595 Claims Adjudication Jobs - Page 20

Job Tile : Claims processing Doctor Job Description: Medical claims processor will have to look into claims where payment was denied. Commonly due to issues of insurance coverage eligibility , the claims handler may be tasked with reviewing documentation from the patient, their physicians, or the insurance. With the medical expertise ,need to master the various products and to apply the same during claim processing. Claims processors process any claim payments when applicable and must ensure they comply with federal, state, and company regulations and policies. List of Responsibilities: To validate the authenticity and the credibility of the claims. To coordinate with various persons (Claimant, Treating Physician, Hospital insurance desk, Field Visit Drs, Investigation officers)for hassle-free claim processing . To expertise ,the process of negotiation when necessitated. The claim handler owes a duty of care to the patient, ensuring that their needs are being met and that they re receiving the treatment or medicine they need. Job Qualifications and Requirements: Required BDS, BHMS, BAMS Graduates. Adapt and inbuilt the process of communication and coordination across the zones and the supporting verticals accordingly.

Job Role : Accurate posting of Patient demographic detail Charge Entry or Payment Posting transactions in the revenue cycle software provided by the customer Strive to achieve the productivity standards Adhere to customer provided turnaround time requirements Actively Participate in all training activities from Induction training, Client specific training and refresher training on billing and compliance Possess strong ability to understand impact of the process on customer KPIs Adhere to the companys information security guidelines Demonstrate ethical behavior at all times Job REQUIREMENTs To be considered for this position, applicants need to meet the following qualification criteria: 1-4 years of experience in Patient Demographics Entry, Payment posting or Charge Entry Strong knowledge of medical billing concepts Good communication and analytical skills Must be flexible to work in shifts This process does not require any call center skills (non-voice) Freshers with good typing and communication skill may also apply Interested candidates can call/ whats app HR Drishty - 9311447632

Urgently hiring a Medical Officer – Team Lead with 5+ years in TPA or insurance. Must have strong process knowledge to lead and manage a team of 20 doctors effectively. interested candidates can send resumes to kalyan.r@isbsindia.in or 9866005517.

locationsBrno - Tech Park Brno - BPuneposted onPosted Today job requisition idR-047213 As a member of the Global Total Rewards team, the Benefits Analyst is responsible for maintaining, implementing, and advancing benefit programs and solutions.Reporting to the Director, Global Benefits, the Benefits Analyst is a key member of the broader global People team and will interact regularly with local, regional, and global stakeholders and business partners. We need an individual with both strategic and hands-on experience, as well as a mix of large company and entrepreneurial, high-growth company experience. Come ready to provide vision and direction around strategic program development in a highly competitive market and dynamic environment. What will you do: Responsible for benefit plans, programs, and portfolios across multiple geographies, with a particular focus on APAC Design, recommend, and implement regional and country-specific benefits programs and portfolios, consistent with Red Hats overall rewards philosophy and People strategy through collaboration and consultation with key stakeholders, partners, and business leadership Drive the capture of local and regional requirements for benefit program enhancements and new programs through collaboration with People team colleagues and business leadership Analyze market data, statutory requirements, and benchmarks of country-specific benefits programs to provide insightful competitive and cost analysis to make program design recommendations and enable implementations Remain up to date on local and regional legislative changes, educate key stakeholders on changes, and recommend program changes accordingly Collaborate and provide subject matter expertise to internal partners, associates, and management on a variety of benefit matters in support of benefit programs Escalation point of contact for associate queries Interface with the Talent Acquisition team to provide enablement on benefit program changes and to review competitive reward data coming from the external candidate market Partner with our People Service Delivery team to ensure delivery processes are efficient and scalable Manage relationships with third-party benefit plan brokers, providers, and external vendors, including renewal and negotiation of benefits contracts and cost management Support benefits-related merger and acquisition (M&A), and geographical expansion efforts, such as due diligence, benchmarking, new program design, integration, and post-integration What will you bring: Experience in international benefits and a strong working knowledge of benefits programs for multiple countries or regions Experience designing, implementing, managing, and delivering benefits programs at scale for a growing organization, across multiple geographies is essential Excellent written and verbal communication skills and the ability to communicate with both empathy and clarity across the organization Outstanding attention to detail is required Ability to work both independently with minimal direction and collaboratively across multiple functions Effective at influencing across virtual/cross-group teams Ability to forge close relationships, influence decisions, and gain trust as an advisor and consultant Strong customer focus Proven track record of aligning benefit programs with business strategy/objectives in a progressive environment while designing and delivering new programs for emerging markets Understanding of payroll processes related to benefits administration Ability to operate at a fast pace with clients and ever-changing business needs, remaining creative and innovative with team and clients Knowledge of international labor and/or benefits legislation. Innovation and creativity Change management Experience in working with or managing an outsourced benefits broker/vendor is preferred Experience with multinational pooling is preferred Bachelors degree in human resources, business, economics, or a related field is desirable About Red Hat is the worlds leading provider of enterprise software solutions, using a community-powered approach to deliver high-performing Linux, cloud, container, and Kubernetes technologies. Spread across 40+ countries, our associates work flexibly across work environments, from in-office, to office-flex, to fully remote, depending on the requirements of their role. Red Hatters are encouraged to bring their best ideas, no matter their title or tenure. We're a leader in open source because of our open and inclusive environment. We hire creative, passionate people ready to contribute their ideas, help solve complex problems, and make an impact.

