Job Title Certified Medical Coder Location Malad West Mumbai US Shift 5 30 PM - 2 30 AM Night Shift Job Overview We are looking for a skilled and detail-driven Medical Coder to join our growing US Healthcare TPA operations This role involves auditing and coding medical claims to ensure accuracy benefit alignment and compliance with federal and state healthcare regulations The ideal candidate will play a critical part in maintaining claims processing quality minimizing errors and supporting the financial integrity of our third-party administration TPA services Key Responsibilities Conduct pre-payment and concurrent audits of medical claims for self-funded and level-funded healthcare plans Verify the accuracy of medical coding ICD-10 CPT HCPCS and ensure correct application of plan benefits Cross-reference claim codes with plan documents to determine appropriate benefit adjudication Collaborate with claims examiners supervisors and compliance teams to identify and resolve discrepancies Document and report audit findings with clarity and detail for internal review Ensure all claims processing complies with HIPAA ERISA ACA and other federal state regulations Participate in internal quality assurance programs and continuous process improvement initiatives Maintain strict confidentiality of member and provider information Required Qualifications Minimum 3 years of experience in medical claims coding and auditing within a US healthcare TPA or insurance environment In-depth knowledge of medical coding systems ICD-10 CPT HCPCS and healthcare claim forms CMS-1500 UB-04 Solid understanding of regulatory compliance frameworks including HIPAA ERISA and ACA Proficiency with auditing tools claim processing systems and Microsoft Office applications Certified Professional Coder CPC Certified Skilled Medical Auditor CPMA or Certified Coding Specialist CCS certification is mandatory Strong analytical problem-solving organizational and communication skills Preferred Qualifications Hands-on experience with claims adjudication platforms like Trizetto VBA Plexis Prior experience in medical claims processing will be considered an added advantage Job Type Full-time Pay 400 000 00 - 600 000 00 per year Benefits Health insurance Leave encashment Paid sick time Paid time off Provident Fund Schedule Fixed shift Monday to Friday Night shift US shift Application Question s What is your current location Experience Medical coding 3 years Preferred Medical Auditing 2 years Preferred License Certification Medical Coding Preferred Location Malad Mumbai Maharashtra Preferred Shift availability Night Shift Preferred Overnight Shift Preferred Work Location In person

📌 Certified Medical Coder (Maharashtra)
🏢 Jaincotech
📍 Maharashtra