Senior Medical Content Analyst

Discover your 100% YOU with MicroSourcing ! Sign-On Bonus: Earn a bonus equivalent to 1 month's salary upon joining! Position: Senior Medical Content Analyst 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.

Your Role: As a Senior Medical Content Analyst , you will: Clinical Policy Research: Analyze Medicare, Medicaid, and commercial billing policies to identify claim denial criteria, coverage limitations, age/quantity thresholds, and place-of-service rules.

Claim Engine Rule Optimization: Maintain and update clinical logic within database platforms, managing code additions, deletions, and edits for ICD-10-CM, CPT, and HCPCS.

Medical Director Presentations: Prepare written summaries and conduct oral presentations for Medical Directors (physicians) and clinical stakeholders to secure consensus on proposed denial rules.

Complex Coding Resolution: Interpret complex ICD-10-CM conventions, inpatient coding guidelines, and coding edits to resolve ambiguous business rule requirements.

Database Entry & System Maintenance: Perform precise data entry of clinical content updates, policy changes, and coding logic using JIRA, SharePoint, MS Access, and Excel. Client & Operational Support: Provide clinical coding support and rule explanations to US health plan clients and internal product teams.

What You Need: Non-negot