Medical Reviewer

5 days ago


Hyderabad, Telangana, India beBeeHealthcare Full time ₹ 8,00,000 - ₹ 12,00,000

This role is a medical reviewer responsible for verifying the accuracy of patient medical records.

The incumbent will investigate and detect fraudulent activity perpetrated by providers, members, and facilities.

Key Responsibilities:
  • Verify medical records for completeness and accuracy
  • Conduct investigations to identify fraudulent activity
  • Gather information through interviews and field investigations
  • Testify in court as needed
Requirements:
  • 7-9 years of relevant work experience
  • Medical degree (MBBS, BHMS, BAMS, BUMS) or equivalent from a reputable university
  • Certified Medical Coder with valid certification from AAPC or AHIMA
  • In-depth knowledge of anatomy, physiology, and disease processes
  • Ability to work independently and as part of a team
Preferred Qualifications:
  • Knowledge of payor side business and denial handling experience
  • Relevant experience in healthcare fraud investigations
  • Exposure to professional billing, HIM, internal audit, and provider contracting

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