About Milliman:

Independent for over 75 years, Milliman delivers market-leading services and
solutions to clients worldwide. Today, we are helping companies take on some of
the world’s most critical and complex issues, including retirement funding and
healthcare financing, risk management and regulatory compliance, data analytics
and business transformation. Through a team of professionals ranging from
actuaries to clinicians, technology specialists to plan administrators, we offer
unparalleled expertise in employee advantages, investment consulting, healthcare,
life insurance, and financial services, and property and casualty insurance.

Role Summary

We are seeking a Clinical Coding & Claims Analytics Consultant with experience
in clinical coding, medical claims analysis, reimbursement methodologies, and
healthcare consulting. The role will support the development of clinical rules
for claims adjudication, conduct coding and reimbursement analytics, contribute
to DRG and grouper initiatives, and deliver consulting projects for healthcare
payers, providers,



and health system stakeholders.

The ideal candidate should possess strong knowledge of clinical coding systems,
health insurance operations, claims adjudication workflows, reimbursement
frameworks, and healthcare data analytics, with exposure to healthcare markets
across the Middle East.

Key Responsibilities

Clinical Rules & Product Development

* Support the design, development, testing, and validation of clinical rules
used in medical claims adjudication and payment integrity programs.
* Define clinical logic for medical necessity review, coding validation,
reimbursement controls, benefit interpretation, and claims editing.
* Participate in user acceptance testing (UAT) and validation of clinical rule
engines and adjudication systems.

Clinical Coding & Classification

* Perform clinical coding reviews and code mapping across healthcare coding and
classification systems - ICD-10-AM, ACHI, SBS and ADRG / AR-D

📌 Clinical Analyst (Gurugram)
🏢 Milliman
📍 Gurugram