Medical Coding Auditor (Payment Integrity)

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

• 5–9 yrs of experience
• Medical coding
• Communication
• MBBS or BDS or B.Pharm or M.Pharm

Good to have

• Six Sigma