21 Claim Processing Jobs

You will be joining Sinex Management Pvt Ltd, a company specializing in providing comprehensive medical billing and revenue cycle management services to healthcare providers. Your primary goal will be to optimize revenue, minimize claim denials, and streamline billing processes to allow medical professionals to focus on patient care. By leveraging the expertise of our billing specialists, you will ensure accurate claim submissions, timely reimbursements, and adherence to industry standards. Our tailored solutions cater to various healthcare settings, such as small clinics, group practices, and independent physicians, to enhance cash flow and reduce administrative burdens. Your role will be a full-time on-site position based in Noida, India. Your responsibilities will include managing daily medical billing tasks, submitting claims accurately, following up with insurance companies, and upholding compliance with industry regulations. You will play a crucial role in reducing claim denials, facilitating timely reimbursements, and safeguarding data confidentiality as per HIPAA guidelines. Additionally, providing exceptional support and solutions to clients will be an integral part of your responsibilities. To excel in this role, you should have experience in medical billing, proficiency in CPT coding and claim processing, and adeptness in insurance follow-ups and reimbursement procedures. Your ability to ensure compliance with industry standards and HIPAA regulations, coupled with strong organizational skills and attention to detail, will be essential. Excellent communication, customer service, and problem-solving skills, along with a proactive approach to addressing client needs, will set you up for success. While relevant qualifications in medical billing or related fields are preferred, your willingness to work on-site in Noida, India is paramount for this position.,

You will be responsible for managing and processing insurance claims under the Ayushman Bharat scheme. Your role will involve ensuring timely and accurate processing of claims, maintaining comprehensive records, and providing exceptional support to beneficiaries. Your key responsibilities will include evaluating and processing Ayushman Bharat insurance claims while ensuring compliance with guidelines and policies. You will also be required to review and verify the accuracy and completeness of claim documents submitted by beneficiaries and hospitals. Effective communication with healthcare providers, beneficiaries, and insurance companies to resolve any discrepancies or issues related to claims is essential. Additionally, you will need to maintain accurate records of claims processed in the system, ensure timely updates, and adhere to regulatory requirements and internal policies related to insurance processing. As an Ayushman Insurance Claim Processor, you will provide assistance to beneficiaries regarding the claim process, including eligibility, documentation, and status updates. Generating reports on claim processing metrics and identifying areas for improvement will also be part of your responsibilities. Preferred experience in a similar role is desirable for this position. A graduation degree is required for this role, and proficiency in English and Kannada languages is essential. The job is located in Bangalore and is a full-time position with day shift schedule. Experience in Ayushman claim process for at least 1 year is preferred for this role. The work location is in person.,

As a Health Admin Services New Associate at Accenture, you will be a part of the Healthcare Claims team responsible for the administration of health claims. Your role will involve core claim processing tasks such as registering claims, editing & verification, claims evaluation, and examination & litigation for health, life, and property & causality claims. You will play a crucial role in embedding digital transformation in healthcare operations end-to-end, driving superior outcomes and value realization today, while enabling streamlined operations to serve the emerging health care market of tomorrow. We are looking for individuals who are adaptable, flexible, and have a commitment to quality. A process-oriented mindset, results orientation, and strong written and verbal communication skills are essential for this role. As a Health Admin Services New Associate, you will be responsible for solving routine problems following general guidelines and precedents. Your primary interactions will be within your team and with your direct supervisor. You will receive detailed instructions on tasks, and decisions made will impact your work closely supervised. This role requires you to work as an individual contributor within a team with a predetermined, narrow scope of work. Please note that rotational shifts may be required for this role. If you are a recent graduate with 0 to 1 years of experience and have a passion for healthcare claims administration, this opportunity at Accenture could be the perfect fit for you. Join our global professional services company with leading capabilities in digital, cloud, and security, and be part of a team that embraces change to create value and shared success for clients, people, shareholders, partners, and communities.,

