Medical Coding Auditor (Payment Integrity)

Saarthi; Bengaluru; On-site; INR 450,000 - 800,000; Full time

Job summary

CoverSelf is seeking a Coding Auditor in Bengaluru to perform hands-on claims review, validate CPT/ICD/HCPCS codes, and support denials management. You will analyze claims using RCM workflows and ensure adherence to CMS, NCCI, and Medicare/Medicaid guidelines.

The role involves working on UB-04 and CMS 1500 forms and collaborating with internal teams to improve claim accuracy. The ideal candidate will identify coding/billing errors, flag incorrect claims, and propose corrections to streamline

Responsibilities

• Perform manual claims review and identify coding/billing errors
• Validate CPT, ICD, HCPCS codes, modifiers
• Support denials management & pre/post payment review
• Analyze claims using RCM workflows & reimbursement methodologies
• Flag incorrect claims and recommend corrections
• Ensure compliance with CMS, NCCI, Medicare/Medicaid guidelines
• Work on UB-04 / CMS 1500 claims forms
• Collaborate with internal teams to improve claim accuracy

Job description

• About CoverSelf:**CoverSelf empowers US healthcare payers with a truly next-generation, cloud-native, holistic, and customizable platform designed to prevent and adapt to the ever-evolving inaccuracies in healthcare claims and payments. By reducing complexity and administrative costs, we offer a unified, healthcare-dedicated platform backed by top VCs like BeeNext, 3One4 Capital, and Z21 Ventures.
• Position Overview:**This role focuses on hands-on claims review, coding validation, and RCM processes. The Coding Auditor will identify incorrect coding/billing, support denials management, and ensure compliance with payer and CMS guidelines to improve payment accuracy.
• Key Responsibilities:**Perform manual claims review and identify coding/billing errors Validate CPT, ICD, HCPCS codes, modifiers Support denials management & pre/post payment review Analyze claims using RCM workflows & reimbursement methodologies Flag incorrect claims and recommend corrections Ensure compliance with CMS, NCCI, Medicare/Medicaid guidelines Work on UB-04 / CMS 1500 claims forms Collaborate with internal teams to improve claim accuracy