Job Summary
CoverSelf is hiring a skilled Medical Coding & Denials Policy Analyst for its Payment Integrity division in Bangalore. This full-time, on-site role requires hands-on experience in medical coding, denials management, and reimbursement policy development. Ideal for professionals with a strong background in Payment Integrity, coding standards like CPT and ICD, and healthcare claims processing, this role offers the opportunity to shape medical reimbursement policies within a cutting-edge healthcare technology platform.
Key Responsibilities
Research and implement concepts to detect incorrect healthcare payments via data analysis and regulatory research.
Manage and develop 1–3 medical reimbursement payment policies based on role level.
Maintain coding guidelines, Medicare/Medicaid edits, and reimbursement frameworks.
Translate complex clinical guidelines into actionable business logic.
Stay updated with CMS, Medicaid, and payer reimbursement policies.
Independently create and refine clinical coding policies and edits.
Leverage AI tools (e.g., ChatGPT, Gemini, Bard) for content development and policy logic automation.
Collaborate cross-functionally while handling multiple priorities in a fast-paced environment.
Required Skills & Qualifications
Expertise in Payment Integrity, Denials Management, Revenue Cycle Management.
In-depth knowledge of CPT, HCPCS, ICD-10, DRG, PCS, modifiers, Medicare/Medicaid policies.
Familiarity with UB-04/CMS 1450 and CMS 1500 forms.
Proficient in Microsoft Word, Excel, and AI tools like ChatGPT, Gemini.
Strong analytical, critical thinking, and problem-solving abilities.
Excellent communication, articulation, and stakeholder management skills.
Ability to synthesize CMS/Medicaid policies into business rules and logic.
Education: MBBS, BDS, BPT, BAMS, Nursing, B.Pharm, M.Pharm, PharmD, or Life Science degree.
Certifications: CPC, CPMA, COC, CIC, CPC-P, CCS, or AAPC/AHIMA specialty certifications (mandatory).
Lean Six Sigma certification preferred.
Experience:
Analyst: 3+ years
Team Lead: 5+ years
Manager: 10+ years
Senior Manager: 13+ years
Perks & Benefits
Best-in-class compensation
Comprehensive family health insurance
Personal accident insurance
Flexible and friendly leave policies
Certification & course reimbursement
Medical Coding CEUs & membership renewals
Regular health checkups
Inclusive and diverse work environment
Company Description
CoverSelf is a next-generation healthcare technology company specializing in claim accuracy and payment integrity for US healthcare payers. With a cloud-native, scalable platform backed by top VCs, CoverSelf simplifies complex healthcare processes and reduces administrative costs.
Work Mode
On-site – Jayanagar, Bangalore
Call to Action
Ready to shape the future of healthcare payment integrity? Apply now to join CoverSelf’s innovative team in Bangalore and contribute to cutting-edge medical coding and policy development.
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Appleton | Kenosha | Pleasant Prairie | Portage | Waukesha |United states :
Arizona | Buffalo Grove | Clayton | Downers Grove | fairmont | Georgia | Keene | Michigan | Mt. Pleasant | New Jersy | OH | Piedmont | Salisbury | United States | Whitesboro | Winston-Salem |Georgia :
Atlanta | Augusta | Rome |Maine :
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Frank Scottile Blvd |Missouri :
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Mexico |northeastern :
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Europe | France | Latvia | Lendava | Leuven | Poland | Slovenia | Spain |Finland :
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Sheffield |Oxfordshire :
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Brazil | Sao paulo |Attica :
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Manila |Croatia :
Croatia |Zagreb :
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Japan | Saitama |Tokyo :
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Turku |Remote Korea :
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