Job Summary: As a Telemedical Underwriter, you will play a crucial role in our underwriting process by assessing and evaluating insurance applications using telemedical technologies. You will work closely with our team of underwriters, medical professionals, and technology experts to ensure accurate risk assessment and efficient decision-making. Responsibilities: Telemedical Verification: Conduct telemedical verifications for insured members using audio, chat, and video communication channels to create comprehensive Medical Examination Reports (MER). Analyse medical records, test results, and other relevant documentation to assess the insurability and risk level of applicants. Profile Analysis and Documentation: Analyze the health profiles of insured members, create detailed Medical Examination Reports (MER), and maintain records in the prescribed format. Interactive Health Assessment: Initiate and facilitate calls or video sessions with insured members to assess their health conditions and gather essential medical information. Medical Expertise: Demonstrate advanced knowledge of medical terminology, human anatomy, physiology, disease processes, signs and symptoms, medications, and laboratory values to ensure accurate assessments and reports. Medical Underwriting: Evaluate and analyze the medical risks associated with insured members to contribute to the medical underwriting process. Multilingual Advantage: Proficiency in vernacular language is an added advantage, enabling effective communication with insured members who prefer to converse in their native language. Qualification: Medical Degree: BHMS, BAMS, BDS, MBBS Valid medical license and certification. Strong medical knowledge encompassing terminology, anatomy, physiology, disease processes, medications, and laboratory values. Excellent communication and interpersonal skills. Strong analytical and critical thinking skills to assess and evaluate complex medical information, familiarity with telemedical technologies and platforms, with the ability to adapt quickly to new systems. Multilingual skills(an advantage). Excellent communication skills, both verbal and written, to conduct telemedical interviews and prepare comprehensive reports. Prior experience in telemedicine or health insurance(preferred). How to Apply: If you are a dedicated medical professional with the expertise to contribute to our mission of revolutionizing health insurance through telemedicine, please submit your resume and cover letter detailing your qualifications and relevant experience letter to aishwaryac@nu10.co with the subject: "Telemedical Underwriter Application-[Your Name]." We appreciate your interest in joining our team and will carefully review all applications received. Shortlisted candidates will be contacted for further steps in the selection process. Thank you for considering this opportunity with Nu10. We look forward to receiving your application.

TPA Executive to manage pre-authorizations, insurance claims & coordination with TPAs and government health scheme. The role requires accurate documentation, timely claim submissions, & effective communication with internal departments and insurers. Required Candidate profile Graduate with 1–3 years of hospital TPA experience. Proficient in handling CGHS, ECHS, PMJAY claims, insurance coordination, billing & documentation. Strong communication, MS Office & software skills.

Samved e-Care Pvt Ltd is a prominent healthcare claim and TPA service provider in India, offering hospitals advanced claim processing solutions. We are currently seeking a diligent and detail-oriented TPA Assistant to become part of our team in Ahmedabad. The ideal candidate will have the opportunity to thrive in the healthcare administration sector and contribute to optimizing cashless claim procedures for our affiliated hospitals. As a TPA Assistant, your primary responsibilities will include supporting cashless claim processing and documentation, ensuring timely submission and approval of claims by collaborating with hospitals, patients, and insurance TPAs. You will be responsible for data entry, verification, and maintaining accurate patient records, as well as following up on pending approvals and addressing any discrepancies. Additionally, you will assist in client communication and backend claim management while ensuring adherence to internal and regulatory protocols. The qualifications for this role include a minimum of 1 year of experience in any field (preferably TPA/Insurance/Healthcare background), along with a graduation or 12+3 diploma. Strong communication and organizational skills are essential, as well as proficiency in basic computer applications and data entry processes. If you are ready to take on this challenging yet rewarding role in our dynamic organization, we welcome you to apply and be a part of our dedicated team in Ahmedabad.,

Role & responsibilities Tariff Negotiations and cost management Conducting surprise audits and checks of the claims and case to case negotiations Manage workload of both field and office effectively Experience in dealing with providers (Hospitals/Diagnostics & OPD Clinics) Understanding of Health Claims and claim related processes Good understanding of Health Insurance and related products Managing relationship with the providers Flexible to travel across locations based on the organizational requirements Managing internal (Claims Team, Sales and Central Teams and external stakeholders (Brokers, Channel partners & Corporates) Managing and controlling of cost for the portfolio assigned Timely reporting of business MIS and reports to leadership team Analytical and data-driven approach in day to day work Lead and manage the technology & process related initiatives Complying to the audit and compliance related concerns as per organization guidelines Preferred candidate profile We are looking for a doctor profile with relevant experience in claims and willing to travel across AP & Telangana states. Ability to collaborate with various cross functional stakeholders and drive the agenda for closure Should have a good analytical mind to understand costs associated with hospital tariffs and claim cost and manage them effectively. Should have excellent communication, presentation and detailed oriented skills (MS Excel, PowerPoint)

Job Summary: We are looking for a skilled and detail-oriented AR Caller to join our healthcare RCM team. The AR Caller will be responsible for following up with insurance companies and patients on outstanding medical claims, ensuring accurate and timely reimbursement for healthcare services rendered. Key Responsibilities: Review unpaid or denied medical claims from insurance companies. Follow up with insurance companies via phone calls to understand claim status and resolve denials or delays. Initiate appeals or re-submissions as required to ensure maximum claim reimbursement. Document all call details and actions taken accurately in the billing system. Analyze and understand Explanation of Benefits (EOBs) and denial reasons. Meet individual and team productivity and quality targets. Maintain up-to-date knowledge of insurance rules, billing guidelines, and coding standards. Coordinate with internal teams for additional documentation or information needed for claim processing.

