1529 Claims Adjudication Jobs - Page 10

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...

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Analyst Qualifications: Any Graduation Years of Experience: 3 to 5 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 emb...

Education Mandatory : Any Graduate (BSC/BCOM/BA) Desirable : Experience 0 to 6 Months organizations work experience/data capture experience preferred Technical Competencies : Computer Savvy Should have working knowledge of MS-Office Soft Skills: Average English Communication Commitment to achieving deadlines Ability to make sound judgment and be decisive Learning Attitude

Retail Claims - Automation & ProjectsKey Responsibilities1 Automate Claims Processes- Design anddevelop automated workflows and business rules to streamline claims processing Integrate with Existing Systems- Integrateautomated claims processing solutions with existing systems and technologies Testing and UAT - Test and validateautomated claims processing solutions to ensure accuracy and efficiency Daily production issue - Troubleshootissues and resolve problems related any day-to-day production issues across allclaim systems for death and health claims5 Collaborate with IT stakeholders, claim team and other requiredstakeholders to understand requirements and implement solutions6 Strong techn...

Essential Duties & Responsibilities Performing clerical tasks related to quality management policies and proceduresCompleting administrative functions as assigned by the Luminare Health leadSupporting the QM team by leveraging Microsoft tools (PowerPoint, Word, Excel)Ensuring deliverables are accurate and meet assigned deadlines Overseeing the quality and timeliness of tasks assigned to the individual Consulting with the Luminare Health lead for guidance on complex tasksInforming the QM team about task progress and completion Preparing and submitting reports related to quality management tasks 1.1 Qualifications and Technical Competencies Required EducationMandatory: Any Graduate (BSC/BCOM/B...

Candidate must have relevant experience of 8+ years of experience with IT/ITES Companies. Should have good knowledge about AMCs of engineering equipment like air-conditioner, UPS batteries, access control system, firefighting system etc., Preventive Maintenance of equipment, housekeeping management, cafeteria management, security management, key management, front office management, contracting with various service provider, Fleet Management. Must have experience on annual budgeting exercise for Facilities operations, Ready to help his DR for AMC Negotiations, Vendor selections and finalization with the help of Procurement Team. Ready to help Procurement team for executing successful RFP proc...

myG is looking for TRAINEE - SCHEMES & CLAIMS to join our dynamic team and embark on a rewarding career journey Assisting experienced employees with their daily tasks and responsibilities Observing and gaining hands-on experience in various aspects of the job Receiving feedback and guidance from supervisors and mentors Completing assigned projects and tasks under the supervision of experienced employees Collaborating with team members and contributing to team projects Demonstrating a strong work ethic, positive attitude, and a willingness to learn and grow Disclaimer: This job description has been sourced from a public domain and may have been modified by Naukri.com to improve clarity for ou...

Primary Source Verification (PSV): Verify professional licenses, board certifications, and educational qualifications directly from the issuing authorities. Contact previous employers, educational institutions, and licensing bodies to confirm credentials. Document Management: Maintain organized and up-to-date files of all credentialing documents. Ensure timely renewals of certifications and licenses, and track expiration dates. Update and maintain credentialing software/databases with all relevant information. Compliance and Accreditation: Ensure that all credentialing activities meet the requirements of regulatory agencies, such as The Joint Commission and state medical boards. Prepare cred...

Job Role : Team Lead(CMS1500/UB04) End to End RCM Organization : ECLAT Health Solutions Location: Lucknow, Uttar Pradesh Mode: Work from Office Shift: Night shift (5:30 to 2:30) No of Openings: 1 Required Skills: 5+ years of experience in PP/EVBV/end to end RCM (with 2 years in Team lead role) Willing to work in flexible shift including night. Proven ability to lead large teams (25+ FTEs) Strong in AR reporting, analytical tools & MS Excel Excellent communication & people management skills Perks and benefits: Travel allowance Dinner provided Contact Details: 9140294477 (Samuel) samueljohn.massey@eclathealth.com

About Us: Medi Assist is India's leading Health Tech and Insure Tech company focused on administering health benefits across employers, retail members, and public health schemes. We consistently strive to drive innovation and participate in such initiatives, to lower health care costs. Our Health Benefits: Administration model is designed to deliver the tools necessary for a health plan to succeed, whether its our modular claims management system, our technology that unveils data to make important decisions, or our service solutions built around the voice of the customer. In short, our goal is to link our success to that of our members Roles and Responsibilities: Check the medical admissibil...

Innolead is looking for Lead Architect (Healthcare Specialist): to join our dynamic team and embark on a rewarding career journey As the Lead Architect, you will be a key member of the architectural team, responsible for providing technical leadership and expertise in designing and developing complex and innovative solutions Your role involves leading the architectural design process, collaborating with cross-functional teams, and ensuring the successful implementation of architectural solutions You will play a critical role in shaping the overall technology landscape and driving the organization's technical vision Key Responsibilities:Architectural Design: Lead the design and development of...

Minimum of 3 years of experience in technical writing, with a focus on business operations policies and procedures for US Healthcare. Qualification - Graduate Work Location - Bangalore Shift - Rotational shifts Required Candidate profile Immediate Joiners OR Max 1 month notice period candidates can apply Call HR Manager Reejo @ 9886360719 for more details.

Manage NCRs for food rations/logistics by coordinating with Ops, Procurement, and insurers. Drive claim settlements, recoveries, RCA & CAPA, supplier engagement, and ensure compliance, documentation, and timely reporting.

