{"id":2805670,"url":"https://alion.io/job/coverself-medical-coding-auditordenial-coders-payment-integrity","title":"Medical Coding Auditor/Denial Coders (Payment Integrity)","company":{"id":4427716,"name":"Coverself","domain":"coverself.com","url":"https://alion.io/company/coverself","size_band":"51-200","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"Keka","truth_index":null},"role":"Finance","role_family":"Finance","seniority":null,"employment_type":"full_time","work_mode":"on_site","remote_scope":null,"remote_scope_basis":null,"remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["Bengaluru, India"],"countries":["IN"],"hiring_countries":[],"hiring_countries_total":0,"salary":null,"salary_estimate":null,"experience_years_min":null,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[],"status":"live","first_seen_at":"2026-10-01T12:12:41Z","employer_posted_date":"2026-10-01","last_verified_at":"2026-10-23T03:15:53Z","board_verified":true,"closed_at":null,"days_open":21,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":21},"description":"About CoverSelf:\nCoverSelf 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.\nPosition Overview:\nThis 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.\nSpecialty Expertise:\nEvaluation & Management (E/M)\nSurgery / Anesthesia / Radiology\nDME\nAny Medical Coding Specialty\nKey Responsibilities:\nPerform manual claims review and identify coding/billing errors\nValidate CPT, ICD, HCPCS codes, modifiers\nSupport denials management & pre/post payment review\nAnalyze claims using RCM workflows & reimbursement methodologies\nFlag incorrect claims and recommend corrections\nEnsure compliance with CMS, NCCI, Medicare/Medicaid guidelines\nWork on UB-04 / CMS 1500 claims forms\nCollaborate with internal teams to improve claim accuracy\nRequirements:\nStrong expertise in Medical Coding & RCM processes\nHands-on experience in claims audit and validation\nUnderstanding of coding guidelines, billing workflows, and compliance\nStrong domain expertise Semi automated Claims review\nSolid understanding of medical coding & billing methodologies and guidelines, including CPT, ICD, LCD/NCD, PTP, NCCI, edits, modifiers, Medicare Physician fee schedule, and coding conventions.\nProficiency in data collection, analysis, and deriving actionable insights from CMS medical policies, Medicaid Provider Manuals and other Medical publications.\nTranslate industry references into actionable business logic to support new rules and policy enhancements.\nStrong understanding of claim forms like UB-04/CMS 1450 and CMS 1500\nCollaborate effectively across teams while managing multiple priorities\nAbility to thrive in a fast-paced, dynamic environment with minimal supervision.\nDemonstrated mindset for continuous learning and improvement and apply insights to policy development, refinement and maintenance.\nStrong stakeholder management, interpersonal, and leadership skills.\nSolution-focused, motivated, entrepreneurial spirit with a strong sense of ownership.\nClear and effective communication.\nStrong attention to accuracy and detail in all deliverables\nQualifications\nEducation & Certification (one of the following required):\nMedical Degree (e.g., MBBS, BDS, BPT, BAMS etc)\nNursing: Bachelor/Master of Science in Nursing\nPharmacist Degree (B.Pharm, M.Pharm or PharmD)\nLife Science -Bachelor/Master\nCertification Requirements:\nMust be CPC Certified\nAdditional weightage will be given for AAPC specialty coding certifications.\nLean Six Sigma certification and practical application experience are preferred.\nExperience:\n1-3 Experience in Payment Integrity Content/Research, Semi automated Claims Review\nExperience in rule requirement Semi automated Claims Review.\nExperience in claims review, denials, coding validation\nKey Skills:\nMedical Coding (CPT, ICD, HCPCS)\nClaims Audit & Validation\nRCM & Denials Management\nKnowledge of NCCI edits, modifiers\nNurse claims Review\nAttention to detail & analytical skills\nDomain Expertise in US Healthcare Medical Coding, Medical Billing, Payment Integrity, Revenue Cycle Management (RCM), Denials Management.\nCodeset Knowledge like CPT/HCPCS, ICD, Modifier, DRG, PCS, etc.