About Us: Paytm is India's leading mobile payments and financial services distribution company. Pioneer of the mobile QR payments revolution in India, Paytm builds technologies that help small businesses with payments and commerce. Paytm’s mission is to serve half a billion Indians and bring them to the mainstream economy with the help of technology. About the teamQR & Soundbox is one of Paytm‘s business tools to help merchants grow and manage their business through simplicity and data driven technology. Expectations/ 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. s- Responsible for the Sales enrollments/Sales in the city. Do the market race and prepare the list of prospective customers , Handle the Team Members and motivate them for better sales , Ensure the team members are in market where enrollments & usage are done regularly. Should have good networking capabilities and be willing to travel extensively throughout their specified areas Key Role: Manage an assigned geographic sales area to maximize sales target and meet corporate. Objectives Build Database of key contact persons in the assigned geography. Build and maintain relationships with key client personnel Manage Category leads from qualification to closure

About Us: Paytm is India's leading mobile payments and financial services distribution company. Pioneer of the mobile QR payments revolution in India, Paytm builds technologies that help small businesses with payments and commerce. Paytm’s mission is to serve half a billion Indians and bring them to the mainstream economy with the help of technology. About the teamQR & Soundbox is one of Paytm‘s business tools to help merchants grow and manage their business through simplicity and data driven technology. Expectations/ 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. s- Responsible for the Sales enrollments/Sales in the city. Do the market race and prepare the list of prospective customers , Handle the Team Members and motivate them for better sales , Ensure the team members are in market where enrollments & usage are done regularly. Should have good networking capabilities and be willing to travel extensively throughout their specified areas Key Role: Manage an assigned geographic sales area to maximize sales target and meet corporate. Objectives Build Database of key contact persons in the assigned geography. Build and maintain relationships with key client personnel Manage Category leads from qualification to closure

We are Conducting Mega Job fair for Top 10 Companies for AR calling. Job Title: AR Caller (Accounts Receivable Caller) Department: Revenue Cycle Management / Medical Billing Location: Bangalore / Hyderabad / Chennai / Noida Job Type: Full-Time / Part-Time Experience: 110 years. Job Summary: We are seeking an AR Caller to follow up on outstanding insurance claims and ensure timely reimbursement. The ideal candidate will be responsible for calling insurance companies (payers) to verify claim status, resolve denials, and secure payment for services rendered. Key Responsibilities: Call insurance companies and follow up on pending claims. Understand and interpret Explanation of Benefits (EOB) and denial codes. Identify reasons for claim denials or delays and take appropriate actions. Resubmit claims or file appeals when necessary. Document all call-related information accurately and clearly. Work with billing teams to resolve billing issues. Meet daily productivity and quality targets. Stay updated on payer policies and healthcare regulations. Required Skills: Excellent communication skills (verbal and written) in English. Basic knowledge of the US healthcare system and insurance claim process. Attention to detail and analytical thinking. Familiarity with denial management and RCM workflow is a plus. Experience using billing software like Athena, NextGen, eClinicalWorks, or similar is a bonus. Qualifications: Bachelors degree preferred, but not mandatory. Prior experience in AR calling/medical billing is an advantage. Willingness to work night shifts (for US clients). contact Hiring Manager : Aditya - 7259027282 / 7259027295 / 7760984460 / 9900024811 / 9686682465

