Senior Medical Content Analyst (Automation)
About this role
Applicants from Visayas and Mindanao are encouraged to apply!
Discover your 100% YOU with MicroSourcing!
Sign-On Bonus: Earn a bonus equivalent to 1 month’s salary upon joining!
Position: Medical Content Analyst – Automation
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.
Summary:
The Content Innovation team is integral to the success of the content development process of Lyric and the expansion of our claims editing solutions. This team member will support development and optimization of AI-driven healthcare solutions. This role bridges clinical coding expertise with artificial intelligence, ensuring that model outputs are accurate, compliant and aligned with claims editing.
- Review and validate AI generated CPT, HCPCS, ICD10CM and other claim data set elements.
● Verify coding or billing guidelines and other data extracts from AI to confirm accuracy in accordance with coding parameters.
● Identify any AI data extract anomalies or defects.
● Provide accurate and timely feedback to AI to improve model performance.
● Remain informed with medical coding and billing regulatory changes to contribute continuous improvement of AI tools.
● Participate in the development of coding guidelines for AI-assisted workflows.
● Validate criteria for policy or rule suitability
● Serve as a subject matter expert (SME) in cross-functional team with Clinical, technical, and product stakeholders.
Required qualifications
● Bachelor’s degree in health information management, Nursing or other Healthcare related degree required
● Active American Academy of Professional Coders (AAPC) Certified Professional Coders (CPC) certification or American Health Information Management Association (AHIMA) Certified Coding Specialist-Physician (CCS-P) or Certified Coding Specialist (CCS)
● Minimum of 5 years of relevant healthcare experience, including at least 3 years in medical coding, chart review, auditing, or abstraction. Must demonstrate proficiency in applying CPT, ICD-10-CM, and HCPCS coding conventions, including translating clinical documentation into appropriate codes.
● Understanding of US health insurance payers including Commercial, Medicare, Medicaid (FFS and MCOs), third-party claims processing (including paper & EDI processes)
● Strong grasp of medical terminology and human anatomy
● Familiarity with AI-driven tools such as Computer-Assisted Coding (CAC) or Natural Language Process (NLP) platforms
● Proficiency in Microsoft applications
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%! For more information, visit *Terms & conditions apply
Originally posted on Himalayas
