92 Claim Processing Jobs - Page 2

Team Management Participate in recruitment process to identify the right talent within the function. Guide and direct the team in efficiently achieving their targets. Establish individual performance expectations and regularly review individual performance of the team. Identify and create development opportunities for team members to enhance functional knowledge. Non Motor Claims and Network Management Implement Claims SOP within the team and service network and ensure adherence of the same. Claims forecasting and workload distribution within the team and service providers based on claims volume, seasonality and ASP skill sets Claim processing an monitoring day to day claims activities and e...

Job Title:Associate Vice President Operations Department : Accounts Receivable Work Location:Navi Mumbai, India Reports To:Vice President Operations Work from Office Role Overview TheAssociate Vice President ARwill lead large-scale operations in the US Healthcare RCM domain, managing teams of 800+ employees across multiple accounts. This role requires strong leadership, client relationship management, operational excellence, and strategic vision to ensure process efficiency, profitability, and superior client satisfaction. Key Responsibilities People Leadership Provide strategic leadership to project teams, ensuring productivity, quality, and performance. Mentor and guide Team Leaders, SMEs,...

As a Motor Operation Sr, you will play a crucial role in supporting motor claims and underwriting operations. Your responsibilities will include assisting in processing motor insurance claims and documentation, coordinating with surveyors, garages, and policyholders for claim assessment, supporting the underwriting team in issuing and renewing motor policies, performing field visits if required, and maintaining accurate records while ensuring timely updates in the system. **Key Responsibilities:** - Assist in processing motor insurance claims and documentation - Coordinate with surveyors, garages, and policyholders for claim assessment - Support the underwriting team in issuing and renewing ...

As a Claims Processing Executive at the company, your primary responsibility will be managing and processing Medicare, Medicaid, and Commercial claims. Your proficiency in MS Excel will be crucial for ensuring operational efficiency and accuracy, especially during night shifts. Your role is essential for contributing to impactful healthcare solutions through data analysis, collaboration with team members, and ensuring compliance with healthcare regulations and policies. Key Responsibilities: - Utilize MS Excel for analyzing and managing claim data to enhance operational efficiency - Collaborate with team members to resolve claim discrepancies and improve processing workflows - Maintain knowl...

Job Description : Team Management Participate in recruitment process to identify the right talent within the function. Guide and direct the team in efficiently achieving their targets. Establish individual performance expectations and regularly review individual performance of the team. Identify and create development opportunities for team members to enhance functional knowledge. 2. Non Motor Claims and Network Management Implement Claims SOP within the team and service network and ensure adherence of the same. Claims forecasting and workload distribution within the team and service providers based on claims volume, seasonality and ASP skill sets Claim processing an monitoring day to day cl...

Description We are seeking a detail-oriented Radiology Coder with 2-5 years of experience to join our healthcare team. The ideal candidate will be responsible for reviewing and coding radiology services accurately, ensuring compliance with industry standards. This role requires a strong understanding of medical coding systems and the ability to work collaboratively with medical staff. Responsibilities Review and analyze medical records and diagnostic reports to assign appropriate codes for radiology services. Ensure coding accuracy and compliance with relevant regulations and guidelines. Collaborate with radiologists and other healthcare professionals to clarify documentation and coding quer...

As an AR Caller / Senior AR Executive at Wave Online (Cochin), a rapidly growing healthcare BPO specializing in end-to-end revenue cycle management, your responsibilities will include: - Reviewing and analysing accounts receivable reports for timely follow-up on outstanding claims. - Initiating calls to insurance companies to resolve pending claims or denials. - Handling claim rejections, denials, and follow-up processes efficiently. - Working on bundled claims and understanding authorization processes. - Meeting client-specific KPIs and productivity targets. - Documenting all activities accurately in the client system. - Maintaining a high level of professionalism and customer service durin...

As an insurance customer service representative, your role will involve providing clear answers to clients regarding any coverage or billing inquiries, including explaining rate fluctuations or policy changes to ensure full comprehension. You will be responsible for updating policy changes on customer accounts within our book of business and notifying clients about these changes in accordance with NAIC regulations. Your key responsibilities will include consulting with clients to facilitate the processing of quotes, issuing renewals, or making any necessary updates to current policies. Additionally, you will be required to gather all necessary documentation for reporting a claim and liaise w...

Role Overview: You will be working as a CRM Helpdesk - Claim Processing Executive with a background in health insurance at Watch Your Health. Your main responsibilities will include resolving customer queries related to policy coverage and health claim processes, driving claims application for submission and tracking by employees, acting as the direct point of contact for specific corporate clients, collecting and dispatching claim documents, coordinating with internal claims units to ensure seamless processing, staying updated on health insurance regulations, maintaining data confidentiality, and traveling twice a week between branches to solve customer queries. Key Responsibilities: - Impl...

As an individual responsible for administering health insurance policies, your role will involve ensuring accurate implementation and adherence to insurance guidelines. You will oversee the claims submission and processing workflow to guarantee timely and precise handling of claims. Your assistance will be crucial in addressing beneficiaries" health insurance queries, claims, and services. Additionally, you will maintain and analyze data related to claims, policy renewals, and beneficiary services to identify trends and enhance processes. It is essential to ensure compliance with regulatory standards and internal policies concerning health insurance. Collaboration with healthcare providers a...

As a Provider Support (Associate/Specialist/Executive) at Integrum Outsource Solutions Private Limited, you will be responsible for handling the Inbound Voice Process, specifically providing eligibility, benefits, and claim status support through calls. Your role involves ensuring high-quality service delivery and adherence to compliance standards. Key Responsibilities: - Analyze, review, and adjudicate provider claims. - Ensure compliance with company policies, state and federal regulations, and client guidelines. - Review claims for cost reasonability and medical necessity. - Communicate with reinsurance brokers for claim processing information. - Verify member eligibility, benefit coverag...

