1967 Claims Adjudication Jobs

We are hiring for Leading US Healthcare Company for Sr. AR Caller - Profile Location: Hyderabad Salary: Upto 33k in hand Responsibilities: > Minimum 1 year experience in AR Calling in medical billing field > Should handle US Healthcare providers/ Physicians/ Hospital's Accounts Receivable. > To work closely with the team leader. > Good Knowledge of RCM and Denial management. > Ensure that the deliverables to the client adhere to the quality standards. > Responsible for working on Denials, Rejections, LOA's to accounts, making required corrections to claims. > Calling the insurance carrier & Document the actions taken in claims billing summary notes. > To review emails for any updates >Identi...

Hiring for leading insurance company for US Claims process Graduate with min 3 years End to end Claims experience is mandate US shift SAT-SUN OFF Package upto 8 LPA Viman Nagar, Pune CALL US 93254 29799 / 87669 05361

Responsibilities: The Claim Adjustment Specialist is responsible for end-to-end validation, reviewing and responding to all requests and questions with respect to Risk Management-related issues which include workers compensation claims. Provide direct assistance on all claim-related questions or requests. Take ownership of the question or request and ensure the question or request is properly handled or documented. Coordinate with TPA on claim issues and concerns while providing claim oversight. Accurately document claim activities and maintain up to date records in claim management system. Review claim forms, supporting documents and customer information. Validate claim eligibility based on...

We are hiring for Claims Adjudication!! HR SPOC: Abhilash Job Title: CSA and Senior CSA Grade: H1/H2 Job Category: Associate Function/Department: Operations Reporting to: Team Lead Roles & Responsibilities (Indicative not exhaustive): A claims examiner needs to analyze multiple documents / contracts and decide to pay / deny the claim submitted by member or providers with respect to client specifications. The claims examiner should also route the claim to different department or provider / member for any missing information that required for claims adjudication. The claims needs to be completed adhering to required TAT and quality SLA. Minimum Eligibility: Graduation is Mandatory Minimum 1 ye...

Responsibilities: *Freshers Preferred * Manage claims from intake to payment. * Investigate health claims accurately. * Ensure timely claim settlements. * Collaborate with stakeholders on claims management. * Process insurance claims efficiently. Office cab/shuttle Food allowance Health insurance Annual bonus Provident fund

Job description Check the medical admissibility of a claim by confirming the diagnosis and treatment details. Scrutinize the claims as per the terms and conditions of the insurance policy Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiate open billing and package, etc. Understand the process difference between PA and an RI claim and verify the necessary details accordingly. Verify the required documents for processing claims and raise an IR in case of an insufficiency. Coordinate with the LCM team in case of higher billing and with the provider team in case of non-availability of tariff. Approve or deny the claims as ...

To contact the insured for Underwriting referred proposals to procure the complete medical history using Audio and/or Video tools. To Follow up with customer for past medical records and/or relevant health documents Maintain end to end TAT / SLAs. Required Candidate profile Location – Bangalore Candidate must know to speak excellent English. CTC – Upto 3.5 LPA

We are looking for a skilled professional to join our team as an Executive in Revenue Cycle Management at Aster RV Hospital, located in the Healthcare/Medicine industry. The ideal candidate will have a strong background in revenue cycle management and excellent leadership skills. Roles and Responsibility Manage and oversee the revenue cycle process to ensure accurate and timely payments. Develop and implement strategies to improve revenue cycle efficiency and reduce costs. Collaborate with cross-functional teams to resolve billing and payment issues. Analyze and report on revenue cycle performance metrics to identify areas for improvement. Ensure compliance with regulatory requirements and i...

Job Summary: We are looking for a detail-oriented and analytical Claims Associate to join our non-medical insurance team. The ideal candidate will be responsible for reviewing, assessing, and processing insurance claims with accuracy and integrity, ensuring adherence to company policies and compliance standards. Key Responsibilities:- Evaluate and process insurance claims to determine validity and payment eligibility. - Review documentation including claim forms, bills, and related records for accuracy and completeness. - Interpret policy terms to determine coverage and liability. - Detect and investigate potential fraudulent or suspicious claims. - Coordinate with internal teams and externa...