As a Claim Processing professional, you will be responsible for handling all aspects of claim processing efficiently and accurately. This includes ensuring compliance with established guidelines and documentation requirements. Your role will involve providing exceptional customer and internal support to address inquiries and resolve issues in a timely manner. In addition to claim processing responsibilities, you will also be tasked with various administrative duties to support the smooth operation of the department. This may include tracking warranty parts and deliveries to ensure timely fulfillment of orders. You will be expected to adapt to changing priorities and perform any other administrative tasks as needed to contribute to the overall success of the team. This is a full-time, permanent position with a day shift schedule. The work location is in person, where you will collaborate with colleagues to deliver high-quality service to clients and stakeholders. If you are detail-oriented, organized, and thrive in a fast-paced environment, we encourage you to apply for this rewarding opportunity.,

Role & responsibilities Warranty failure investigation Warranty/GW Claim processing in System AMC Claim processing in System Warranty parts sending to plant as per the desired list shared by Plant team. Coordinating with plant warranty team & CSM for settlement of claims BDMS claim processing and approval

Urgent Opening for Back Office Executive Good English Communication required (Verbal and Written) Min 6 months to maximum 2 years experience in back office Ready to work in early morning shift 4.30AM to 1.30PM 2 Rotational week offs Salary based on last drawn (Max 25000) Pick up provided. Location : Thane, Kalwa, Airoli, Mulund, Bhandup Immediate joiners required Interested candidates can share the updated CV on whatsapp 7900117773 Email to: [HIDDEN TEXT]

Role & responsibilities A key member of Customer Service Operations team, responsible for providing an efficient, effective and compliant service to policyholders. Key accountabilities include handling of simple and complex cases, quality in service delivery, accuracy in providing and capturing information while adhering to compliance guidelines and support to team managers. Preferred candidate profile Good verbal and written communication skills Freshers eligible ; Preference would be given to individuals from an insurance background with approximately 1 years experience (Insurance Associate) with experience in handling written communication Perks and benefits Hybrid working mode - 3 days in office

Role & responsibilities 1. Making the inpatients billing without errors. 2. Maintaining the transparency in billing. 3. Proper updation of chargeable items in the patients bills. 4. Before finalizing the bills to be confirmed with few departments like OT Blood bank regarding any costly item to be used to the patients. 5. If it is company Patients to be confirmed with approval letters and supporting documents before finalizing the bills & collection of non-medical charges, co-payments etc. 6. Giving proper explanation to the patient's attender regarding the final bill. 7. Proper collection of cash and deposit e to the Bank. 8. Day to day transactions, cash handling details, and petty cash details Daily reports will be reported to the Finance. 9. Rectify any errors from the previous shift so as to minimize the error rate. 10. Work towards streamlining the process and identify and implement process improvements throughout. Preferred candidate profile

1) Receiving of claims courier sent by employees 2) Segregation of claims according to department, 3) Validation of employee claims as per the Travel policy, GST requirements and Eligibility by following internal processes and SOPs in CRM 4) Communication of status of claim process and related queries and updates by e-mail and CRM 5) Co-ordinate by calling the employees on disputed balance confirmations and clarifying the doubts and get the confirmations 6) Preparing of weekly exception and pending claims report and GST sheets 7) Follow up mails in case of no revert 8) Accounting of Claims into weekly batch, 9) Writing file numbers on the accounted claims and filing of the hard copies of the claim in order of file numbers 10) Capture of GST details and Invoice segreegation and scanning of invoices to handover to tax team

Key Responsibilities: Process insurance claims efficiently and accurately. Ensure compliance with company policies and industry regulations. Coordinate with internal teams and external stakeholders to resolve claim-related issues. Maintain detailed records and documentation of all claims. Key Skills: Mandatory:Claim Processing Preferred:Experience in insurance domain, familiarity with healthcare processes, and prior experience in a startup environment. Additional Criteria: Candidates with experience in startups will be given preference. Strong attention to detail and ability to work in a fast-paced environment.

