karnataka physician Jobs – 125 Open Jobs Today

Clinical Content Specialist (Payment Integrity)
CoverSelf —Bengaluru, Karnataka
- Nursing
- Medicine
- Master's degree
- Health insurance
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Staff Nurse
DHC —Bengaluru, Karnataka
- ₹18,000 - ₹25,000 a month
- Full-time
- Nursing
- B.Sc
- Bachelor's degree
Quick apply
Staff Pharmacist
Runforservice —Kormangala, Karnataka
- ₹12,000 - ₹15,000 a month
- Full-time
- Customer service
- In-person
- Communication skills
- Flexible schedule
Quick apply
Staff Nurse
Cadabams Group —Bengaluru, Karnataka
- ₹12,000 - ₹18,000 a month
- Full-time
- Nursing
- B.Sc
- Master's degree
- Food provided
Quick apply
Pharmacist
Dr Aravind's ISWARYA IVF Fertility Centre —Electronics City, Bengaluru, Karnataka
- ₹15,000 - ₹25,000 a month
- Weekend availability
- Doctoral degree
- Computer literacy
- Bachelor's degree
- Cell phone reimbursement
Quick apply
1d

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Clinical Content Specialist (Payment Integrity)

CoverSelf
Bengaluru, Karnataka

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Job details

Benefits

Health insurance

Qualifications

Six Sigma Certification
Nursing
Medicine
Interpretation
Data mining
Medical coding
Content management systems
MBBS
Master's degree
Analysis skills
Bachelor's degree
Content development
CPT coding
Pharmacy
Lean Six Sigma
Data collection
BAMS
Leadership
Billing
Communication skills
Lean Six Sigma Certification

Full job description

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 Z21 Ventures.

Position Overview:

This role focuses on developing clinical content, payment integrity rules, and code edit solutions. The Clinical Content Specialist will translate clinical guidelines and payer policies into business logic, algorithms, and rule frameworks for automated claims validation.

Specialty Expertise:

Payment Integrity

Clinical Coding & Policy Development

Claims Prepayment Review

Data Mining & Content Development

Key Responsibilities:

Develop and maintain payment integrity rules, edits, and policies

Design clinical logic & algorithms for claims validation

Translate CMS guidelines business rules

Build code edit solutions to detect incorrect payments

Conduct research on medical policies and reimbursement methodologies

Enhance and maintain policy libraries and rule frameworks

Support semi-automated claims review systems

Requirements:

Strong experience in Payment Integrity / Clinical Content / Policy building

Ability to convert clinical guidelines into logical rules

Knowledge of CMS policies, payer guidelines, and coding standards

Strong analytical and problem-solving mindset

Solid understanding of medical coding & billing methodologies and guidelines, including CPT, ICD, LCD/NCD, PTP, NCCI, edits, modifiers, Medicare Physician fee schedule, and coding conventions.
Proficiency in data collection, analysis, and deriving actionable insights from CMS medical policies, Medicaid Provider Manuals and other Medical publications.
Translate industry references into actionable business logic to support new rules and policy enhancements.
Strong understanding of claim forms like UB-04/CMS 1450 and CMS 1500
Collaborate effectively across teams while managing multiple priorities
Ability to thrive in a fast-paced, dynamic environment with minimal supervision.
Demonstrated mindset for continuous learning and improvement and apply insights to policy development, refinement and maintenance.
Strong stakeholder management, interpersonal, and leadership skills.
Solution-focused, motivated, entrepreneurial spirit with a strong sense of ownership.
Clear and effective communication.
Strong attention to accuracy and detail in all deliverables

Qualifications

Education & Certification (one of the following required):

Medical Degree (e.g., MBBS, BDS, BPT, BAMS etc)
Nursing: Bachelor/Master of Science in Nursing
Pharmacist Degree (B.Pharm, M.Pharm or PharmD)
Life Science -Bachelor/Master

Certification Requirements:

Must hold any of the following certifications: CPC, CPMA, COC, CIC, CPC-P, CCS or any specialty certifications from AHIMA or AAPC.
Additional weightage will be given for AAPC specialty coding certifications.
Lean Six Sigma certification and practical application experience are preferred.

Experience:

3+ years experience for Analyst
5+ years experience for TL
10+ Years for Manager
13+ years for Senior Manager
Experience in policy development, rule engines, or PI companies

Key Skills:

Payment Integrity domain knowledge
Clinical policy & content development
CMS / Medicare / Medicaid guidelines
Code edit logic (NCCI, LCD/NCD)
Strong analytical & interpretation skills
Excellent verbal & written communication skills.
Excellent Interpretation and articulation skills
Strong analytical, critical thinking, and problem-solving skills
Willingness to learn new products and tools

Work Details:

Location: Jayanagar, Bangalore
Mode: Work from Office

Benefits:

Best-in-class compensation
Health insurance for Family
Personal Accident Insurance
Friendly and Flexible Leave Policy
Certification and Course Reimbursement
Medical Coding CEUs and Membership Renewals
Health checkup
And many more!

Our Commitment to Diversity:

At CoverSelf, we are building a global workplace where every individual can discover their true potential, passion, and purpose — regardless of background, gender, race, sexual orientation, religion, or ethnicity. We believe a diverse workplace fosters innovation, creativity, and progress for our employees, communities, and business.

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physician jobs in karnataka

Clinical Content Specialist (Payment Integrity)

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