18 Payment Integrity Jobs

For a leading RCM Company in India Required Assistant Vice President - Payment Integrity - Operations - Payment Services Exp15 Years to 16 Years Work Type Hybrid – working partly from home and partly from office Payment Integrity - Operations Required Candidate profile Required AVP for a leading Medical Billing company For more details pl contact: Saran 8939678664

About CoverSelf: CoverSelf 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 Saison Capital. Position Overview: To play a critical role within the CoverSelf Content team, contributing to the development, enhancement and maintenance of medical policy content. This position is responsible for researching new medical policies, ensuring quality assurance, and identifying opportunities to expa...

Key Skills: Strong proficiency in PHP and Laravel Framework . Experience with MySQL/PostgreSQL . Payment Integration, Responsive UI, API implementation HTML, CSS, JavaScript,AJAX, jQuery . Familiarity with RESTAPIs, MVC architecture, and OOP concepts .

Support Lead - Production Support (Healthcare Platform) Experience Level: 15+ Years Employment Type: Full-Time About the Role: We are seeking a proactive and technically adept Support Lead Production support to oversee customer support operations for our enterprise-grade B2B platform serving healthcare clients. This role is pivotal in managing escalations, driving resolution of complex issues, and ensuring a seamless post-implementation experience. You will work closely with implementation, engineering, and product teams to deliver exceptional customer satisfaction in a regulated, mission-critical environment. Key Responsibilities: Lead the technical support function for enterprise healthcar...

We are seeking a passionate and experienced Subject Matter Expert with strong hands-on expertise in one or more of the following areas Claims prepayment review Payment Integrity Clinical Coding Analyst Data mining Medical Coding Denials Management

Medical Coding Trainee Job Category: Healthcare Job Type: Full-Time Job Location: Bangalore Experience: 0-1 years Salary: 3-6 LPA CTC Position Summary We are looking for a Medical Coding Trainee with 0-1 years of experience to join our payment integrity team in Bangalore. This is a vital role focused on converting healthcare guidelines into system-readable configurations. You will be responsible for comprehensive testing and collaborating with cross-functional teams to ensure the accuracy and quality of our medical policy content. This role is ideal for a passionate individual with strong analytical skills and a desire to contribute to the healthcare sector. The work mode for this position i...

Position Overview: This Manager / Senior Manager Learning & Development (L&D) role is a fantastic opportunity for a seasoned professional passionate about Medical Coding and US Healthcare Payment Integrity . Based in Jayanagar, Bangalore , youll be joining a rapidly growing HealthTech company focused on revolutionizing US healthcare payment integrity through a next-gen, cloud-native platform. Why This Role is for You: You wont just be delivering training; youll be building a future-ready L&D function from the ground up. This means leading the charge on: Pioneering Medical Coding & Payment Integrity Training: Design and deliver cutting-edge programs on claim lifecycle, fraud/waste/abuse (FWA)...

Job description Trainer - Claims Adjudication Location : Chennai - Navalur Roles & Responsibilities: In-depth Knowledge and experience in the US Healthcare. 4-9 years of experience in Claims Adjudication/Payment Integrity/Adjustments/Prepay, Post Pay audit . With over 1 year of experience as a Trainer. Conducting multiple trainings for new hires and managed nesting along with certification process Maintain the training effectiveness above the required threshold by holding strong governance process in training Ability to read through various standard operating procedures and communicate the extracts to the trainees clearly Identify gaps between internal process and customers expectations to h...

Job description Trainer - Payment Integrity/Adjustments Location : Chennai - Navalur Roles & Responsibilities: In-depth Knowledge and experience in the US Healthcare. 4-9 years of experience in Payment Integrity/Adjustments/Prepay, Post Pay audit . With over 1 year of experience as a Trainer. Conducting multiple trainings for new hires and managed nesting along with certification process Maintain the training effectiveness above the required threshold by holding strong governance process in training Ability to read through various standard operating procedures and communicate the extracts to the trainees clearly Identify gaps between internal process and customers expectations to help busine...

Job description Trainer - Payment Integrity Location : Chennai - Navalur Roles & Responsibilities: In-depth Knowledge and experience in the US Healthcare. 4-9 years of experience in Payment Integrity/Adjustments/Prepay,Post Pay audit . With over 1 year of experience as a Trainer. Conducting multiple trainings for new hires and managed nesting along with certification process Maintain the training effectiveness above the required threshold by holding strong governance process in training Ability to read through various standard operating procedures and communicate the extracts to the trainees clearly Identify gaps between internal process and customers expectations to help business produce th...

