Junior Payment Integrity analyst (Medical coding) – 0-1 yr Exp – Bengaluru – upto 4L CTC

Angel and Genie; Bengaluru; On-site; INR 600,000 - 1,000,000; Full time

Benefits offered by this job

Best-in-class compensation

Health insurance for Family

Personal Accident Insurance

Friendly and Flexible Leave Policy

Certification and Course Reimbursement

Medical Coding CEUs and Membership REN

Health checkup and many more!

Job summary

Angel and Genie in Bengaluru seeks a Clinical Content Specialist to translate clinical guidelines and payer policies into automated rules for claims validation.

You will develop payment integrity rules, build code edits, and research reimbursement methodologies while collaborating with cross-functional teams.

Qualifications

• Education or certification in clinical domain with emphasis on payer policies.
• Ability to convert guidelines into logical, testable rules.
• Freshers welcome with strong pharmacy/clinical foundation and research mindset.

Responsibilities

• Develop and maintain payment integrity rules and policies.
• Translate payer guidelines into business rules.
• Build code edits to detect incorrect payments.
• Research medical policies and reimbursement methodologies.

Skills

Clinical concepts

Rules translation

Research mindset

Testing rules

Communication skills

Education

MBBS / BDS / BPT / BAMS

Nursing: BSN / MSN

Pharmacist degree (B.Pharm / M.Pharm / PharmD)

Life Science degree

Job description

Position Overview:

This role focuses on developing clinical content, payment integrity rules, and code edit solutions. The Clinical Content Specialist will translate clinical guidelines and payer policies into business logic, algorithms, and rule frameworks for automated claims validation.

Key Responsibilities:

• Develop and maintain payment integrity rules, edits, and policies
• Translate Healthcare Payer guidelines → business rules
• Build code edit solutions to detect incorrect payments
• Conduct research on medical policies and reimbursement methodologies

Requirements:

• Passionate about working in the clinical domain, with a focus on learning and growth
• Strong foundation in clinical concepts, Ability to convert clinical guidelines into logical rules
• Demonstrated experience in research work, college thesis, or complex case study analysis
• Strong research mindset with the ability to interpret clinical and medical literature
• Excellent communication, articulation, and interpretation skills
• Ability to translate complex clinical information into clear and structured insights
• Sound clinical knowledge with attention to detail and accuracy
• Support the configuration of payment integrity rules/solutions based on business requirements.
• Assist with testing configured rules and validating results to ensure expected outcomes.

Qualifications

Education & Certification (one of the following required):

• Medical Degree (e.g., MBBS, BDS, BPT, BAMS etc)
• Nursing: Bachelor/Master of Science in Nursing
• Pharmacist Degree (B.Pharm, M.Pharm or PharmD)
• Life Science -Bachelor/Master

Certification Requirements:

• Must hold any of the following certifications: CPC, CPMA, COC, CIC, CPC-P, CCS or any specialty certifications from AHIMA or AAPC.

Experience:

Freshers with a strong foundation in Pharmacy/Clinical concepts and a research mindset can be considered.

Key Skills:

• Strong analytical & interpretation skills
• Excellent verbal & written communication skills.
• Excellent Interpretation and articulation skills
• Strong analytical, critical thinking, and problem-solving skills
• Willingness to learn new products and tools

Work Details:

• Location: Jayanagar, Bangalore
• Mode: Work from Office

Benefits:

• Best-in-class compensation
• Health insurance for Family
• Personal Accident Insurance
• Friendly and Flexible Leave Policy
• Certification and Course Reimbursement
• Medical Coding CEUs and Membership Renewals
• Health checkupAnd many more!