1508 Claims Adjudication Jobs

Role & responsibilities Team management: Supervise and guide a team of claims processors, delegating tasks, setting performance goals, and conducting regular performance reviews. Claim processing oversight: Monitor and manage the day-to-day workflow, ensuring claims are processed accurately, efficiently, and in a timely manner. Quality assurance: Review claims submissions to ensure they are compliant with policy terms, conditions, and relevant healthcare regulations. Problem-solving: Investigate and resolve complex and escalated claims issues, including discrepancies, in an accurate and timely manner. Training and development: Provide training and support to team members to enhance their ski...

Mandate ASK : Experience: 1-3 yrs in claims adjudication Location : Chennai , Coimbatore 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 insur...

Role & responsibilities Preferred candidate profile Hiring for US Healthcare Claims Adjudication Experience Required: 2-6 years Good communication skills Any Graduates Flexible to work US shifts Ready to work from office Work location: Kochi

Accuracy in Inpatient Billing. Effectively monitoring of day-to-day activities. Resolve customer complaints or answer customers' questions regarding policies and procedures. Supervise the work of office, administrative, or customer service employees to ensure adherence to quality standards, deadlines, and proper procedures, correcting errors or problems. Provide employees with guidance in handling difficult or complex problems or in resolving escalated complaints or disputes. Implement corporate or departmental policies, procedures, and service standards in conjunction with management. Discuss job performance problems with employees to identify causes and issues and to work on resolving prob...

Role Objective: To bill out medical accounts with accuracy within defined timelines and reduce rejections for payers. Essential Duties and Responsibilities: Process Accounts accurately basis US medical billing within defined TAT Able to process payer rejection with accuracy within defined TAT. 24*7 Environment, Open for night shifts Good analytical skills and proficiency with MS Word, Excel, and PowerPoint Qualifications: Graduate in any discipline from a recognized educational institute. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Good communication Skills (both written & verbal)Skill Set: Candidate should have good healthcare knowledge. Candidate should have...

Role- We are looking to hire an experienced Coder / Sr. Coder with active coding certifications (CPC / CPC-A / CIC / CCS / COC). With strong domain expertise in CPT and ICD (diagnosis) coding, the incumbent should be able to validate the coding after reviewing all relevant medical records ensuring codes are accurate and sequenced correctly in accordance with government and insurance regulations. Working in an evolving healthcare setting, delivering innovative solutions using our shared expertise. Using opportunities to learn and grow through rewarding interactions, collaboration, and the freedom to explore professional interests. Giving priority always to what is best for our clients, patien...

Role- Medical Coder: We are looking to hire an experienced Coder / Sr. Coder with active coding certifications (CPC / CPC-A / CIC / CCS / COC). With strong domain expertise in CPT and ICD (diagnosis) coding, the incumbent should be able to validate the coding after reviewing all relevant medical records ensuring codes are accurate and sequenced correctly in accordance with government and insurance regulations. Working in an evolving healthcare setting, delivering innovative solutions using our shared expertise. Using opportunities to learn and grow through rewarding interactions, collaboration, and the freedom to explore professional interests. Giving priority always to what is best for our ...

Role- Medical Coder: We are looking to hire an experienced Coder / Sr. Coder with active coding certifications (CPC / CPC-A / CIC / CCS / COC). With strong domain expertise in CPT and ICD (diagnosis) coding, the incumbent should be able to validate the coding after reviewing all relevant medical records ensuring codes are accurate and sequenced correctly in accordance with government and insurance regulations. Working in an evolving healthcare setting, delivering innovative solutions using our shared expertise. Using opportunities to learn and grow through rewarding interactions, collaboration, and the freedom to explore professional interests. Giving priority always to what is best for our ...

