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:
Solid expertise in Medical Coding & RCM processes
Hands-on experience in claims audit and validation
Understanding of coding guidelines, billing workflows, and compliance
Solid 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 current rules and policy enhancement

📌 Medical Coding Auditor Bengaluru
🏢 2070Health
📍 Bengaluru