Job Summary: We are seeking a skilled and detail-oriented ETL Developer to join our Data Engineering team. The ideal candidate will have strong proficiency in SQL and T-SQL, along with hands-on experience in building and maintaining ETL workflows using tools like SSIS, Azure Data Factory, or Informatica. You will play a critical role in designing and implementing scalable and efficient data pipelines to support business intelligence, analytics, and data warehousing initiatives. Key Responsibilities: Design, develop, and maintain scalable ETL workflows and data pipelines. Work with stakeholders to gather data requirements and translate them into technical specifications. Develop complex SQL/T-SQL queries, stored procedures, functions, and scripts. Ensure high-quality data extraction, transformation, and loading processes across systems. Optimize and troubleshoot ETL workflows for performance and reliability. Collaborate with data analysts, architects, and other developers to deliver high-quality solutions. Adhere to best practices for data governance, data quality, and system security. Required Skills & Qualifications: Strong hands-on experience with SQL and T-SQL. Experience with at least one ETL tool such as SSIS, Azure Data Factory, or Informatica. Solid understanding of data integration, data transformation, and loading best practices. Ability to work with structured and unstructured data across various data sources. Proficient in analyzing and resolving data inconsistencies and performance issues. Strong analytical, problem-solving, and communication skills. Preferred Qualifications: Experience working with cloud data platforms (e.g., Azure, AWS). Familiarity with data warehousing concepts and dimensional modeling. Knowledge of version control systems (e.g., Git) and CI/CD processes. Job Type: Full-time Pay: From ₹30,000.00 per month Work Location: In person

Position Overview: We are seeking a detail-oriented and clinically knowledgeable Clinical Client Policy Data Analyst to join our Clinical Coding Policy team. This role involves the clinical analysis of professional, and facility claims, validation of edit logic, and development of review guidelines aligned with industry standards. The ideal candidate will serve as a subject matter expert in clinical policy interpretation and coding edits and will play a key role in root-cause analysis, edit ideation, and dispute resolution from providers. This role is integral to ensuring that all claims reviewed under clinical coding policy guidelines are accurate, compliant, and consistent with payer policies and national coding standards such as NCCI, AMA, and CMS guidelines. Key Responsibilities: Conduct clinical coding reviews of professional and facility claims routed through the Clinical Coding Policy queue. Perform in-depth research and analysis of complex coding scenarios and edit performance. Collaborate with cross-functional teams, including resolution analysts, IT, and leadership, to improve review logic and workflow. Analyze provider disputes related to accepted coding edits and support decisions with clinical and coding evidence. Maintain up-to-date documentation of review processes, guidelines, and clinical validation standards. Assist in the creation and maintenance of job aids to ensure consistency and efficiency across validation processes. Submit and support IT enhancement requests to improve reporting and claims analysis tools. Ensure alignment with payer reimbursement policies, federal/state regulations, and standard coding references (NCCI, AMA, CMS). Identify root causes of edit performance issues and provide data-driven recommendations for resolution. Support the development of new edits and clinical coding policies in response to industry or client needs. Contribute to training efforts and share insights for continuous improvement initiatives. Maintain high standards of documentation, audit readiness, and internal data accuracy. Required Qualifications: Minimum of 2 years’ experience in healthcare claims processing, payer operations, or clinical coding analysis. Certified coder credential required (CPC, CCS, or CCS-P). Ability to interpret claim edit rules, reference clinical coding standards, and perform in-depth root-cause analysis. Strong understanding of clinical policies, payer edits, medical necessity, and reimbursement guidelines. Proficiency with Microsoft Excel and data manipulation. Excellent verbal and written communication skills, with a collaborative team mindset. Experience reviewing medical records and applying NCCI and related guidelines. Familiarity with both professional and facility claim forms and standard billing practices. Preferred Qualifications: Licensed RN, LPN, or LVN (preferred but not required). Bachelor’s degree in Nursing, Health Information Management, or related field. Knowledge of provider-payer dynamics and experience managing business relationships. Experience working with health plans, TPAs, or payment integrity vendors. Job Types: Full-time, Permanent Pay: From ₹20,000.00 per month Work Location: In person

Position Overview: We are seeking a detail-oriented and clinically experienced Nurse Reviewer to join our healthcare claims review team. The Nurse Reviewer will be responsible for performing comprehensive reviews of facility and outpatient claims (pre- and post-payment), assessing alignment with medical documentation, clinical guidelines, coding accuracy, and policy compliance. The role is critical to ensuring billing accuracy, identifying overpayments, and generating cost savings for our clients. This position requires clinical judgment, an understanding of billing and coding practices, and the ability to communicate effectively with healthcare providers and internal stakeholders. The Nurse Reviewer will manage a high-volume claim review workload, document findings thoroughly, and contribute to the quality and efficiency of the claim audit process. Key Responsibilities: Conduct post-service, pre- or post-payment in-depth reviews across a variety of claim types. Apply medical guidelines, clinical criteria, plan exclusions, and coding standards to identify inaccuracies or overcharges. Validate billing charges against medical documentation to ensure compliance and accuracy. Contact medical providers via phone/email to discuss billing discrepancies and request additional information. Maintain detailed and accurate notes on claim review progress, communications, and outcomes. Manage and prioritize a caseload of 25+ claims based on client specifications and deadlines. Achieve and maintain production and quality metrics as established by the leadership team. Collaborate with Team Leads and escalate claim issues or client-specific needs as appropriate. Ensure compliance with internal standards and external privacy regulations (e.g., HIPAA). Qualifications & Skills: Required: Active and unrestricted RN or LPN license. Clinical experience in areas such as Medical-Surgical, ICU, or Emergency Medicine. Strong understanding of medical documentation, hospital coding, and billing rules. High attention to detail with a focus on accuracy and compliance. Excellent communication skills, both verbal and written. Proficient in Microsoft Office Suite (Outlook, Word, Excel). Skilled in basic math calculations and claim-related financial validation. Ability to handle multiple tasks simultaneously in a fast-paced environment. Comfortable working with dual-screen setups and extended periods of computer usage. Preferred: Experience in claims auditing, medical billing, or revenue cycle management. Working knowledge of Medicare guidelines, health insurance policies, and payer programs. Familiarity with audit techniques and identification of claim-level revenue opportunities. Job Type: Full-time Pay: From ₹15,000.00 per month Work Location: In person