Skill required: Operations Support - Pharmacy Benefits Management (PBM) Designation: Health Operations New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years About Accenture Accenture is a global professional services company with leading capabilities in digital, cloud and security.Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the world's largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than ...

A Release of Information (ROI) Executive in US Healthcare is responsible for managing the disclosure of medical records and ensuring compliance with HIPAA (Health Insurance Portability and Accountability Act) and other regulations. This role is crucial in handling patient information requests while maintaining confidentiality and accuracy. Mandatory Skills: Indexing , US Healthcare Medical Records Roles & Responsibilities Process Medical Record Requests Handle patient record requests from patients, providers, insurers, and legal entities while ensuring accuracy. Ensure HIPAA Compliance Follow privacy laws to protect patient information and prevent unauthorized disclosures. Coordinate with St...

Responsible for handling backend operations, data entry, documentation, record management, claim processing, and daily reporting through PC. Ensure accuracy, timely updates, and smooth support to front-end teams

Role & responsibilities Short Paid Claim Contesting Executive-Drive timely and accurate contesting of short-paid claims across hospital-insurer interfaces, ensuring recovery yield and SOP compliance. Analyze short-paid claims and categorize by deduction type, insurer, and RCA triggers. Draft and submit contest letters with supporting documentation via IHX and insurer portals. Track contesting outcomes and escalate unresolved cases per SLA timelines. Collaborate with unit credit cells and central recovery team for RCA discipline and documentation hygiene. Maintain dashboards for contesting status, win-loss ratios, and financial impact. Ensure adherence to SOPs and flag deviation trends for go...

Role & responsibilities Maximize recovery of outstanding claims from TPAs and insurers through disciplined follow-up, documentation, and stakeholder coordination. Monitor aging reports and follow up on pending claims across TPAs and insurers. Coordinate with internal billing, credit cell, and finance teams for claim documentation and query resolution. Engage with insurer/TPA representatives to expedite settlements and resolve disputes. Maintain tracker for recovery status, escalations, and financial realization. Support RCA documentation and contesting for short-paid or denied claims. Prepare weekly MIS and recovery dashboards for leadership review. Preferred candidate profile Familiarity wi...

Role Overview: 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. Key Responsibilities: - Registering health claims and ensuring accuracy and c...

Role Overview: As a Health Admin Services New Associate at Accenture, you will be part of the Healthcare Claims team responsible for the administration of health claims. Your role involves core claim processing, such as registering claims, editing & verification, claims evaluation, and examination & litigation. You will play a vital role in embedding digital transformation in healthcare operations end-to-end, driving superior outcomes and value realization today, and enabling streamlined operations to serve the emerging health care market of tomorrow. Key Responsibilities: - Solve routine problems, largely through precedent and referral to general guidelines - Interact primarily within your ...

Role Overview: 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. Key ...

You are applying for the position of Provider Support (Inbound Voice Process) at Integrum Outsource Solutions Private Limited. As a Provider Support Associate/Specialist/Executive, your role will involve handling inbound calls from healthcare providers regarding claims, eligibility, and benefits. You will be responsible for verifying member eligibility, benefit coverage, and authorization requirements, while maintaining HIPAA compliance and protecting confidential claim information. Additionally, performing administrative duties as assigned will be part of your responsibilities. Key Responsibilities: - Handle inbound calls from healthcare providers regarding claims, eligibility, and benefits...

Role & responsibilities: Outline the day-to-day responsibilities for this role. Preferred candidate profile: Specify required role expertise, previous job experience, or relevant certifications.

Role & responsibilities: Outline the day-to-day responsibilities for this role. Preferred candidate profile: Specify required role expertise, previous job experience, or relevant certifications.

Role Overview: You will be a part of a Mumbai-based health-tech company specializing in cutting-edge digital health solutions. Your primary role as a CRM Helpdesk - Claim Processing will involve managing claims and providing customer support at a client location. Your responsibilities will include deploying CRM implants, handling customer queries, guiding users in claim processes, acting as a single point of contact for corporate clients, and ensuring smooth claim facilitation. Key Responsibilities: - Deploy CRM implants at client site for claim support - Handle customer queries related to policy coverage and claim processing - Guide users in submitting and tracking claims via the claims app...

Process and review Life insurance claims, ensuring adherence to company policies and guidelines. Verify claim documentation, including Death certificate , Employment details, medical records to rule out cause of death and co-morbidities, PMR, FIR , and other supporting documents. Examine insurance applications and documents to ensure accuracy. Communicate with claimants to obtain necessary information and explain the claim process. Assess the validity and coverage of claims, determining eligibility for reimbursement or settlement. Collaborate with claimants, insurance agents, and medical professionals to gather necessary information and resolve any claim-related queries or issues. Keep claim...

What will your essential responsibilities include Process the treaty contract set up in multiple system i.e., Genius, the Frame and Procede. Process the reinsurance recoveries in the multiple system i.e., Genius, the Frame. Process the facultative reinsurance contract set ups as per the process guidelines in both ProCede and the frame. Get them reviewed. Ensure collections / advices are issued promptly to relevant parties. Respond to broker queries and collaborate with Ceded Technical accounting. Assist in data collection and adhoc processing exercises arising from time to time. reporting. Request for test bordereaux. Review them and obtain signoffs before requesting live bordereaux. Prepare...