Appeal Writer - DRG Coding

PrimEra Medical Technologies · India

Job Description

Position Title

Appeal Writer - DRG Coding (Fresher)

Department

DRG Coding & Clinical Appeals

Job Summary

We are seeking highly motivated MBBS,MD graduates with strong clinical knowledge to join our DRG Coding and Appeals team as an Appeal Writer . 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.

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.
• Analyze 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 organization.
• Participate in training programs related to DRG coding, medical coding, and denial management.

Required Qualifications

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.

Preferred Candidate Profile

• MBBS/MD graduate seeking a non-clinical career in healthcare.
• Strong academic background and clinical aptitude.
• Interest in medical coding, DRG validation, CDI, payer denials, and revenue cycle management.
• Quick learner with a passion for healthcare analytics and documentation review.

Career Growth Opportunities

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

Job Location: Hyderabad / Work from office

Employment Type: Full-Time

Experience: Fresher (0-1 Year)

Qualification: MBBS, MD Mandatory