CoverSelf is hiring for two full-time positions in Bengaluru, Karnataka: Junior Clinical Content Specialist and Medical Coding Auditor (Payment Integrity). These opportunities are relevant to candidates with backgrounds in pharmacy, medicine, nursing, and life sciences who meet the respective certification and experience requirements.

The roles focus on clinical content development, healthcare claims validation, medical coding, payment integrity, and reimbursement policy research. Both positions are based in Jayanagar, Bengaluru, and require working from the office.

CoverSelf Recruitment 2026: Job Details

Positions Available at CoverSelf

1. Junior Clinical Content Specialist

Experience: Freshers may apply if they have a strong foundation in pharmacy or clinical concepts and a research-oriented mindset.

The Junior Clinical Content Specialist will develop clinical content and payment integrity rules by translating healthcare payer guidelines and medical policies into structured business logic for automated claims validation.

Key Responsibilities

• Develop and maintain payment integrity rules, edits, and policies.
• Translate healthcare payer guidelines into business rules.
• Build code-edit solutions to identify incorrect payments.
• Research medical policies and reimbursement methodologies.
• Interpret clinical guidelines and medical literature to develop structured insights.

Eligibility and Qualifications

Candidates must hold one of the following qualifications:

• MBBS, BDS, BPT, BAMS, or another listed medical degree.
• B.Sc. or M.Sc. in Nursing.
• B.Pharm, M.Pharm, or Pharm.D.
• Bachelor’s or Master’s degree in Life Sciences.

Candidates must also hold at least one of the following certifications:

• CPC
• CPMA
• COC
• CIC
• CPC-P
• CCS
• Specialty certifications from AHIMA or AAPC

Required Skills

• Clinical knowledge and understanding of medical concepts.
• Analytical thinking and interpretation skills.
• Ability to translate clinical guidelines into logical rules.
• Research and medical literature interpretation.
• Strong written and verbal communication.
• Attention to detail and accuracy.

2. Medical Coding Auditor (Payment Integrity)

Experience: 1–3 years in payment integrity content or research, semi-automated claims review, claims auditing, coding validation, or denials-related work.

The Medical Coding Auditor will review healthcare claims, validate medical codes, identify coding and billing errors, and support payment accuracy by applying relevant coding and reimbursement guidelines.

Key Responsibilities

• Perform manual claims reviews and identify coding or billing errors.
• Validate CPT, ICD, and HCPCS codes, including modifiers.
• Support denials management and pre-payment or post-payment reviews.
• Analyze claims using revenue cycle management (RCM) workflows.
• Identify incorrect claims and recommend corrections.
• Ensure compliance with CMS, NCCI, Medicare, and Medicaid guidelines.
• Review UB-04/CMS 1450 and CMS-1500 claim forms.
• Research medical policies and translate industry references into actionable business rules.
• Contribute to payment policy development, refinement, and maintenance.

Specialty Expertise

Candidates with expertise in the following areas are relevant to the role:

• Evaluation and Management (E/M)
• Surgery
• Anesthesia
• Radiology
• Durable Medical Equipment (DME)
• Other medical coding specialties

Eligibility and Qualifications

Candidates must hold one of the following qualifications:

• MBBS, BDS, BPT, BAMS, or another listed medical degree.
• B.Sc. or M.Sc. in Nursing.
• B.Pharm, M.Pharm, or Pharm.D.
• Bachelor’s or Master’s degree in Life Sciences.

Mandatory Certification: CPC certification.

AAPC specialty coding certifications carry additional weight. Lean Six Sigma certification and practical application experience are preferred.

Required Skills

• Medical coding expertise in CPT, ICD, and HCPCS.
• Claims auditing and coding validation.
• Revenue Cycle Management (RCM) and denials management.
• Knowledge of NCCI edits, modifiers, and coding conventions.
• Understanding of Medicare and Medicaid reimbursement policies.
• Familiarity with LCD/NCD policies, CMS guidelines, and payment methodologies.
• Knowledge of UB-04 and CMS-1500 claim forms.
• Data analysis, research, and policy interpretation.
• Proficiency in Microsoft Word and Excel.
• Strong communication, analytical, and problem-solving skills.

Benefits

CoverSelf lists the following benefits for both positions:

• Health insurance for family.
• Personal accident insurance.
• Flexible leave policy.
• Certification and course reimbursement.
• Medical coding continuing education units (CEUs) and membership renewals.
• Health checkup.
• Best-in-class compensation.

Application Details

Application Link for Medical Coding Auditor (Payment Integrity)

Application Link for Junior Clinical Content Specialist