Clinical Reimbursement Specialist
3 days ago
This position is responsible for reviewing, analyzing, and validating claims, itemized bills and medical records to ensure accuracy of charges, compliance with payer guidelines, and adherence to contractual agreements.
Responsibilities:- Review itemized bills, claims, and supporting documentation for accuracy and completeness.
- Verify that billed services, procedures, and supplies are supported by medical records and documentation.
- Identify duplicate charges, unbundling, upcoding, non-covered services, or charges inconsistent with guidelines and billing protocol.
- Apply payer rules, federal/state regulations, and internal policies when evaluating charges.
- Compare charges against contracts, fee schedules, and usual & customary rates.
- Work on appeals related to billing discrepancies.
- Create documentation related to the above protocol
- Certification in medical coding or auditing - CPMA (preferred), CPC, CCS, COC, etc.
- 3-4 years of experience in hospital billing, claims auditing, or insurance claims review.
- Knowledge of legal and regulatory aspects of healthcare reimbursement.
- Medical background with MBA/MHA preferable, but not mandated.](reimbursement specialist role)
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Clinical Documentation Improvement Specialist
4 weeks ago
Hyderabad, Telangana, India Thryve Digital Health LLP Full timeThryve Digital Health LLP is an emerging global healthcare partner that delivers strategic innovation, expertise, and flexibility to its healthcare partners.Being a US healthcare conglomerate captive, we have direct access to deeper insights that help us accelerate our learning process and keeps us ahead of the curve.Thryve delivers next-generation...
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Clinical Documentation Improvement Specialist
4 weeks ago
Hyderabad, Telangana, India Thryve Digital Health LLP Full timeThryve Digital Health LLP is an emerging global healthcare partner that delivers strategic innovation, expertise, and flexibility to its healthcare partners. Being a US healthcare conglomerate captive, we have direct access to deeper insights that help us accelerate our learning process and keeps us ahead of the curve. Thryve delivers next-generation...
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Clinical Documentation Improvement Specialist
4 weeks ago
Hyderabad, Telangana, India Thryve Digital Health LLP Full timeThryve Digital Health LLP is an emerging global healthcare partner that delivers strategic innovation, expertise, and flexibility to its healthcare partners. Being a US healthcare conglomerate captive, we have direct access to deeper insights that help us accelerate our learning process and keeps us ahead of the curve. Thryve delivers next-generation...
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Clinical Documentation Improvement Specialist
4 weeks ago
Hyderabad, Telangana, India Thryve Digital Health LLP Full timeThryve Digital Health LLP is an emerging global healthcare partner that delivers strategic innovation, expertise, and flexibility to its healthcare partners. Being a US healthcare conglomerate captive, we have direct access to deeper insights that help us accelerate our learning process and keeps us ahead of the curve. Thryve delivers next-generation...
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Hyderabad, Telangana, India Thryve Digital Health LLP Full timeThryve Digital Health LLP is an emerging global healthcare partner that delivers strategic innovation, expertise, and flexibility to its healthcare partners. Being a US healthcare conglomerate captive, we have direct access to deeper insights that help us accelerate our learning process and keeps us ahead of the curve. Thryve delivers next-generation...
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Clinical Documentation Improvement Specialist
5 hours ago
Hyderabad, Telangana, India Thryve Digital Health LLP Full timeThryve Digital Health LLP is an emerging global healthcare partner that delivers strategic innovation, expertise, and flexibility to its healthcare partners. Being a US healthcare conglomerate captive, we have direct access to deeper insights that help us accelerate our learning process and keeps us ahead of the curve. Thryve delivers next-generation...
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Outpatient Clinical Documentation Improvement
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Hyderabad, Telangana, India Doctus Data Services Private Limited Full timeJob Description: Outpatient Clinical Documentation Improvement (CDI) Specialist: Position Summary: The Outpatient Clinical Documentation Improvement (CDI) Specialist is responsible for ensuring the accuracy, completeness, and compliance of clinical documentation in outpatient medical records. This role collaborates with healthcare providers, coding staff,...
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Senior Clinical Data Specialist
3 days ago
Hyderabad, Telangana, India beBeeData Full time ₹ 30,00,000 - ₹ 50,00,000Job Title: Senior Clinical Data Specialist">We are seeking a skilled and detail-oriented Senior Clinical Data Specialist to join our team. In this role, you will be responsible for ensuring the accuracy and integrity of clinical trial data, as well as maintaining a controlled documentation system that meets regulatory requirements.">Key responsibilities...
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Hyderabad, Telangana, India Seven Consultancy Full timeJOB DETAILS 1) Evaluate health message scripts and content for clinical accuracy.2) Check documents (mentioned above) developed by copywriters for clinical and scientific, reporting errors by checking the developed material against annotated references, clinical guidelines, other published sources data3) Check for discrepancy within different components of...
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Clinical Documentation Specialist
3 weeks ago
Hyderabad, Telangana, India Mancer Consulting Services Full timeMajor Responsibilities:- Perform concurrent reviews of inpatient records using EHR platforms (e.g., Iodine, Epic)- Identify documentation gaps and issue compliant, patient-specific queries- Apply knowledge of DRG classification, ICD-10-CM/PCS, and coding guidelines- Maintain accurate logs of reviews, query status, and follow-ups in designated systems-...