Job Title - Claims Supervisor Location - Taratala , Kolkata Roles and Responsibilities Manage claims processing from receipt to settlement, ensuring timely and accurate resolution. Oversee claims adjudication, including investigation, assessment, and payment processing. Ensure compliance with insurance policies, regulations, and industry standards. Analyze data to identify trends and areas for improvement in the claims process. Coordinate with TPAs (Third Party Administrators) for smooth claim settlement. Desired Candidate Profile 3-5 years of experience in claims management or related field. Strong knowledge of claims processing, adjudication, and settlement procedures. Proficiency in handl...

Hiring SPE in Mumbai (WFO, US Night Shift) 1.5–4 yrs exp in AR Calling RCM Skills: Medical Bill, Denial Mngt, Claims, Charge Entry, Pay Posting, Eligibility Verification. CTC 28K. NP: Immediate–30 days. HR shoba: 8655512320 shoba@careerguideline.com

Hello Jobseekers, Were Hiring! Claims Process | Bangalore Looking to grow your career in the Claims Process domain? We are hiring experienced professionals for our Bangalore location! Position: Claims Process Executive Experience: Minimum year in Claims Process Location: Bengaluru Salary: Up to 5 LPA Working Days: 5 Days (Monday-Friday) Transport: Both-way cab provided What Were Looking For: Minimum 1 year of hands-on experience in Claims Processing Strong analytical & documentation skills Ability to handle claims with accuracy and timelines Good communication skills How to Apply: Share your CV at [7355126736 Ishwari ] #Hiring #ClaimsProcess #BangaloreJobs #JobOpening #NowHiring #ClaimsExecu...

- Desired qualification: BHMS/ BAMS/ BDS/ BPT/ MPT/ BUMS - To check documents and process medical insurance claims - Prior experience in cashless/reimbursement/pre-auth claims preferred Required Candidate profile - Should have relevant experience in medical/health claims processing.

We Are Hiring: Deputy Manager Claims | Life Insurance We are looking for an experienced Deputy Manager Claims to join our Operations Service Delivery team. If you have strong exposure to life insurance claim assessment , customer handling, fraud detection, and regulatory compliance this opportunity is for you! Position: Deputy Manager Claims Experience: 4+ yrs Education: Graduate Location: Gurugram Industry: Life Insurance Key Responsibilities Assess and approve life insurance claims within authority limits. Support in evaluating complex/doubtful claim cases. Coordinate with doctors, vendors, hubs, claimants & authorities. Ensure adherence to IRDAI regulations and internal audit guidelines. ...

Greetings from Access Healthcare! We have openings for Claims Adjudication in Chennai location, below is the requirement. Minimum 1 year experience is required in claims adjudication/Rejection and Authorization . work from Office. Immediate joiners preferred. Shift : Night shift available Work Location : KTP Ambattur or Porur DLF, Chennai. Interested candidate call or whatsapp. HR -POC Gokul - 9514538636 Rupavathi - 8807096725 Janani -9003665297 Kaaveya - 9080230766 Minithra -8807148612 Aparna - 9384022096 If the call was not responded kindly send a text in WhatsApp. (Your Name - years of Experience in Claims adjudication) Can also refer your friends.

Job description Check the medical admissibility of a claim by confirming the diagnosis and treatment details. Scrutinize the claims as per the terms and conditions of the insurance policy Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiate open billing and package, etc. Understand the process difference between PA and an RI claim and verify the necessary details accordingly. Verify the required documents for processing claims and raise an IR in case of an insufficiency. Coordinate with the LCM team in case of higher billing and with the provider team in case of non-availability of tariff. Approve or deny the claims as ...

