clinical content
- You'll enter content changes into the database and resolve inpatient coding questions
- You'll recommend claim-denial logic using coding conventions and guidelines
What you bring
- A BS in Nursing or an equivalent qualification
- At least four years in medical billing, coding, claims, or bill and chart review
- Experience with US health insurers in claims, appeals, or coding work
- A CCS-P or CPC coding certification
- Strong communication skills and proficiency with MS Word, Excel, Access, Visio, JIRA, and SharePoint
Who this fits
This role suits a mid-level clinical content professional who can interpret coding guidance and communicate recommendations to physicians, colleagues, and customers. The listing places the full-time position in Manila, Philippines, and requires the stated nursing or equivalent background, US payer experience, and coding certification.
From the employer
Lyric is the trusted leader in healthcare decision intelligence. Built on more than 35 years of proven results, Lyric combines responsible AI with clinical, payment, regulatory, and policy expertise to deliver transparent, auditable insights in milliseconds across real-time claims workflows. Lyric augments human decision-making so health plans can make faster, more accurate payments while maintaining full control. Today, Lyric supports 200 million lives, with nine of the top 10 U.S. health plans relying on its platform to reduce waste, improve efficiency, and support accurate payments.
Essential Job Responsibilities & Key Performance Outcomes
Provide additions, deletions or updates to diagnosis codes, procedure codes, age minimums & maximums, quantity limitations, place of service limitations and other clinical content criteria
Provide written and oral presentations to Medical Director (physicians) and other clinical colleagues to obtain consensus on proposed denial criteria
Provide clinical content support to our customers as needed
Perform data entry of clinical content updates into database, as needed
Solve problems related to the interpretation of inpatient coding or ICD-10-CM coding conventions/guidelines for inclusion or exclusion within Lyric business rules
Responsible for making recommendations within the software for the denial of diagnosis, age, or other criteria on medical claims based on coding guidelines
Required Skills & Experience
BS Nursing or equivalent required
4 years’ experience in medical billing, coding, claims processing, bill and/or chart review/auditing, is required. Previous experience working with US health insurance payers in a claims, appeals or coding capacity is also required
Experience in denial management or claim review management is a plus
Excellent communication skills (verbal and written) enabling effective communication both internally with all areas of the business and externally
Demonstrated proficiency with various software applications, including but not limited to: MS Word; MS Excel; MS Access; Visio; JIRA; SharePoint with MS project a plus
AHIMA Certified Coding Specialist – Physician (CCS-P) or AAPC Certified Professional Coder (CPC) is required
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