I nterview details: Role Name: Great Britain - Insurance Date : 04 June , 2025 Time: 11.30 AM- 1.00 PM Venue : WTW Global Delivery and Solutions India Private Limited WTW, 7th floor, A&B Wing, ithink Techno Campus, Pokharan Road 2, Subhash Nagar, Thane- 400606. Landmark Beside Viviana Mall Shift timing : Rotational Day Shift (6.30AM to 3:30PM & 1.30PM & 10:30PM) Work Mode : Hybrid Experience : Graduate Freshers *Candidate Address should fall withing WTW's transport boundary Role & responsibilities About Great Britain - Claims Great Britain Claims, a line of business within the Corporate Risk and Broking segments operates to deliver the best client outcomes by fully integrating and mobilizing Willis Towers Watsons relationships with their Clients, third parties and insurers / reinsurers and providing specialist expertise throughout the client experience. Our services include: Claims and Settlement Notification System set-up Correspondence with external parties via email / calls Renewal Stats creation Managing queries Client Service Documentation and evidencing Managing financials (Debts, Refunds etc.) Principal Duties/Responsibilities Adopt and adhere to all Willis Towers Watson values without compromise Delivery on performance standards: - Productivity to be maintained at 100% - Quality standards to be maintained in excess of 99.5% - Deliver all standard units of production within the stipulated timelines - Responsible for managing assigned portfolios. To flag immediately with the Line Manager if any concerns or issues on the account To develop effective relationships with stakeholders (Internal and external) Maintain data security standards as defined within the Information Security policy Flexible, able to shift priorities to accommodate changing business demands Adapt to flexible shift rotation policy (Weekly/Bi-weekly) as per business demands Develop a sound understanding of the business process Ensure adherence to compliance and operate within the guidelines of internal and external regulators Ensure that all statutory and company procedures are followed while processing work to protect clients, colleagues, and the business interests of the company Top Competencies Focusing on Clients Working in Teams Driving Excellence Fostering Innovation Developing Talent Adjusting to Change Required Skills, Knowledge, Experience Skills: Good verbal and written communication skills Attention to detail is vital to succeed in this role Logical thinking is a must Ability to learn new processes and systems, also should have the ability to adapt to changes Ability to seek out and learn from unfamiliar situations/experiences Ability to prioritize and organize tasks, work within stiff timelines Ability to work independently and as part of a team Knowledge: Basic knowledge of the Microsoft office, particularly Word & Excel Qualification: Any Graduate or Postgraduate No gap in education

I nterview details: Role Name: Great Britain - Insurance Date : 04 June , 2025 Time: 11.30 AM- 1.00 PM Venue : WTW Global Delivery and Solutions India Private Limited WTW, 7th floor, A&B Wing, ithink Techno Campus, Pokharan Road 2, Subhash Nagar, Thane- 400606. Landmark Beside Viviana Mall Shift timing : Rotational Day Shift (6.30AM to 3:30PM & 1.30PM & 10:30PM) Work Mode : Hybrid Experience : 0-4 years *Candidate Address should fall withing WTW's transport boundary Role & responsibilities About Great Britain - Claims Great Britain Claims, a line of business within the Corporate Risk and Broking segments operates to deliver the best client outcomes by fully integrating and mobilizing Willis Towers Watsons relationships with their Clients, third parties and insurers / reinsurers and providing specialist expertise throughout the client experience. Our services include: Claims and Settlement Notification System set-up Correspondence with external parties via email / calls Renewal Stats creation Managing queries Client Service Documentation and evidencing Managing financials (Debts, Refunds etc.) Principal Duties/Responsibilities Adopt and adhere to all Willis Towers Watson values without compromise Delivery on performance standards: - Productivity to be maintained at 100% - Quality standards to be maintained in excess of 99.5% - Deliver all standard units of production within the stipulated timelines - Responsible for managing assigned portfolios. To flag immediately with the Line Manager if any concerns or issues on the account To develop effective relationships with stakeholders (Internal and external) Maintain data security standards as defined within the Information Security policy Flexible, able to shift priorities to accommodate changing business demands Adapt to flexible shift rotation policy (Weekly/Bi-weekly) as per business demands Develop a sound understanding of the business process Ensure adherence to compliance and operate within the guidelines of internal and external regulators Ensure that all statutory and company procedures are followed while processing work to protect clients, colleagues, and the business interests of the company Top Competencies Focusing on Clients Working in Teams Driving Excellence Fostering Innovation Developing Talent Adjusting to Change Required Skills, Knowledge, Experience Skills: Good verbal and written communication skills Attention to detail is vital to succeed in this role Logical thinking is a must Ability to learn new processes and systems, also should have the ability to adapt to changes Ability to seek out and learn from unfamiliar situations/experiences Ability to prioritize and organize tasks, work within stiff timelines Ability to work independently and as part of a team Knowledge: Basic knowledge of the Microsoft office, particularly Word & Excel Qualification: Any Graduate or Postgraduate No gap in education

