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US Medical Billing Process jobs in Mumbai, Maharashtra

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US Healthcare billing RCM Auth L1 Appeals!
Allied HANR
Sakinaka, Mumbai, Maharashtra
₹25,000 - ₹32,000 an hour
Full-time

Job details

Here’s how the job details align with your profile.

Pay

₹25,000 - ₹32,000 an hour

Job type

Full-time

Benefits

Pulled from the full job description
Provident Fund
Flexible schedule

Full job description

We’re looking for talented professionals to join our team in an Authorization (Auth) L1 Appeals role.

Role: Auth L1 Appeals
Experience: [1-2 years]
Location: Sakinaka, Mumbai
Employment: [Full-time / Contract]

What we’re looking for:

  • Experience in healthcare authorization and appeals
  • Strong understanding of payer processes and medical necessity
  • Ability to review, analyze, and resolve authorization/appeal cases
  • Strong attention to detail and documentation skills
  • Excellent communication and problem-solving abilities

Key Responsibilities

  • Clinical Review: Examine medical records, physician notes, and treatment plans to validate medical necessity.
  • Criteria Application: Use standard medical guidelines like InterQual, MCG, or CMS regulations (NCD/LCD) to assess level-of-care and authorization denials.
  • Appeal Submission: Draft and submit structured, evidence-based appeal arguments to overturn prior authorization and claims denials.
  • Peer-to-Peer Coordination: Coordinate and schedule peer-to-peer reviews between attending physicians and payer medical directors.
  • Regulatory Compliance

Pay: ₹25,000.00 - ₹32,000.00 per hour

Benefits:

  • Flexible schedule
  • Provident Fund

Work Location: In person

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