This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Healthcare Coding Expert (Certified Professional Coder) based in India.
This role offers an prospect to apply deep healthcare coding and claims expertise to initiatives focused on identifying and preventing fraud, waste, and abuse.
You will analyze complex medical claims data, identify potential risks and patterns, and develop actionable leads and referrals.
Working as part of a multidisciplinary healthcare analytics team, you will contribute to projects supporting program integrity and better use of healthcare resources.
The position combines detailed claims analysis with policy research, investigative work, reporting, and quality assurance.
You will collaborate with internal and external stakeholders and help translate analytical findings into meaningful outcomes.
Your expertise in coding standards, reimbursement methodologies, and healthcare compliance will be central to maintaining accuracy and regulatory alignment.




The role also provides opportunities to guide less experienced professionals and contribute to complex projects with significant public-sector impact.
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Accountabilities
Perform analytical activities supporting healthcare fraud, waste, and abuse prevention initiatives, including identifying potential referrals and investigative leads.
Analyze medical claims data to identify trends, anomalies, patterns, and potential indicators of fraud, waste, or abuse.
Review medical claims for accuracy, completeness, coding compliance, reimbursement appropriateness, and adherence to applicable insurance policies.
Apply expertise in ICD-10, CPT, HCPCS, medical terminology, reimbursement methodologies, and healthcare coding guidelines to claims analysis.
Research healthcare policies, coding standards, reimbursement criteria, and regulatory requirements to support investigations and referrals.
Contribute to the development of analytica

📌 Healthcare Coding Expert (India)
🏢 Jobgether
📍 India