1575 Claims Adjudication Jobs - Page 16

Roles and Responsibility Conduct thorough analysis of clinical trial data to identify potential safety risks and trends. Develop and implement effective safety protocols and procedures to mitigate identified risks. Collaborate with cross-functional teams, including regulatory affairs, quality assurance, and product development. Review and approve safety-related documentation, such as clinical study reports and investigational reports. Provide training and guidance on safety best practices to internal stakeholders. Stay up-to-date with changing regulations and industry standards related to clinical safety. Job Requirements Strong understanding of clinical trials, safety protocols, and regulat...

Roles and Responsibility 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. Proficient in using various software applications and tools. Excellent analytical and problem-solving skills. Ability to work effectively in a fast-paced environment. Strong communication and interpersonal skills. F...

Roles and Responsibility Develop high-quality medical documents, including clinical trial protocols, informed consent forms, and case study reports. Review and edit medical documents for accuracy, clarity, and compliance with regulatory requirements. Collaborate with cross-functional teams, including physicians, researchers, and other stakeholders, to develop and review medical documents. Conduct thorough reviews of medical documents to identify areas for improvement and implement changes as needed. Stay up-to-date with industry trends and developments in medical research and technology. Participate in the development of new medical document templates and tools. Job Requirements Minimum 3 ye...

Roles and Responsibility Conduct thorough analysis of clinical trial data to identify potential safety risks and trends. Develop and implement effective safety protocols and procedures to mitigate identified risks. Collaborate with cross-functional teams, including regulatory affairs, quality assurance, and product development. Prepare and review safety reports, such as adverse event reports and periodic safety update reports. Stay up-to-date with changing regulations and guidelines related to clinical safety. Provide training and guidance to internal stakeholders on clinical safety best practices. Job Requirements Strong understanding of clinical trials, safety protocols, and regulatory req...

Bpo Hiring For Health Care Domain Voice Process 6.5 LPA Location Gurugram Only Graduates. No B.E./Btech/UG''s Minimum 1 Year of Voice Experience With International BpO MUST Pls Cal Dipankar @ 9650094552 Email CV @ jobsatsmartsource@gmail.com

Roles and Responsibilities: 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, differentiation of 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 d...

Eurofins Assurance India Pvt Ltd is a leading certification body providing Audit & Certification , Inspections , and other services covering the broad spectrum of sustainable supply chain. Eurofins will help the customers to mitigate risks in their supply chain and to ensure the benchmarking performance with operations, processes, systems, people or capabilities. Whether you are in Food, Cosmetics, Consumer products or Health care sector, our global auditor and technical expert network will help to mitigate/eliminate your risks against supply chain and distribution flows: Regulatory and Industrial standards . We have accreditations for a number of different industry standards/memberships to ...

Eurofins Assurance India Pvt Ltd is a leading certification body providing Audit & Certification , Inspections , and other services covering the broad spectrum of sustainable supply chain. Eurofins will help the customers to mitigate risks in their supply chain and to ensure the benchmarking performance with operations, processes, systems, people or capabilities. Whether you are in Food, Cosmetics, Consumer products or Health care sector, our global auditor and technical expert network will help to mitigate/eliminate your risks against supply chain and distribution flows: Regulatory and Industrial standards . We have accreditations for a number of different industry standards/memberships to ...

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: To directly supervise and motivate a team of frontline employees, ensuring day-to-day operations run smoothly, meet performance targets, maintain quality standards, and effectively communicate company goals while fostering a positive work environment and addressing challenges at the operational level, acting as a bridge between management and the workforce. Essential Duties and Responsibilities: Great with Healthcare knowledge Should be aware of all type of payers. Must have good understanding of payer portal for benefits & denials. Should have people centric mindset to manage team Should have verbal and written communication skills, probing skills and denials understanding W...

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...

About The Role Project Role : Business Analyst Project Role Description : Analyze an organization and design its processes and systems, assessing the business model and its integration with technology. Assess current state, identify customer requirements, and define the future state and/or business solution. Research, gather and synthesize information. Must have skills : Microsoft Dynamics CRM Functional Good to have skills : NAMinimum 3 year(s) of experience is required Educational Qualification : 15 years full time education Summary :As a Business Analyst, you will engage in a variety of tasks that involve analyzing organizational processes and systems. Your typical day will include assess...

