Gnm Staff Nurse

Job Description

Job Title: Medical Coding Associate / Medical Review Analyst
Industry

Healthcare / Medical Coding / Utilization Management

Employment Type

Full-Time

Job Overview

Medical Coding is one of the fastest-growing professions in the healthcare industry. This role is ideal for fresh graduates and healthcare professionals who possess strong analytical abilities, excellent communication skills, and a keen eye for detail.

The selected candidate will be responsible for reviewing medical cases, supporting utilization management activities, ensuring compliance with healthcare regulations, and assisting in medical review assessments while maintaining quality and accuracy standards.

Key Responsibilities
Medical Review & Case Management
Identify cases eligible for medical reviews and assign them to appropriate reviewers.
Review healthcare service utilization and medical documentation.
Perform Medical Review Assessments (MRA) accurately and efficiently.
Identify missing records and necessary information required for review completion.
Coordinate physician reviewer referrals and follow up on pending cases.
Compliance & Quality Assurance
Adhere to URAC guidelines and utilization management regulations.
Ensure compliance with federal, state, and client-specific requirements.
Follow established turnaround times and healthcare review protocols.
Maintain confidentiality and data security standards.
Client & Customer Interaction
Contact clients regarding issues identified during case reviews.
Respond to inbound calls related to medical reviews.
Process customer inquiries according to established protocols.
Provide professional communication and customer service support.
Documentation & Reporting
Maintain accurate records of reviews and case statuses.
Track all ongoing utilization management reviews.
Prepare concise review summaries based on medical records.
Assist management in implementing utilization management programs.
Eligibility Criteria
Educational Qualification
Diploma or Degree in any discipline.
Healthcare-related backgrounds are preferred but not mandatory.
Experience
Freshers can apply.
Candidates with Medical Coding or Healthcare Process experience will have an added advantage.
Required Skills
Technical Skills
Medical Coding Concepts
Medical Record Review
Documentation Analysis
Utilization Management
Healthcare Compliance
Case Tracking and Reporting
Soft Skills
Excellent English Communication Skills
Strong Attention to Detail
Analytical Thinking
Problem Solving
Customer Service Orientation
Time Management
Ability to Work in Fast-Paced Environments
Ideal Candidate Profile
Strong attention to detail and quality standards.
Goal-oriented and capable of meeting deadlines.
Comfortable working with medical documentation and healthcare processes.
Willing to learn new systems, procedures, and healthcare regulations.
Excellent verbal and written communication skills.
Career Benefits
Opportunity to enter the rapidly growing healthcare industry.
Exposure to medical coding and utilization management processes.
Professional growth and certification opportunities.
Stable long-term career path in healthcare operations.
Contact Information

HR Contact: Bhavani

Phone: 9566284629