Analyze pricing variations and ensure benefit accuracy across systems - Design and execute automated test scripts using Python + Selenium - Write and optimize SQL queries for data validation and backend testing -Perform end-to-end validation of healthcare claims and HRP processes - Conduct API testing using Postman, including request/response validation - Collaborate with cross-functional teams to ensure healthcare compliance and data integrity

Role & 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 performed by the team Resolving com...

Job Description AR Calling (Physician Billing) | Sutherland Healthcare Company: Sutherland Healthcare Role: AR Caller Physician Billing Experience: 1–5 Years Notice Period: Immediate Joiners Preferred (Up to 15 days acceptable) Salary: Up to 5,00,000 LPA Work Days: 5 Days Working Cab Facility: 2-Way Cab Provided work Location: Manikonda About Sutherland Healthcare Sutherland Healthcare digitally transforms healthcare providers, payers, and MedTech organizations by embedding AgenticAI-powered workflow platforms with automation and analytics to improve business outcomes. We partner with Health Plans, Providers, MedTech, Product, and Life Sciences customers to deliver results against outcome-ba...

JOB DESCRIPTION This form is designed to describe the main objectives of this job and its essential functions and job qualifications. I. Basic Information Job Title : Process Lead, SDU Report to Assistant Manager, Service Delivery Job Grade Grade 7 Department Service Delivery Unit Location: Bangalore, India II. Job Summary (describe in 2-3 sentences the purpose of this position) III. Principal Responsibilities (identify 4-5 major categories of work) # Responsibilities Description (E.g. Budgeting s Planning, Team Management, etc.) Description (Do in order to/to ) [3 to 5 Points under each Responsibility] Percentage of Time [%] 1 Task Processing and Operations Operates a variety of client syst...

We are conducting a Walk-In Drive as per the details below: Date : 10th Dec 2025 to 15th December 2025 Time: 3:00 PM to 6:00 PM Mode of Interview : Face-to-Face Venue: R1 RCM, Tower 9, 7th Floor , Candor TechSpace, Sector 135, Noida 201304 Point of Contact: Megha (mjain960@R1RCM.COM) Shift Timings : 6:00 PM to 3:00 AM ( US Shift) About the Apprenticeship Program: Role: Apprentice AR Follow-Up (U.S. Healthcare Process) Duration: 6 months (Paid Apprenticeship) followed by Full Time Employment subject to performance. Program Type: Registered under NATS program Future Scope: Conversion to full-time employee based on performance This program is designed to provide structured training in insurance...

Purpose/Objective The Head-Strategic Sourcing-MEP is a key leadership role within the Adani Group. The position requires an experienced professional with a strategic mindset and extensive knowledge in vendor management and global supply chain management. The successful candidate will play a pivotal role in driving cost-benefit analysis, project management, negotiation skills, market knowledge, business understanding, strategic thinking, cost management, and risk management Key Responsibilities of Role - Category Strategy Development: Develop and execute category-specific procurement strategies that align with the overall procurement goals and objectives of the group and business units - Mark...

HR SPOC: Aiswarya We are hiring for Claims Adjudication!! Job Title: CSA and Senior CSA Grade: H1/H2 Job Category: Associate Function/Department: Operations Reporting to: Team Lead Role Description: Roles & Responsibilities (Indicative not exhaustive) A claims examiner needs to analyse multiple documents / contracts and decide to pay / deny the claim submitted by member or providers with respect to client specifications. The claims examiner should also route the claim to different department or provider / member for any missing information that required for claims adjudication. The claims needs to be completed adhering to required TAT and quality SLA. Minimum Eligibility: Graduation is Manda...

- Acts as an interface between the TPA, Insurance Company and the hospital. - Responsible for investigation of suspicious claims. - Effective usage of Fraud control measures. - Act as a backend support to the TPA. - Responsible for data mining and analytics related to Fraud and Investigation (IFD) -Interested can share CV or call on 7030949730 . HR Sonali .

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Associate Qualifications: Any Graduation Years of Experience: 1 to 3 years 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 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. We e...