# Medical Coding Auditor (Payment Integrity)

> 2070Health · Bengaluru, India · Full-time · Posted 2026-06-05

**Workplace:** on_site

**Department:** 2070 Health

## Description

**This role is not for 2070 Health.**

**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.  

**Specialty Expertise:**

Evaluation & Management (E/M)

Surgery / Anesthesia / Radiology

DME

Any Medical Coding Specialty  

**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  

**Requirements:**

-   Strong expertise in Medical Coding & RCM processes
-   Hands-on experience in claims audit and validation
-   Understanding of coding guidelines, billing workflows, and compliance
-   Strong domain expertise Semi automated Claims review
-   Solid understanding of medical coding & billing methodologies and guidelines, including CPT, ICD, LCD/NCD, PTP, NCCI, edits, modifiers, Medicare Physician fee schedule, and coding conventions.
-   Proficiency in data collection, analysis, and deriving actionable insights from CMS medical policies, Medicaid Provider Manuals and other Medical publications.
-   Translate industry references into actionable business logic to support new rules and policy enhancements.
-   Strong understanding of claim forms like UB-04/CMS 1450 and CMS 1500
-   Collaborate effectively across teams while managing multiple priorities
-   Ability to thrive in a fast-paced, dynamic environment with minimal supervision.
-   Demonstrated mindset for continuous learning and improvement and apply insights to policy development, refinement and maintenance.
-   Strong stakeholder management, interpersonal, and leadership skills.
-   Solution-focused, motivated, entrepreneurial spirit with a strong sense of ownership.
-   Clear and effective communication.
-   Strong attention to accuracy and detail in all deliverables  
    

**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.
-   Additional weightage will be given for AAPC specialty coding certifications.
-   Lean Six Sigma certification and practical application experience are preferred.  
    

**Experience:**

-   Experience in Payment Integrity Content/Research, Semi automated Claims Review

-   3+ years experience for Analyst
-   5+ years experience for TL
-   10+ Years for Manager
-   13+ years for Senior Manager

-   Experience in rule requirement Semi automated Claims Review.
-   Experience in claims review, denials, coding validation  
    

**Key Skills:**

-   Medical Coding (CPT, ICD, HCPCS)
-   Claims Audit & Validation
-   RCM & Denials Management
-   Knowledge of NCCI edits, modifiers
-   Nurse claims Review
-   Attention to detail & analytical skills
-   Domain Expertise in US Healthcare Medical Coding, Medical Billing, Payment Integrity, Revenue Cycle Management (RCM), Denials Management.
-   Codeset Knowledge like CPT/HCPCS, ICD, Modifier, DRG, PCS, etc.
-   Payment Policies knowledge like Medicare/Medicaid Reimbursement, Payer Payment Policies, NCCI, IOMs, CMS Policies etc
-   High proficiency in Microsoft Word and Excel, with adaptability to new platforms.
-   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 checkup
-   And many more!

## Apply

[Apply at 2070Health](https://apply.workable.com/2070health/j/4153DF276F/apply)

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