1575 Claims Adjudication Jobs - Page 15

Conduct thorough analysis of clinical trial data to identify potential safety concerns. Develop and implement effective safety protocols to mitigate risks associated with medical devices. Collaborate with cross-functional teams to ensure compliance with regulatory requirements. Perform regular audits to ensure adherence to safety standards. Provide training and guidance on safety procedures to staff members. Review and approve safety documents, such as protocols and reports. Job Requirements Strong understanding of clinical trials, medical devices, and regulatory requirements. Excellent analytical and problem-solving skills. Ability to work effectively in a fast-paced environment. Good commu...

Manage and maintain accurate medical data records. Ensure compliance with regulatory requirements and industry standards. Collaborate with cross-functional teams to achieve project goals. Develop and implement effective data management processes. Analyze and interpret complex medical data to inform business decisions. Provide expert guidance on data-related matters to stakeholders. Job Requirements Strong understanding of medical terminology and concepts. Proficiency in data management software and tools. Excellent analytical and problem-solving skills. Ability to work effectively in a fast-paced environment. Strong communication and interpersonal skills. Experience working with IT Service &...

Conduct thorough analysis of clinical trial data to identify potential safety risks. Develop and implement effective safety protocols and procedures. Collaborate with cross-functional teams to ensure compliance with regulatory requirements. Perform regular audits to ensure adherence to safety standards. Provide training and guidance on safety procedures to staff members. Investigate adverse events and report findings to senior management. Job Requirements Strong knowledge of clinical safety principles and regulations. Experience working with medical devices is preferred. Excellent analytical and problem-solving skills. Ability to work effectively in a team environment. Strong communication a...

Manage and maintain accurate medical data records. Ensure compliance with regulatory requirements and industry standards. Collaborate with cross-functional teams to achieve project goals. Develop and implement effective data management processes. Analyze and interpret complex medical data sets. Provide expert guidance on data-related matters. Job Requirements Strong knowledge of medical terminology and concepts. Proficient in data management software and tools. Excellent analytical and problem-solving skills. Ability to work effectively in a fast-paced environment. Strong communication and interpersonal skills. Familiarity with IT Service & Consulting industry practices.

Manage and maintain accurate medical data records. Ensure compliance with regulatory requirements and industry standards. Collaborate with cross-functional teams to achieve project goals. Develop and implement effective data management processes. Analyze and interpret complex medical data to inform business decisions. Provide training and support to junior staff members. Job Requirements Strong knowledge of medical terminology and concepts. Experience with data management systems and software. Excellent analytical and problem-solving skills. Ability to work effectively in a team environment. Strong communication and interpersonal skills. Familiarity with IT Service & Consulting industry prac...

Gainwell Technologies LLC Summary As a Business Analyst at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve a community's most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare's biggest challenges. Here are the details on this position. Your role in our mission Play a critical part in ensuring Gainwell is meeting our clients objectives in important areas. Help coordinate a business analyst team's duties and activities on IT projects and nurture newer team members by providing guidance and support Be a ...

Summary Gainwell Technologies is the leading provider of technology solutions that are vital to the administration and operations of health and human services programs. We are the key player in the Medicaid space with a presence in 51 of the 56 U.S. states and territories with offerings including Medicaid Management Information Systems (MMIS), Fiscal Agent Services, Program Integrity, Care Management, Immunization Registry, and Eligibility Services. We generate over $2 billion in annual revenue, and we've been innovating in the industry for more than 50 years. Powered by more than 14,000 employees, Gainwell solutions support more than 60 million Medicaid beneficiaries nationwide and manage 1...

Gainwell Technologies LLC Gainwell Technologies is the leading provider of technology solutions that are vital to the administration and operations of health and human services programs. We are the key player in the Medicaid space with a presence in 51 of the 56 U.S. states and territories with offerings including Medicaid Management Information Systems (MMIS), Fiscal Agent Services, Program Integrity, Care Management, Immunization Registry, and Eligibility Services. We generate over $2 billion in annual revenue, and we've been innovating in the industry for more than 50 years. Powered by more than 14,000 employees, Gainwell solutions support more than 60 million Medicaid beneficiaries natio...

