Clinical Appeals Reviewer

V3 Staffing; Hyderabad; On-site; INR 600,000 - 900,000; Full time

Job summary

V3 Staffing is hiring for Clinical Denials & Appeals roles in Hyderabad to support the US healthcare team. Positions include Specialist, Senior Specialist, Quality Analyst, and Trainer, requiring 2+ years in denials and strong understanding of US payer guidelines.

MBBS/MD or nursing degrees are preferred, with CPC/CCS/COC certifications welcomed. Roles involve reviewing denials, drafting appeals, and ensuring quality documentation for successful resolutions across multispecialty cases.

Qualifications

• 2+ years in Denials & Appeals, Utilization Review, or Case Management.
• Experience in multispecialty denials and US payer guidelines.
• Strong clinical documentation review and medical necessity assessment skills.
• Ability to draft and manage high-quality appeal letters.
• Preferred: CPC / CCS / COC certification.

Responsibilities

• Draft and manage high-quality appeal letters for US payer denials.
• Review clinical documentation to assess medical necessity and eligibility for appeal.
• Collaborate with healthcare professionals to compile supporting evidence for denials appeals.

Skills

Denials & appeals experience

US payer guidelines

Clinical documentation review

Medical necessity assessment

Draft appeal letters

Education

MBBS

MD

B.Sc. Nursing

M.Sc. Nursing

BDS

BHMS

BPT

Job description

Clinical Denials & Appeals | US Healthcare | Multiple Openings

We are hiring experienced healthcare professionals for our Clinical Denials & Appeals team across four levels — Specialist, Senior Specialist, Quality Analyst, and Trainer.

MBBS / MD / B.Sc. Nursing / M.Sc. Nursing / BDS / BHMS / BPT

Key Requirements:

• 2+ years in Denials & Appeals, Utilization Review, or Case Management
• Experience in multispecialty denials and US payer guidelines
• Strong clinical documentation review and medical necessity assessment skills
• Ability to draft and manage high-quality appeal letters
• Preferred: CPC / CCS / COC certification
• Specialist
• Senior Specialist
• Quality Analyst
• Trainer

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