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.
• Solid understanding of claim f

📌 Medical Coding Auditor/Denial Coders (Bengaluru)
🏢 CoverSelf
📍 Bengaluru