\nPayment Policies knowledge like Medicare/Medicaid Reimbursement, Payer Payment Policies, NCCI, IOMs, CMS Policies etc\nHigh proficiency in Microsoft Word and Excel, with adaptability to new platforms.\nExcellent verbal & written communication skills.\nExcellent Interpretation and articulation skills\nStrong analytical, critical thinking, and problem-solving skills\nWillingness to learn new products and tools\nWork Details:\nLocation: Jayanagar, Bangalore\nMode: Work from Office\nBenefits:\nBest-in-class compensation\nHealth insurance for Family\nPersonal Accident Insurance\nFriendly and Flexible Leave Policy\nCertification and Course Reimbursement\nMedical Coding CEUs and Membership Renewals\nHealth checkup\nAnd many more!\nOur Commitment to Diversity:\nAt CoverSelf, we are building a global workplace where every individual can discover their true potential, passion, and purpose - regardless of background, gender, race, sexual orientation, religion, or ethnicity. We believe a diverse workplace fosters innovation, creativity, and progress for our employees, communities, and business.","description_format":"text","description_chars":4681,"description_truncated":false,"requirements":{"experience_years_min":null,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":{"level":"master","optional":false},"security_clearance":false,"languages":[]},"benefits":["Continuous learning","Health insurance"],"hiring_locations":[],"hiring_excludes":[],"relocation_offered":false,"industries":["Revenue Cycle & Medical Billing"],"lifecycle":[{"event":"open","at":"2026-10-18T05:24:15Z"}],"visa":[],"liveness":{"score":63,"band":"ok","label":"Likely open","p_open":1,"p_active":0.704,"p_room":0.9,"age_days":20,"expected_fill_days":32,"reasons":["conf:2","win:mid"],"computed_at":"2026-10-22T06:10:10Z"},"pay":null,"html_url":"https://alion.io/job/coverself-medical-coding-auditordenial-coders-payment-integrity","json_url":"https://alion.io/job/coverself-medical-coding-auditordenial-coders-payment-integrity.json","meta":{"generated_at":"2026-10-23T03:21:21Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","about":"Alion is a live layer of people, companies and AI agents: who they are, whether they are real and active right now, what they do and how to work with them, readable by people and by agents and paid per call.","catalog":"https://alion.io/catalog.json","usage":{"tier":"crawler_verified","counted_by":"address","units_charged":1,"used_today":5545,"day_limit":null,"remaining_today":null,"minute_limit":300,"resets_at":"2026-10-24T00:00:00Z"}},"offers":[{"id":"company.slices","title":"One company in depth, by slice","status":"live","price":{"credits":0.02,"usd":0.002,"plus_per_slice":{"credits":0.05,"usd":0.005}},"unit":"per company, plus each slice with data","note":"the employer in depth","call":{"mcp_tool":"get_company","arguments":{"id":4427716},"rest":"https://alion.io/mcp/rest/get_company?id=4427716"},"human":"https://alion.io/catalog?offer=company.slices&for=job%2Fcoverself-medical-coding-auditordenial-coders-payment-integrity"},{"id":"market.stats","title":"A market slice: pay, demand and time to fill","status":"live","price":{"credits":1,"usd":0.1},"unit":"per slice","note":"pay, demand and time to fill for this role and place","call":{"mcp_tool":"market_stats"},"human":"https://alion.io/catalog?offer=market.stats&for=job%2Fcoverself-medical-coding-auditordenial-coders-payment-integrity"},{"id":"job.search","title":"Open jobs by role, technology, place, pay and visa","status":"live","price":{"credits":0.02,"usd":0.002},"unit":"per posting in a list","note":"similar open postings","call":{"mcp_tool":"search_jobs"},"human":"https://alion.io/catalog?offer=job.search&for=job%2Fcoverself-medical-coding-auditordenial-coders-payment-integrity"},{"id":"company.verify","title":"Is this company real and active right now","status":"pilot","price":null,"unit":"per company","request":{"url":"https://alion.io/catalog/request","method":"POST","body":"{\"offer\": \"company.verify\", \"for\": \"job/coverself-medical-coding-auditordenial-coders-payment-integrity\", \"note\": \"what you need it for\"}"},"human":"https://alion.io/catalog?offer=company.verify&for=job%2Fcoverself-medical-coding-auditordenial-coders-payment-integrity"}]}