Gainwell Technologies LLC Gainwell Technologies is the leading provider of technology solutions that are vital to the administration and operations of health and human services programs. We are the key player in the Medicaid space with a presence in 51 of the 56 U.S. states and territories with offerings including Medicaid Management Information Systems (MMIS), Fiscal Agent Services, Program Integrity, Care Management, Immunization Registry, and Eligibility Services. We generate over $2 billion in annual revenue, and we've been innovating in the industry for more than 50 years. Powered by more than 14,000 employees, Gainwell solutions support more than 60 million Medicaid beneficiaries natio...

Gainwell Technologies LLC Summary As a Sr Business Analyst at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve a community's most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare's biggest challenges. Here are the details on this position. Your role in our mission Play a critical part in ensuring Gainwell is meeting our clients objectives in important areas. Help coordinate a business analyst team's duties and activities on IT projects and nurture newer team members by providing guidance and support. B...

Gainwell Technologies LLC Summary As a Sr Business Analyst at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve a community's most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare's biggest challenges. Here are the details on this position. Your role in our mission Play a critical part in ensuring Gainwell is meeting our clients objectives in important areas. Help coordinate a business analyst team's duties and activities on IT projects and nurture newer team members by providing guidance and support Be...

Cognizant Walk-in drive for US Healthcare - Senior Claims Auditor with Amisys experience in Hyderabad Interview Date : 27th Sep 2025 (Saturday) Interview Time : 10:00 AM 1:30 PM Venue : Building 12A , 1st floor Raheja Mindspace IT Park, Mindspace Madhapur Rd, HITEC City, Hyderabad, Telangana 500081 Contact Person : Vamsi Krishna Preferred candidates Profile: Must be a graduate. Minimum 1 to 6 Years of experience in US Healthcare Claims audit process. Must have worked on Claims Audit, including adjustments, pricing processes, and experience in high-dollar , COB , and PDR workflows. Strong knowledge of root cause analysis techniques . Proficiency in error categorization , documentation , and t...

Cognizant walk-in Drive for Senior claims adjudication in Coimbatore location. Interview Date : 27th Sep 2025 (Saturday) Interview Time : 9:30 AM - 12:30 PM Venue : Cognizant, CCC Campus, CHIL SEZ Campus, CHIL SEZ IT Park, Saravanampatti, Keernatham Village, Coimbatore-641035 Building Details : Food court - 2 nd floor, North End Contact Person : Govindaraj S / Gokul R Desired profile : Any graduates Minimum 1 to 4 Years of experience in US Healthcare Claims adjudication process (Payer side) Must have experience into End to End claims processing (US Healthcare) Must have strong knowledge in US Healthcare plans and claims forms like CMS 1500 & UB04 Must be willing to work in Night Shift (US Sh...

SUMMARY Job Title: P&C Insurance Team Lead Location: Noida Experience: 7+ years in claim processing Requirements Requirements: Graduate or Post graduate with 7+ years of experience Experience in dealing with international clients (Preferred) Must have Property and Casualty (P&C) Insurance experience Should have claims adjudication and adjusting experience Experience in end-to-end claims processing Minimum 2 years of experience in a team handling role Preferably CPCU or equivalent insurance designation Position Summary: The job holder will be responsible for managing a team and overseeing all relevant technical/operational processing activities. This role also involves providing direct assist...

Graduate from recognized universities. (B Tech CSE/IT not eligible). Freshers and experienced candidates from 2.5 to 4 years are eligible Preferred candidates with Claims/Claims Adjudication Experience with BPO sector/ domain are preferrable Possess strong Problem solving skills, analytical knowledge and communication skills- both written and verbal. Collaborative, high-energy and diligent work ethics to be displayed at all times. Strong ability to multi-task and support different functions based on business requirements. Complete tasks according to the established standards with limited instruction and supervision. Should possess team-based working style coupled with the zeal to expand the ...

Job Track Description: Performs business support or technical work, using data organizing and coordination skills. Performs tasks based on established procedures. In some areas, requires vocational training, certifications, licensures, or equivalent experience. General Profile Ability to perform in an analytical and operational process. Entry-level position with limited requirements for licenses, training, and certifications. Applies experience and skills to complete assigned work. Works within established procedures and practices. Works with a close degree of supervision. Functional Knowledge Basic skillset in a range of processes, procedures, and systems. Business Expertise Supports in the...

