Medical Reviewer Job at PrimEra Medical Technologies
A rare chance has emerged for medical graduates as PrimEra Medical Technologies is seeking an Appeal Writer for their DRG Coding and Clinical Appeals team in Hyderabad. This Medical Reviewer Job is ideal for fresh MBBS and MD graduates eager to build a career in the US Healthcare Revenue Cycle Management.
About PrimEra Medical Technologies:
PrimEra Medical Technologies is a leading organization in the healthcare sector, specializing in providing innovative solutions for medical coding and clinical appeals. The company focuses on enhancing the efficiency of healthcare revenue cycle management, ensuring accurate documentation and reimbursement processes. With a commitment to excellence, PrimEra aims to support healthcare providers in navigating the complexities of medical coding and appeals.
Job Details:
- Position Title: Appeal Writer – DRG Coding (Fresher)
- Department: DRG Coding & Clinical Appeals
- Job Location: Hyderabad / Work from office
- Employment Type: Full-Time
- Experience: Fresher (0-1 Year)
- Qualification: MBBS, MD Mandatory
Job Description:
This Appeal Writer Job involves reviewing inpatient medical records, understanding clinical documentation, analysing payer denials, and drafting evidence-based appeal letters to support appropriate DRG assignments and reimbursement. This is an excellent opportunity for fresh medical graduates looking to build a career in the US Healthcare Revenue Cycle Management (RCM), Clinical Documentation Improvement (CDI), and DRG validation domain.
Key Responsibilities:
- Review inpatient medical records, discharge summaries, operative notes, laboratory results, and physician documentation.
- Analyse DRG downgrades, coding denials, and clinical validation denials.
- Prepare clear, concise, and evidence-based appeal letters using clinical findings and supporting documentation.
- Interpret disease processes, treatments, diagnostic findings, and procedures to support appeal rationale.
- Research payer denial reasons and assist in preparing appropriate rebuttals.
- Collaborate with coding specialists, auditors, CDI teams, and physicians to gather necessary clinical evidence.
- Ensure compliance with ICD-10, DRG guidelines, CMS regulations, and payer-specific policies.
- Maintain productivity and quality standards established by the organisation.
- Participate in training programs related to DRG coding, medical coding, and denial management.
Eligibility Criteria for the Medical Reviewer Job:
- Education: MBBS, MD (Mandatory). Freshers are encouraged to apply.
- Experience: No prior experience required; clinical internship experience will be an added advantage.
Required Skills:
- Clinical Knowledge: Strong understanding of human anatomy, physiology, pathology, pharmacology, and disease processes.
- Ability to interpret medical records, diagnostic reports, and physician documentation.
- Good clinical reasoning and analytical skills.
- Communication Skills: Excellent written and verbal communication; strong medical writing and documentation skills.
- Ability to present clinical arguments logically and effectively.
- Analytical Skills: Attention to detail and accuracy; ability to analyze complex clinical scenarios and identify relevant supporting evidence.
- Problem-solving mindset and willingness to learn.
- Technical Skills: Basic knowledge of US healthcare systems, medical coding, or DRG concepts is preferred but not mandatory; proficiency in MS Office applications.
Career Growth in a Medical Reviewer Job:
The role provides exposure to:
- DRG Coding and Validation
- Clinical Documentation Improvement (CDI)
- Denial Management and Appeals
- Medical Coding Audits
- Revenue Integrity
- US Healthcare Reimbursement Systems
This Appeal Writer Job opportunity at PrimEra Medical Technologies is perfect for motivated MBBS and MD graduates looking to establish a career in healthcare. Interested candidates are encouraged to apply before the deadline to seize this promising role in the dynamic field of healthcare revenue cycle management.
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