Medical Coding Auditor (Payment Integrity)
BengaluruFull-time5–9 yrsPosted 5 months ago
Senior pharma role at 2070Health in Bengaluru. Needs 5+ years and an MBBS, BDS or B.Pharm.
About the role
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.
What you'll do
- Perform manual claims review and identify coding/billing errors
- 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
What you need
- Medical coding
- Communication
Good to have
- Six Sigma