Graduate from recognized universities. (B Tech CSE/IT not eligible). Freshers and experienced candidates from 1-4 years are eligible Preferred candidates with Claims/Claims Adjudication Experience with BPO sector/ domain are preferrable Possess strong Problem solving skills, analytical knowledge and communication skills- both written and verbal. Collaborative, high-energy and diligent work ethics to be displayed at all times. Strong ability to multi-task and support different functions based on business requirements. Complete tasks according to the established standards with limited instruction and supervision. Should possess team-based working style coupled with the zeal to expand the learn...

Job Track Description: Requires relevant expertise through formal education in a professional, sales, or technical area. Performs technical-based activities. Contributes to and manages projects. Uses deductive reasoning to solve problems and make recommendations. Interfaces with and influences key stakeholders. Leverages previous knowledge and expertise to achieve results. Able to complete work self-guided. College or university degree required or equivalent work experience. General Profile Performs routine assignments. Exposure to fundamental theories and concepts. Develops skills by performing structured work assignments. Uses existing procedures to solve routine or standard problems. Rece...

JOB TITLE Technical Business Analysis Engineer II RESPONSIBILITIES May perform one or more of the following: Requirement/Analysis Ability to comprehend Business Requirement Documents (BRD) Maintain and Update Data/Vendor Interfaces BRD Interprets requirements to create systems specifications documents to build and execute system. Perform Data Analysis, Audit, and associated research and provide subsequent resolutions. Understanding of database/SQL Query Writing Work alongside with Sr. members or individually (as required) to assist in smooth integration/transition of processes and create/maintain documentations for the same. Responsible for solving the data and Vendor files related issues an...

Job Track Description: Requires experience in a professional, sales, or technical area through formal education. Performs technical-based activities. Contributes to and manages projects. Uses deductive reasoning to solve problems and make recommendations. Interfaces with and influences key stakeholders. Leverages previous knowledge and expertise to achieve results with teams and can complete work self-guided. A college or university degree required. General Profile Requires in-depth knowledge and experience. Uses best practices and understanding of business issues to improve products and services. Solves complex problems. Takes a new perspective using existing solutions. Works unaided and re...

About the team: QR & Soundbox is one of Paytms business tools to help merchants grow and manage their business through simplicity and data driven technology. Expectations/ Requirements 1. Must have Smart Phone, Bike & Helmet 2. Candidate must have a zeal for Growth 3. Candidate should have good market knowledge 4. Must have done a Channel Sales Role before with 5 Member Sales Team handled before 5. Must understand concepts of distribution, expansion, metrics 6. Must have experience in getting team earn Lucrative Incentives Education Graduate or above / Post Graduation preferred. Job Descriptions- Responsible for the Sales enrollments/Sales in the city. Do the market race and prepare the list...

TPAs, insurance companies, and corporate clients Pre-authorization and final approval process TPA desk operations Claims submission Discharge processes TPA tariff rates

Utilize advanced automation technologies to optimize operational processes, ensuring adherence to established procedures and quality standards. Analyze and interpret complex data sets to uncover patterns, providing insights that support operational initiatives and strategic decision-making. Contribute to the development of innovative solutions within the boundaries of established protocols, leveraging your understanding of business strategies and data analytics. Assist in the implementation of business strategies by developing and communicating technical requirements, ensuring alignment with overall business objectives. Provide quality service to customers through continuous communication. R...

Job Title: Assistant Manager US Healthcare RCM (Dental Management) | Immediate Joiners Company: ACN Healthcare Pvt Ltd About the Role: ACN Healthcare Pvt Ltd is looking for an Assistant Manager Dental RCM to lead and manage our US Healthcare operations. The ideal candidate should have strong expertise in Dental RCM with proven team management skills. Key Responsibilities: Manage end-to-end Dental RCM processes Hospital Billing. Lead and mentor a team to ensure quality and productivity. Maintain client relationships and ensure SLA compliance. Identify process improvement opportunities and drive efficiency. Candidate Profile: Minimum 6+ years of experience in US Healthcare RCM, with 2+ years i...

Job Description: Under direct supervision, the Associate is responsible for the timely and accurate posting and imaging of new claims. This includes accessing various systems, both internal and external, for eligibility. Other assignments can include managing incoming email inboxes, bulk uploading of claims and managing automated claims kick outs. The essential functions and responsibilities of this job position include, but are not limited to the following: Timely and accurately posts new claims in the Administrative System within established turnaround time Codes incomplete claims as appropriate Research claims eligibility to ensure the claim belongs to DRMS prior to posting. Reaches out t...