Location: Jayanagar, Bangalore (Work from Office) Experience Required: Analyst: 3+ years (Budget upto 10 LPA) Team Lead: 5+ years (Budget upto 13 LPA) Manager: 10+ years (Budget up to 20 LPA) Sr. Manager: 13+ years (Budget up to 30 LPA) Key Responsibilities: Manage 13 end-to-end medical reimbursement payment policies (based on role level) Identify and implement rules to detect incorrect healthcare payments Analyze Medicare/Medicaid edits, coding guidelines, and reimbursement frameworks Translate clinical coding guidelines and industry references into actionable business logic Ensure coding compliance and maintain alignment with CMS and payer policies Collaborate across teams and operate inde...

Job description Team Executive - Payment Integrity Location : Bangalore Roles & Responsibilities: In-depth Knowledge and Experience in the US Health Care Payer System. 4 - 9 years of experience in Claims Adjudication(Payment Integrity,PrePay audit,Postpay audit) . With over 1 year of experience as a Team leader Proven track record in managing processes, streamlining workflows and excellent people management skills. Need to be a people centric manager who could articulate the employee challenges to the management as well as motivate the team towards desired project goals. Circulate quality dashboards at agreed periodic intervals to all relevant stake holders Adhering to various regulatory and...

Openings for SME/TL/Quality/Trainer roles Need candidates with exp in US health care claims adjudication -payment integrity process 5 days working/rotational shifts Chennai/Bangalore location Interested Candidates do call Sadiq @ 8904378561 Required Candidate profile Openings for SME/TL/Quality/Trainer roles Need candidates with exp in US health care claims adjudication -payment integrity process Interested Candidates do call Sadiq @ 8904378561

The candidate should be working as a Quality Analyst / Trainer in the US healthcare industry for the Claims Adjudication Payment Integrity process. Qualification - Graduate Shift - US rotational shifts Work Location - Chennai and Bangalore Required Candidate profile Immediate Joiners OR Max 1 month notice period candidates can apply Contact Sr. HR Kenedy at 9620999035 for more details.

The candidate should be working as a Team Leader/SME in the US healthcare industry for the Claims Adjudication Payment Integrity process. Qualification - Graduate Shift - US rotational shifts Work Location - Chennai and Bangalore Required Candidate profile Immediate Joiners OR Max 1 month notice period candidates can apply Contact Sr. HR Kenedy at 9620999035 for more details.

Job description Preferred candidate profile : Bachelors degree Proven experience in training with over 1+ years of experience as a Trainer on papers. Minimum of 3 years of experience from Healthcare Payer side ( Claims & Payment Integrity ) Experience with the development of training materials including presentations, user manuals, and assessments. Classroom management skills Strong analytical and technical skills Exceptional organizational abilities Excellent interpersonal and communication skills. Visionary mindset with the ability to identify and implement innovative training solutions. Ability to thrive in a fast-paced and dynamic work environment. Familiarity with learning management sy...

Job description Team Executive - Payment Integrity Location : Chennai & Bangalore Roles & Responsibilities: In-depth Knowledge and Experience in the US Health Care Payer System. 4 - 9 years of experience in Claims Adjudication(Payment Integrity,PrePay audit,Postpay audit) . With over 1 year of experience as a Team leader Proven track record in managing processes, streamlining workflows and excellent people management skills. Need to be a people centric manager who could articulate the employee challenges to the management as well as motivate the team towards desired project goals. Circulate quality dashboards at agreed periodic intervals to all relevant stake holders Adhering to various regu...

1. Product Strategy & Roadmap Development: Develop and execute a strategic product roadmap for payments integration that aligns with the banks overall digital banking strategy and business objectives. Drive innovation in corporate payment solutions , focusing on integrating payment platforms and fintech solutions to provide a superior and competitive offering to clients. Create clear, data-driven product requirements based on market research, customer feedback, and internal stakeholder input. 2. Payment System Integration & Architecture: Lead the integration of various payment systems (e.g., RTGS, NEFT, IMPS, UPI, card payments, SWIFT) into the bank's digital channels (web, mobile, and API-b...