Role Objective: To bill out medical accounts with accuracy within defined timelines and reduce rejections for payers. Essential Duties and Responsibilities: Process Accounts accurately basis US medical billing within defined TAT Able to process payer rejection with accuracy within defined TAT. 24*7 Environment, Open for night shifts Good analytical skills and proficiency with MS Word, Excel, and PowerPoint Qualifications: Graduate in any discipline from a recognized educational institute. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Good communication Skills (both written & verbal)Skill Set: Candidate should have good healthcare knowledge. Candidate should have...

Role- Medical Coder: We are looking to hire an experienced Coder Sr. Coder with active coding certifications (CPC CPC-A CIC CCS COC). With strong domain expertise in CPT and ICD (diagnosis) coding, the incumbent should be able to validate the coding after reviewing all relevant medical records ensuring codes are accurate and sequenced correctly in accordance with government and insurance regulations. Working in an evolving healthcare setting, delivering innovative solutions using our shared expertise. Using opportunities to learn and grow through rewarding interactions, collaboration, and the freedom to explore professional interests. Giving priority always to what is best for our clients, p...

Role Objective: To bill out medical accounts with accuracy within defined timelines and reduce rejections for payers. Essential Duties and Responsibilities: Process Accounts accurately basis US medical billing within defined TAT Able to process payer rejection with accuracy within defined TAT. 24*7 Environment, Open for night shifts Good analytical skills and proficiency with MS Word, Excel, and PowerPoint Qualifications: Graduate in any discipline from a recognized educational institute. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Good communication Skills (both written & verbal)Skill Set: Candidate should have good healthcare knowledge. Candidate should have...

Role Objective Follow up is the most essential part in the RCM cycle. It is usually the last step in the cycle after cash posting. After Denial management (AR Follow up), again the cycle starts till the payment is made by the insurance company. Essential Duties and Responsibilities Establishes and assures compliance with departmental policies and procedures in conformance with corporate policies and procedures. a) Day-to-day operations b) People Management (Work Allocation, On job support, Feedback & Team building) c) Performance Management (Productivity, Quality, One-On-One sessions, KRA, PIP) d) Reports (Internal and Client performance reports) e) Work allocation strategy f) CMS 1500 & UB0...

Reports to (level of category) : Senior Operations Manager Role Objective Follow up is the most essential part in the RCM cycle. It is usually the last step in the cycle after cash posting. After Denial management (AR Follow up), again the cycle starts till the payment is made by the insurance company. Essential Duties and Responsibilities Establishes and assures compliance with departmental policies and procedures in conformance with corporate policies and procedures. a) Day-to-day operations b) People Management (Work Allocation, On job support, Feedback & Team building) c) Performance Management (Productivity, Quality, One-On-One sessions, KRA, PIP) d) Reports (Internal and Client perform...

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Senior Analyst Qualifications: Any Graduation Years of Experience: 5 to 8 years Language - Ability: English(Domestic) - Advanced About Accenture 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 worlds 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 120 countries. Visit us at www.accenture.com What would yo...

About The Role Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years What would you do? We help insurers redefine their customer experience while accelerating their innovation agenda to drive sustainable growth by transforming to an intelligent operating model. Intelligent Insurance Operations combines our advisory, technology, and operations expertise, global scale, and robust ecosystem with our insurance transformation capabilities. It is structured to address the scope and complexity of the ever-changing insurance environment and offers a flexible operating mod...

About The Role Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Associate Qualifications: Any Graduation Years of Experience: 1 to 3 years What would you do? We help insurers redefine their customer experience while accelerating their innovation agenda to drive sustainable growth by transforming to an intelligent operating model. Intelligent Insurance Operations combines our advisory, technology, and operations expertise, global scale, and robust ecosystem with our insurance transformation capabilities. It is structured to address the scope and complexity of the ever-changing insurance environment and offers a flexible operating model t...

About The Role Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Specialist Qualifications: Any Graduation Years of Experience: 7 to 11 years What would you do? As Team Manager, you will lead and oversee a claims adjudication team focused on Commercial Linesincluding Marine, Workers Compensation (WC), and Property insurance. You will ensure timely, accurate claim decisions while driving vertical-specific process improvements, compliance, and strategic performance reporting.Lead, mentor, and manage a team of claims adjudicators across Marine, WC, and Property portfolios.End-to-end adjudication authority:make final decisions on claim appro...

