Job Title: Clinical Denials & Appeals

Job Location: Hyderabad, Telangana
Work Mode: Work from Office
Experience: 2+ Years

Job Description

We are looking for qualified healthcare professionals with experience in Clinical Denials & Appeals, Utilization Review, Case Management, or clinical documentation review.

Key Responsibilities
Review clinical denials, appeals, and medical records across multiple specialties.
Assess medical necessity and clinical documentation.
Handle utilization review, case management, and appeals processes.
Apply US healthcare payer guidelines and denial management procedures.
Ensure quality, accuracy, and compliance during case reviews.

Required Qualifications

MBBS, MD, B.Sc. Nursing, M.Sc. Nursing, BDS, BHMS, or BPT.

Preferred Certifications: CPC, CCS, or COC.

Required Skills & Experience




Minimum 2 years of relevant experience in Clinical Denials & Appeals, Utilization Review, Case Management, or related clinical review.
Solid clinical knowledge and medical record review skills.
Understanding of US healthcare and payer guidelines.
Positive analytical and documentation skills.

Shift & Advantages
Initial 6–8 weeks: Night shift starting at 6:00 PM.
Thereafter: 11:00 AM–8:00 PM shift.
Pick-up and drop transportation with an escort provided.
Open positions: Specialist, Senior Specialist, Quality Analyst, and Trainer.

Interested candidates with relevant experience are encouraged to apply.

Pay: ₹500,000.00 - ₹1,300,000.00 per year

Work Location: In person

📌 Clinical Denials & Appeals Hyderabad (India)
🏢 V3 Staffing
📍 India