The Senior Platform Architect will work closely with cross-functional teams to ensure the platform is used effectively across multiple teams and ensures the successful deployment of features that make it easy and motivating for healthcare consumers to find best-fit care when they need it most. The ideal candidate will have a strong background in healthcare and a deep understanding of the needs of patients, providers, and payers. This role serves as the primary Applications/Systems Platform Architect for all related projects and tasks on the platform across the Claims Cost Solutions division. This role will communicate and work collaboratively with internal software engineers, quality assurance engineers, product owners, project managers and project stakeholders for the implementation and sustainability of the platform, supporting existing data needs and contributing to resolution of major incidents. Major areas of focus will include interoperability, scalability, privacy and security. As a Senior Platform Architect, you’ll be a key member of a dynamic team of IT professionals responsible for the leading the way on platform development and performance. The Senior Platform Architect will work closely with cross-functional teams to ensure the platform is used effectively across multiple teams and ensures the successful deployment of features that make it easy and motivating for healthcare consumers to find best-fit care when they need it most. The ideal candidate will have a strong background in healthcare and a deep understanding of the needs of patients, providers, and payers. This role serves as the primary Applications/Systems Platform Architect for all related projects and tasks on the platform across the Claims Cost Solutions division. This role will communicate and work collaboratively with internal software engineers, quality assurance engineers, product owners, project managers and project stakeholders for the implementation and sustainability of the platform, supporting existing data needs and contributing to resolution of major incidents. Major areas of focus will include interoperability, scalability, privacy and security. As a Senior Platform Architect, you’ll be a key member of a dynamic team of IT professionals responsible for the leading the way on platform development and performance. Responsibilities Subject Matter Expert for the engineering team focused on all aspects of the product. Align vision for the platform development and execute on the strategy. Lead journey mapping activities Develop and review solution artifacts and manage adherence to architecture standards. Perform risk analysis to include: defining strategic direction, architecture leadership and determine, expose and communicate opportunities as needed Drive adherence to existing and evolving security requirements to ensure a robust and secure environment for which to deploy applications. Develop high quality object-oriented code and a mixture of internal and popular external frameworks. Analyze datasets, collaborate with analysts to devise ways to ingest data from a large number of data sources. Develop tools and features to enable customization of system functions and workflows without the need to create additional code. Produce technical specifications. Design and develop relational data structures needed to support new development efforts (including keys, indexes, triggers and stored procedures). Develop and maintain coding standards such as style guides. Facilitate security assessments to ensure system meets overall security posture. Conduct code reviews for work submitted by junior team members. Coach and develop the skills of other team members. Perform application performance analysis and tuning. Conduct and participate in training sessions. Identify and recommend process improvements. Accurately estimate level of effort and forecast completion targets: Provide technology expertise in a variety of areas and provide direction and assistance to development team members and monitor application architecture related to other areas of IT, the business community, and outside vendors to ensure the relevance of architecture to meet business needs. Define and manage KPI's that measure success for platform initiatives. Additional Responsibilities Collaborate with the broader architecture community to provide input into IT strategies and standards, ensure solution reuse and to eliminate solution redundancy across the enterprise. Research and stay abreast of technology trends and assist with the development of solution, integration, workflow, cloud, infrastructure (including software defined storage and networking) and/or web service standards. * Required Experience 10+ years of progressive experience in a combination of development, design, architecture and/or related IT disciplines Software development using Agile methodologies Experience in requirements gathering from project stakeholders Technical Leadership experience, with proven success in the design and delivery of quality, scalable IT solutions, on budget and in compliance with applicable requirements Understanding of computer and network systems Building solutions with a focus on Service architecture (e.g., microservices, SOA) Database design and optimization Experience with Application and service modernization including migration to cloud (e.g., AWS, Azure, GCP) CI/CD pipelines implementation using Azure DevOps or similar platforms Required technical tools: .NET, C#, SQL Server, Visual Studio technologies Kubernetes or similar container technologies Linux operating systems Open source technologies Windows operating systems Experience working with technical offshore teams Preferred Experience Healthcare IT products knowledge NET to .NET Core migration knowledge/experience Exposure to multiple, diverse technical integrations, technologies and processing environments, including cloud and SaaS technologies Experience in design principles and practices, system development methodologies, and software life cycles Passion and ability to create and drive the strategy and architecture of enterprise-level technology strategies Ability to work with tight timelines including working on multiple projects at the same time Familiarity of Enterprise service bus architectures Knowledge of ANSI X12 (837, 834, 835) standards Understanding of emerging technology landscape Queueing and RPC technologies Knowledge of: SAN, Network, Firewalls Job Type: Full-time Pay: From ₹35,000.00 per month Work Location: In person Speak with the employer +91 9925552425