About The Role Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Analyst Qualifications: Any Graduation Years of Experience: 3 to 5 years Language - Ability: English(Domestic) - Intermediate What would you do? We help insurers redefine their customer experience while accelerating their innovation agenda to drive sustainable growth by transforming to an intelligent operating model. Intelligent Insurance Operations combines our advisory, technology, and operations expertise, global scale, and robust ecosystem with our insurance transformation capabilities. It is structured to address the scope and complexity of the ever-changing insurance ...

About The Role Skill required: Talent Development - Learning Operations Designation: Learning Operations Associate Qualifications: Any Graduation Years of Experience: 1 to 3 years What would you do? Improve workforce performance and productivity, boosts business agility, increases revenue and reduces costsTalent Development process. Manage learning solutions, including activities such as registration, vendor management, product support, learning management system.Multi-cultural awareness.Passion for customer service.Team player.MS Office skills:Ability to understand and make sense of large amounts of data in a complex environment, strong Excel & Word skills, working knowledge of other MS Off...

About The Role Skill required: Talent Development - Learning Operations Designation: Learning Operations Associate Qualifications: Any Graduation Years of Experience: 1 to 3 years What would you do? Improve workforce performance and productivity, boosts business agility, increases revenue and reduces costsTalent Development process. Manage learning solutions, including activities such as registration, vendor management, product support, learning management system.Multi-cultural awareness.Passion for customer service.Team player.MS Office skills:Ability to understand and make sense of large amounts of data in a complex environment, strong Excel & Word skills, working knowledge of other MS Off...

About The Role Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years What would you do? We help insurers redefine their customer experience while accelerating their innovation agenda to drive sustainable growth by transforming to an intelligent operating model. Intelligent Insurance Operations combines our advisory, technology, and operations expertise, global scale, and robust ecosystem with our insurance transformation capabilities. It is structured to address the scope and complexity of the ever-changing insurance environment and offers a flexible operating mod...

About The Role Skill required: Talent Development - Learning Operations Designation: Learning Operations Analyst Qualifications: Any Graduation Years of Experience: 3 to 5 years What would you do? Improve workforce performance and productivity, boosts business agility, increases revenue and reduces costsTalent Development process.Personal organization to ensure work is monitored and completed in priority order and on time.Data collation / AnalysisDSM / Onshore interactionAbility to work on own InitiativeManage learning solutions, including activities such as registration, vendor management, product support, learning management system.Respond to incoming mail in the Scheduling mailbox and res...

About The Role Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years What would you do? We help insurers redefine their customer experience while accelerating their innovation agenda to drive sustainable growth by transforming to an intelligent operating model. Intelligent Insurance Operations combines our advisory, technology, and operations expertise, global scale, and robust ecosystem with our insurance transformation capabilities. It is structured to address the scope and complexity of the ever-changing insurance environment and offers a flexible operating mod...

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Specialist Qualifications: Any Graduation Years of Experience: 7 to 11 years Language - Ability: English(Domestic) - Advanced About Accenture 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 worlds 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 120 countries. Visit us at www.accenture.com What would you d...

About The Role Skill required: Retirement Solutions - Claims Case Mgmt - Claims Processing Designation: Claims Management Analyst Qualifications: Any Graduation Years of Experience: 3 to 5 years What would you do? Tower:UK Life and Pensions- Claims Processer- CL 11 What are we looking for? Skillset:Graduate in any discipline from a recognized institution. While a degree in finance, commerce, or business administration is an advantage, it is not mandatory. Experience in the UK Life and Pensions domain (Preferred, not mandatory)Open to flexible shifts based on business requirements.Strong verbal and written communication skills in English, with the ability to convey information clearly and pro...