Job Summary
CoverSelf is hiring an experienced Inpatient Medical Coding Analyst for its Payment Integrity division at its Bangalore office. This role requires expertise in DRG validation, inpatient coding (MS DRG/APR DRG), denial management, and policy research. Ideal for candidates passionate about reducing healthcare claim inaccuracies, this role supports the enhancement and development of medical reimbursement policies within a tech-driven healthcare platform.
Key Responsibilities
Research, interpret, and develop concepts to detect inaccurate healthcare payments.
Analyze inpatient claims data for inconsistencies or errors.
Manage medical reimbursement payment policies end-to-end based on role level.
Maintain coding guidelines and reimbursement frameworks including Medicare/Medicaid edits.
Translate complex clinical coding guidelines into actionable business logic.
Develop clinical coding policies and edits ensuring compliance with industry standards.
Independently create content, algorithms, and automation logic using AI tools (e.g., ChatGPT, Bard, Gemini).
Stay updated with industry policies and regulatory guidelines.
Required Skills & Qualifications
Deep expertise in US Healthcare Payment Integrity, Denials Management, and Revenue Cycle Management.
Proficient in ICD-10-CM, DRG, PCS, Revenue Codes, CPT/HCPCS coding systems.
Knowledge of Medicare/Medicaid Reimbursement, CMS Policies, IPPS, SNF, Hospice.
Familiarity with UB-04/CMS 1450 and CMS 1500 claim forms.
High proficiency in MS Word & Excel.
Strong analytical, critical thinking, and problem-solving abilities.
Clear verbal & written communication skills.
Ability to work independently in a fast-paced, evolving environment.
Knowledge of AI tools for content development and policy automation (e.g., ChatGPT, NotebookLLM).
Education & Certifications
MBBS, BDS, BPT, BAMS, B.Sc Nursing, B.Pharm, M.Pharm, PharmD, or Life Science Degree.
Mandatory certifications: CIC, CPC, CPMA, CCS, or AHIMA/AAPC specialty certifications.
Lean Six Sigma certification preferred.
Experience
3+ years for Analyst roles.
5+ years for Team Lead roles.
10+ years for Manager roles.
Strong experience in Payment Integrity, Denial Management, Reimbursement Policy Development.
Perks & Benefits
Competitive industry compensation.
Comprehensive family health insurance.
Personal Accident Insurance.
Flexible and employee-friendly leave policy.
Certification & course reimbursement.
Medical Coding CEUs & membership renewals.
Regular health checkups.
A diverse and inclusive work environment.
Company Description
CoverSelf is a cutting-edge healthcare technology company empowering US healthcare payers with a cloud-native, scalable platform designed for claim accuracy and payment integrity. Backed by leading investors, CoverSelf reduces administrative costs and ensures high claim compliance across the healthcare ecosystem.
Work Mode
On-site – Jayanagar, Bangalore
Call to Action
Ready to advance your career in medical coding and payment integrity? Apply now to join CoverSelf’s innovative healthcare technology team in Bangalore and make a real impact in healthcare claims accuracy.
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Adelanto | Alameda | Albion | Arcata | Atherton | Berkeley | Brisbane | Burlingame | Burney | California | Carlsbad | Crescent City | Davis | Downey | El Monte | El Segundo | Emeryville | Eureka | Fortuna | Foster City | Fremont | Glendale | Hayward | Hoopa | Irvine | La Jolla | Los Angeles | Martinez | McKinleyville | Menlo Park | Millbrae | Milpitas | Morgan Hill | Mountain View | Nevada | Novato | Oakland | Orange | Pacheco | Palo Alto | Pasadena | Pleasanton | Pomona | Redding | Redwood City | Riverside | Roseville | Sacramento | San Bernardino | San Carlos | San Diego | San Francisco | San Gabriel | San Jose | San Mateo | San Rafael | Santa Clara | Santa Cruz | Santa Monica | Simi Valley | Soledad | South San Francisco | St. Helena | Stanford | Stanton | Stockton | Sunnyvale | Temecula | Thousand Oaks | Valencia | Vallejo | West Sacramento | West Valley City | Whittier | Willits |Colorado :
Boulder | Denver | Westminster |Connecticut :
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Edgewood | Ft MItchell | Louisville | Shelbyville |Kington :
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Baton Rouge | Monroe | New Orleans |Louisiana :
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Bangor | Brewer |Maryland :
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Detroit | Houghton Lake | Macomb | Southfield |Minnesota :
Duluth | Eden Prairie | Fridley | Hibbing | Maple Grove | Minneapolis and St. Paul, Minnesota. | Minnetonka | St.Paul |Missouri :
Fulton | Milan | St. Louis |Nebraska :
Hebron | Nebraska City |Nevada :
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Bavaria |North Rhine Westphalia :
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Galway |Meath :
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China | Quarry Bay |Hubei :
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Hangzhou |Melbourne :
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Ballina | Sydney |Queensland :
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Brussels |Flemish Brabant :
Zaventem |Bosnia and Herzegovina :
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Sofia |Canada :
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Croatia |Zagreb :
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Turku |France :
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Greece |East Java :
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Be'Er Sheva | Yavne | Kfar Saba | Tel Aviv | Netanya |Italy :
Italy |Lombardy :
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Japan | Saitama |Tokyo :
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Bucharest |Makkah :
Khulais | Jeddah | King Abdullah Economic City | Najran | Riyadh | Rabigh |Nišava District :
Niš |Singapore :
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Midrand | South Africa |Brazil :
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Madrid |Sweden :
Sweden |Taipei :
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Ho Chi Minh City |