Appeal Writer - DRG Coding

<p><strong>Job Description</strong></p><p><strong>Position Title</strong></p><p><strong>Appeal Writer - DRG Coding (Fresher)</strong></p><p><strong>Department</strong></p><p>DRG Coding & Clinical Appeals</p><p><strong>Job Summary</strong></p><p>We are seeking highly motivated <strong>MBBS,MD graduates</strong> with strong clinical knowledge to join our DRG Coding and Appeals team as an <strong>Appeal Writer</strong>. The role involves reviewing inpatient medical records, understanding clinical documentation, analyzing payer denials, and drafting evidence-based appeal letters to support appropriate DRG assignments and reimbursement.</p><p>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.</p><p><strong>Key Responsibilities</strong></p><ul><li>Review inpatient medical records, discharge summaries, operative notes, laboratory results, and physician documentation.</li><li>Analyze DRG downgrades, coding denials, and clinical validation denials.</li><li>Prepare clear, concise, and evidence-based appeal letters using clinical findings and supporting documentation.</li><li>Interpret disease processes, treatments, diagnostic findings, and procedures to support appeal rationale.</li><li>Research payer denial reasons and assist in preparing appropriate rebuttals.</li><li>Collaborate with coding specialists, auditors, CDI teams, and physicians to gather necessary clinical evidence.</li><li>Ensure compliance with ICD-10, DRG guidelines, CMS regulations, and payer-specific policies.</li><li>Maintain productivity and quality standards established by the organization.</li><li>Participate in training programs related to DRG coding, medical coding, and denial management.</li></ul><p><strong>Required Qualifications</strong></p><p><strong>Education</strong></p><ul><li><strong>MBBS, MD (Mandatory)</strong></li><li>Freshers are encouraged to apply.</li></ul><p><strong>Experience</strong></p><ul><li>No prior experience required.</li><li>Clinical internship experience will be an added advantage.</li></ul><p><strong>Required Skills</strong></p><p><strong>Clinical Knowledge</strong></p><ul><li>Strong understanding of human anatomy, physiology, pathology, pharmacology, and disease processes.</li><li>Ability to interpret medical records, diagnostic reports, and physician documentation.</li><li>Good clinical reasoning and analytical skills.</li></ul><p><strong>Communication Skills</strong></p><ul><li>Excellent written and verbal communication.</li><li>Strong medical writing and documentation skills.</li><li>Ability to present clinical arguments logically and effectively.</li></ul><p><strong>Analytical Skills</strong></p><ul><li>Attention to detail and accuracy.</li><li>Ability to analyze complex clinical scenarios and identify relevant supporting evidence.</li><li>Problem-solving mindset and willingness to learn.</li></ul><p><strong>Technical Skills</strong></p><ul><li>Basic knowledge of US healthcare systems, medical coding, or DRG concepts is preferred but not mandatory.</li><li>Proficiency in MS Office applications.</li></ul><p><strong>Preferred Candidate Profile</strong></p><ul><li>MBBS/MD graduate seeking a non-clinical career in healthcare.</li><li>Strong academic background and clinical aptitude.</li><li>Interest in medical coding, DRG validation, CDI, payer denials, and revenue cycle management.</li><li>Quick learner with a passion for healthcare analytics and documentation review.</li></ul><p><strong>Career Growth Opportunities</strong></p><p>The role provides exposure to:</p><ul><li>DRG Coding and Validation</li><li>Clinical Documentation Improvement (CDI)</li><li>Denial Management and Appeals</li><li>Medical Coding Audits</li><li>Revenue Integrity</li><li>US Healthcare Reimbursement Systems</li></ul><p><strong>Job Location:</strong> Hyderabad / Work from office</p><p><strong>Employment Type:</strong> Full-Time</p><p><strong>Experience:</strong> Fresher (0-1 Year)</p><p><strong>Qualification:</strong> MBBS, MD Mandatory</p><p><br></p>

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