Roles and Responsibilities Conduct thorough reviews of medical records, claims submissions, and other relevant documents to determine accurate payment amounts. Analyze complex healthcare data to identify trends, patterns, and areas for improvement in claims processing. Collaborate with internal stakeholders to resolve claim discrepancies and ensure timely resolution. Develop expertise in specific disease categories or procedure codes to improve accuracy in adjudication decisions. Walk in Drive 01-11-25 & 03-11-25 Please Note - 2nd Oct is national holiday

Eurofins is a leading provider of assurance and inspection services, covering a broad spectrum of sustainable supply chain practices, including the circular economy. Eurofins helps the customers to identify and mitigate risks in their supply chain and to ensure the benchmarking performance with operations, processes, systems, people, or capabilities. We hold accreditations for various industry standards and memberships, ensuring comprehensive service throughout the supply chain. Whether you are in the food, consumer products, healthcare, or cosmetics industries, we offer a full range of services including product inspection, auditing, certification, training, and consultation. Eurofins Assur...

Summary The Sales & Product SME bridges sales, product, and demo engineering by designing realistic demo scenarios, defining business outcomes, and representing the user perspective. This SME ensures all demos align to practical workflows, working closely with the Demo COE, Product, and Infra teams. This role is strictly involved in the development of the product and does not involve access to Protected Health Information (PHI) & Personally Identifiable Information (PII) or any secured/confidential client data. The work is limited to application development and does not include handling or processing of sensitive health information. Key Responsibilities Author, document, and maintain detaile...

About The Role Skill required: Claims Services - Payer Claims Processing Designation: Health Operations New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years What would you do? 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 tomorrowYou will be a part of the Healthcare Claims team which is responsible for the administration of health claims. This team is involved in core claim processing such as registering claims, editing & verification, claims evaluation, and examination & litigation.Business solutions that sup...

About The Role Skill required: Membership - Life Sciences Regulatory Operations Designation: Health Operations New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years What would you do? 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 tomorrowYou will be a part of the Healthcare Management team which is responsible for the administration of hospitals, outpatient clinics, hospices, and other healthcare facilities. This includes day to day operations, department activities, medical and health services, budgeting and r...

Job Description Associate Claims (Non-Medical) Hiring for Freshers Job Title: Associate Claims Non-Medical Location: Bangalore 5 Days working Role Overview: We are seeking a dedicated and empathetic Associate Claims Executive (Non-Medical) to join our health insurance team. The role involves evaluating claims, reviewing documentation, determining coverage, and ensuring smooth and transparent claim settlement. The ideal candidate should have strong analytical skills, attention to detail, and excellent communication abilities to deliver a positive experience for policyholders. Key Responsibilities Claims Evaluation: Review and assess insurance claims to determine validity and payment eligibili...

Ready to shape the future of work? At Genpact, we don’t just adapt to change—we drive it. AI and digital innovation are redefining industries, and we’re leading the charge. Genpact’s AI Gigafactory, our industry-first accelerator, is an example of how we’re scaling advanced technology solutions to help global enterprises work smarter, grow faster, and transform at scale. From large-scale models to agentic AI, our breakthrough solutions tackle companies’ most complex challenges. If you thrive in a fast-moving, tech-driven environment, love solving real-world problems, and want to be part of a team that’s shaping the future, this is your moment. Genpact (NYSE: G) is anadvanced technology servi...

Position Summary : As a Demo Speaker at NxtWave, you will be responsible for conducting demo sessions in person with parents and students and engaging them, and driving enrollment in the NIAT (NxtWave Institute of Advanced Technologies) program. The ideal candidate is a motivated communicator with excellent language proficiency, and a passion for helping students succeed in tech careers. Key Responsibilities : 1. Demo Sessions & Presentations : Conduct demo sessions for parents and students, showcasing the benefits of NxtWaves NIAT product and how it prepares students for high-paying tech roles. Present the value proposition clearly, emphasizing the programs potential to boost future career ...

Bigfix Gadget Care is looking for Process Executive (Claims) to join our dynamic team and embark on a rewarding career journey Analyze and identify areas for process improvement Develop and implement process improvement strategies Monitor and evaluate operational processes and provide recommendations for improvement Develop and implement policies and procedures to ensure compliance with regulatory and legal requirements Ensure that operational processes are efficient, effective, and meet established goals and objectives Proven experience in process improvement and project management Strong analytical and problem-solving skills Excellent communication and interpersonal skills Disclaimer: This...

KPMG India is looking for Manager - Business Analyst to join our dynamic team and embark on a rewarding career journey Delegating responsibilities and supervising business operations Hiring, training, motivating and coaching employees as they provide attentive, efficient service to customers, assessing employee performance and providing helpful feedback and training opportunities. Resolving conflicts or complaints from customers and employees. Monitoring store activity and ensuring it is properly provisioned and staffed. Analyzing information and processes and developing more effective or efficient processes and strategies. Establishing and achieving business and profit objectives. Maintaini...

Reviewing and investigating claims processing, verifying the proper payment of claims, and bringing insurance claims to full resolution through a combination of external third-party relationships and cross-functional communication and collaboration. Maintaining service level agreements regarding assigned accounts receivable tasks while ensuring timely resolution of all claims while prioritizing responsibilities, problem solving, and thinking critically as you perform your regular duties and accommodate other time sensitive tasks as they arise. Conducts regular review and follow up of accounts receivables, ensuring the timely resolution and payment of accounts. Utilizing multiple reports and ...

1. Provide expert knowledge and guidance in medical billing procedures, coding, and compliance standards. 2. Process Improvement: Analyze existing billing processes and systems to identify opportunities for improvement in efficiency and accuracy. 3. Training and Development: Develop training materials and conduct training sessions for staff on medical billing best practices, new regulations, and software updates. 4. Audit and Compliance: Conduct regular audits to ensure billing practices comply with regulatory requirements and internal policies. 5. Quality Assurance: Implement quality assurance measures to maintain high standards of accuracy and completeness in billing documentation and subm...