57 Adjudication Jobs - Page 3

Greetings!!! Openings at Sagility for Process Trainer-Enrollment(US Healthcare) Minimum of 4 years of experience as a Process Trainer in an International BPO. Excellent written and verbal communication skills, with strong interpersonal abilities. Proven experience as a Trainer in an International BPO environment. Strong presentation and Excel skills. Sound knowledge of basic training methodologies. Ability to work in US rotational shifts. Immediate joiners are mostly preferred. Interested candidates can share your resume to anitha.c@sagilityhealth.com

Role & responsibilities Candidate should have sound medical/technical underwriting knowledge to process Life and Health Insurance applications & proposals (Underwriting). He/she should have good decision-making ability referring to standard guidelines and principles. Productivity is the key KPI for this process and should engage in full time production. As a process lead, he or she should handle team queries, give expert opinion for the TM, cascade the process updates, conduct refresher training. Should drive for the team accuracy and achieve KPI goals for the team (productivity, TAT, pend%, quality %) Should act as back-up for AM in performing monthly QC, query handling, reporting to client...

Greetings from NTT DATA, Roles and Responsibilities: Process Adjudication claims and resolve for payment and Denials Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process Knowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of pocket, maximum inside limits and exclusions, state variations Ensuring accurate and timely completion of transactions to meet or exceed client SLAs Organizing and completing tasks according to assigned priorities. Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes perfor...

Roles and Responsibilities : Conduct thorough investigations into property damage claims to determine validity and extent of damage. Manage the entire claims process from intake to settlement, ensuring timely resolution and customer satisfaction. Collaborate with adjusters, contractors, and other stakeholders to gather evidence and resolve complex claims issues. Analyze policy coverage, state laws, and regulations to ensure accurate assessment of damages. Job Requirements : 3-8 years of experience in claims handling or adjudication (property & casualty). Strong understanding of travel insurance policies, including coverage options and limitations. Proficiency in claims processing software sy...

Job Title: Team Leader-Claims Adjudication (US Healthcare)-Coimbatore Experience: 5-8 years Qualification: Bachelors degree Shift: Night shift Transportation: Pick up and drop would be provided Job Summary: Team Leader - Claims Adjudication will oversee a team of healthcare professionals responsible for processing member enrollments and adjudicating claims in compliance with US healthcare regulations, client-specific guidelines, and quality standards. The role ensures efficient workflow, team performance, process improvement, and client satisfaction. Key Responsibilities: Team Management & Leadership: Lead, mentor, and manage a team handling enrollment, Provider configuration- Coimbatore and...

Role & responsibilities The Claims Adjudicator is responsible for the assessment of claims for individual insurance and make the payments Main Accountabilities: Assess the documentation received for a claim in order to reach a decision Determine how the contract applies to each claim Communicate clearly and proactively with clients, advisors and various professionals and effectively manage their expectations Maintain established service standards Evaluate opportunities for process improvements and actively participate in team initiatives and projects. Competencies • Knowledge of individual life insurance • Excellent written and verbal communication skills with an ability to handle written in...

Greetings!!! Openings at Sagility for Process Trainer-(US Healthcare) Minimum of 4 years of experience as a Process Trainer in an International BPO. Excellent written and verbal communication skills, with strong interpersonal abilities. Proven experience as a Trainer in an International BPO environment. Strong presentation and Excel skills. Sound knowledge of basic training methodologies. Ability to work in US rotational shifts. Immediate joiners are mostly preferred. Interested candidates can share your resume to anitha.c@sagilityhealth.com