Description We are looking for enthusiastic AR Callers to join our team in India. This role is ideal for freshers or entry-level candidates who are eager to start their career in accounts receivable and finance. The successful candidates will be responsible for managing calls related to outstanding payments, ensuring timely collection, and maintaining accurate records. Responsibilities Handle inbound and outbound calls related to accounts receivable. Follow up with clients to collect outstanding payments and resolve discrepancies. Maintain accurate records of calls and payments received. Communicate effectively with clients and internal teams to resolve issues. Prepare and send invoices to clients in a timely manner. Assist in the reconciliation of accounts and prepare reports as needed. Skills and Qualifications Excellent verbal and written communication skills in English. Basic knowledge of accounts receivable processes and procedures. Proficiency in using MS Office Suite (Excel, Word, etc.). Ability to handle multiple tasks and work under pressure. Strong attention to detail and problem-solving skills. Familiarity with accounting software is a plus. Good interpersonal skills and a customer-oriented approach.

R1 RCM India is proud to be recognized amongst India's Top 50 Best Companies to Work Fo2023 by Great Place To Work Institute. We are committed to transform the healthcare industry with our innovative revenue cycle management services. Our goal is to make healthcare simpler and enable efficiency for healthcare systems, hospitals, and physician practices. With over 30,000 employees globally, we are about 14,000 strong in India with offices in Delhi NCR, Hyderabad, Bangalore, and Chennai. Our inclusive culture ensures that every employee feels valued, respected, and appreciated with a robust set of employee benefits and engagement activities. Responsibilities: Follow up with the payer to check on claim status. Responsible for calling insurance companies in USA on behalf of doctors/physicians and follow up on outstanding accounts receivables. Identify denial reason and work on resolution. Save claim from getting written off by timely following up. Candidates must be comfortable with calling on denied claims. Interview Details: Interview Mode: Face-to-Face Interview Walk-in Day : 07-Jun-2025 (Saturday) Walk in Timings :11 AM to 3 PM Walk in Address: Candor Tech Space Tower No. 3, 6th Floor, Plot 20 & 21, Sector 135, Noida, Uttar Pradesh 201304 Desired Candidate Profile: Candidate must possess good communication skills. Only Immediate Joiners can apply & Candidate must be confortable with Gurgaon Location. Provident Fund (PF) Deduction is mandatory from the organization worked. B.Tech/B.E/LLB/B.SC Biotech aren't eligible for the Interview. Candidates not having Healthcare experience shouldnt have more than 24 Months Exp. Undergraduate with Min. 12 Months Exp is mandatory. Benefits and Amenities: 5 days working. Both Side Transport Facility and Meal. Apart from development, and engagement programs, R1 offers transportation facility to all its employees. There is specific focus on female security who work round-the-clock, be it in office premises or transport/ cab services. There is 24x7 medical support available at all office locations and R1 provides Mediclaim insurance for you and your dependents. All R1 employees are covered under term-life insurance and personal accidental insurance.

Handle incoming calls &emails related to insurance claims with professionalism, empathy Provide accurate information and support to policyholders regarding claim status, documentation, procedures Proficient in CRM software and Microsoft Office tools Required Candidate profile Assist in claim intake, verification, and documentation in accordance with company and regulatory standards. Collaborate with internal claims Excellent verbal and written communication skills. Perks and benefits Perks and Benefits

I. Primary Responsibilities Prepare placement slips, generate UMR, calculate premiums, issue debit and credit notes for Cedants and Re-insurers Perform sanction checks on booked accounts, verify policies booked after inception, and organize debit notes, credit notes, and tax invoices for future reference Suggest and implement improvements to accounting processes for enhanced efficiency and accuracy Collaborate with internal teams, communicate with clients and liaise with regulatory bodies to ensure smooth operations and compliance II. Additional Responsibilities Understanding of best practices in business processes and quality assurance Ability to work independently and as part of a team to achieve quality and compliance objectives Commitment to maintaining confidentiality and handling sensitive information appropriately Willingness to continuously learn and develop new skills to enhance audit effectiveness Publish dashboards to suggest the improvement in matched and unmatched revenues III. Skills and Competencies Technical Proficiency and Understanding of Insurance service Excellent Written and Oral communication skills Interpersonal skills Ownership and Accountability Insurance domain knowledge IV. Minimum Qualifications Education Graduate in Finance/Accounting or Postgraduate with any Specialization Degree Bachelor / Master Licenses/Certificates Insurance Certification will be the additional advantage Work Experience Minimum 1+ year of experience of Quality Analysis in Insurance domain & reconciliation process Collaborate with Underwriters and Claims Adjusters. Experience with Post Policy Placements

* Updating records and files in portal * Knowledge in computers like MS office. * Usage of company platform for patients data updation. * Database management. * Good interpersonal skill. * Coordination with other team members and internal department of the hospital * Share daily activity report to the reporting manager Note: Apply only if fine to work at hospital and location

Manages the processing of health insurance claims incld. coordinating with hospitals, patients, and insurance companies to ensure efficient and accurate claim processing, pre-authorization, document verification, and report generation & compliances.