About The Role Skill required: Operations Support - Pharmacy Benefits Management (PBM) Designation: Health Operations Specialist Qualifications: Any Graduation Years of Experience: 7 to 11 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.The business pr...

Analyst Claims- Review and process property insurance claims, including analyzing policies, assessing damage, and determining coverage and settlements. Work with insurance adjusters, clients, and third-Frty vendors to gather necessary information and documentation for claims processing. Collation of data and information of claims for reporting purposes Investigate and evaluate claims to ensure accuracy and completeness. Prepare and present reports and recommendations to management regarding claims status, trends, and outcomes. Involvement in subrogation requests and required follow-ups. Communicate with clients and stakeholders regarding claims status and resolution. Provide support to other...

Responsibilities * Lead a team of voice process professionals to achieve operational excellence in revenue cycle management, claims adjudication, and customer satisfaction. * Develop and implement strategies to reduce shrinkage, attrition, and improve overall team performance. * Manage escalations effectively to ensure timely resolution of issues while maintaining high levels of customer satisfaction. * Analyze key performance indicators (KPIs) such as AHT, CSAT, TAT, SLA compliance to identify areas for improvement. Job Requirements * 5-12 years of experience in BPO/Call Centre industry with expertise in voice process operations. * Strong understanding of Revenue Cycle Management (RCM), Cla...

SUMMARY Retail Staff Job Description Our client, a UAE-based multinational conglomerate headquartered in Dubai, is seeking freshers to join their retail staff team. The group is involved in the retailing of various products such as apparel, footwear, consumer electronics, cosmetics & beauty products, home improvement, and baby products. Additionally, the group focuses on hospitality & leisure, healthcare, and mall management. Responsibilities: Folding and stacking at a basic table. Timely display of received stocks. Upkeep of section. Ensuring a carton-free floor. Maintaining display standards, including signage. Merchandise clearance from the trial room. Ensuring the right product is displa...

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...

Mercer is seeking candidates to join our Claims Service team based in the Pune/Mumbai office. This is a hybrid role that requires working in the office at least three days a week. Specialist Claims Service (Grade C1) What can you expect: Excellent exposure to complex & diverse claims handling. Opportunity to enhance Claims knowledge and understanding & build on client management skills. As a new colleague, you will be provided with Business Overview/Insights, in-depth process training, roles & responsibilities overview, expectations of various stakeholders to make you successful in this role. Within the first 30 days, we expect you to gain good understanding of the role and requirement that ...

Primary Responsibilities: Claims adjudication/Adjustments/Rework by reviewing the policies, researching, investigating, negotiating, processing, and adjusting claims Consistently meet established productivity, schedule adherence and quality standards Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regard to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company ma...

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...

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...

Job description CREDENSE MB is looking for multiple candidates with good analytical skills with understanding of US Health care. Candidate should have knowledge on Complete Revenue Cycle Management Accounts Receivables Medical Billing **MUST HAVE EXCELLENT COMMUNICATION SKILLS IN ENGLISH ** **MUST BE GOOD IN MS OFFICE TOOLS****NEED TO WORK IN SHIFTS ** Job Description: US Healthcare Charge Entry Payment posting Accounts Receivables Calls Denials and Appeals Management End to End Billing Cycle Management Posting Payments Eligibility Verification Prior Authorization Knowledge of Insurance Eligibility verification Good understanding of medical terminology, disease processes Excellent Communicat...

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...

Bpo Hiring For Health Care Domain Voice Process 6.5 LPA Location Gurugram Only Graduates. No B.E./Btech/UG''s Minimum 1 Year of Voice Experience With International BpO MUST Pls Cal Dipankar @ 9650094552 Email CV @ jobsatsmartsource@gmail.com

Summary: The Senior Back-End Registration Verification and Eligibility Specialist is responsible for ensuring the accuracy and completeness of patient registration data and verifying insurance eligibility after the patient encounter. This role focuses on resolving registration errors, investigating eligibility discrepancies, and working with payers to obtain accurate coverage information. The Senior Specialist handles complex cases, provides guidance to junior team members, and plays a key role in minimizing billing errors and maximizing reimbursement. Key Responsibilities: Registration Verification: Review patient registration data for accuracy and completeness, including demographics, insu...