Job Description: We are looking for an experienced Sr. Operations Manager to lead our Revenue Cycle Management (RCM) operations. The role requires overseeing the end-to-end RCM process including Eligibility, AR, Denial Management, Billing, and Payment Posting. Key Responsibilities: Manage a team of 4050 RCM professionals. Oversee AR, Denials, Appeals, and Claims Adjudication. Drive quality, productivity, and attrition management. Collaborate with clients, payers, and internal teams to resolve issues. Monitor KPIs and implement process improvements. Ensure compliance with HIPAA, CMS, and healthcare regulations. Requirements: 12+ years of experience in US Healthcare RCM. Strong domain knowledge across the billing cycle. Hands-on experience with AR, denials, and appeals. Excellent communication & stakeholder management. Proficient in MS Excel and reporting.

Job Role : Accurate posting of Patient demographic detail Charge Entry or Payment Posting transactions in the revenue cycle software provided by the customer Strive to achieve the productivity standards Adhere to customer provided turnaround time requirements Actively Participate in all training activities from Induction training, Client specific training and refresher training on billing and compliance Possess strong ability to understand impact of the process on customer KPIs Adhere to the companys information security guidelines Demonstrate ethical behavior at all times Job REQUIREMENTs To be considered for this position, applicants need to meet the following qualification criteria: 1-4 years of experience in Patient Demographics Entry, Payment posting or Charge Entry Strong knowledge of medical billing concepts Good communication and analytical skills Must be flexible to work in shifts This process does not require any call center skills (non-voice) Freshers with good typing and communication skill may also apply Interested candidates can call/ whats app 7303413866, 9311441474, 9971170400 , 9311446976

Job Description: Medical Record Retrieval and Release of Information Specialist Position Overview: We are seeking dedicated and detail-oriented Medical Record Retrieval and Release of Information (ROI) Specialists to join our healthcare team. The position is responsible for efficiently and accurately retrieving, processing, and releasing medical records in accordance with healthcare regulations and policies. Key Responsibilities: Contacting healthcare providers to retrieve medical records and information required for patient care or legal purposes. Engaging with patients and healthcare professionals over the phone to verify information, resolve issues, and ensure timely release of medical records. Manage follow-ups on outstanding requests, ensuring medical records are retrieved within the designated time frame. Document communication and actions taken for record-keeping purposes in compliance with HIPAA and other healthcare privacy regulations. Provide excellent customer service by addressing any questions or concerns from patients, healthcare providers, or insurance companies related to medical records. Process release of information requests and ensure proper documentation and authorization are in place before records are released. Contacting healthcare providers to retrieve medical records and information required for patient care or legal purposes. Engaging with patients and healthcare professionals over the phone to verify information, resolve issues, and ensure timely release of medical records. Manage follow-ups on outstanding requests , ensuring medical records are retrieved within the designated time frame. Document communication and actions taken for record-keeping purposes in compliance with HIPAA and other healthcare privacy regulations. Provide excellent customer service by addressing any questions or concerns from patients, healthcare providers, or insurance companies related to medical records. Process release of information requests and ensure proper documentation and authorization are in place before records are released. Skills & Qualifications: Experience in healthcare administration or medical records management (preferred). Knowledge of HIPAA regulations and patient confidentiality. Strong communication skills (for calling positions). Excellent attention to detail and organizational skills. Ability to work efficiently and accurately in a fast-paced environment. Experience with medical records systems and software (e.g., Epic, Cerner, etc.) preferred. Ability to handle sensitive information with professionalism and discretion. Salary & Benefits: Competitive salary based on experience. Health and Accidental insurance.

Handling TPA related all process from billing to co-ordinate with TPA companies. Maintaining & uploading patient's files on the portal. Handling billing Department, Implants bill updating & reconciliation.

locationsMumbai - Times Squareposted onPosted 11 Days Ago job requisition idR_306281 Company: Marsh Description: Position Overview: We are seeking a dedicated and detail-oriented Claim Servicing Executive to join our Employee Benefits team in Marsh India. The ideal candidate will be responsible for managing and servicing claims related to employee benefits, ensuring a seamless experience for our clients and their employees. This role requires strong communication skills, a customer-centric approach, and the ability to work collaboratively within a team. Key Responsibilities: Claims Management: Process and manage employee benefits claims efficiently and accurately. Review and assess claims documentation to ensure compliance with policy terms and conditions. Liaise with clients, insurance providers, and internal teams to resolve claims-related inquiries and issues. Client Communication: Serve as the primary point of contact for clients regarding claims inquiries and updates. Provide timely and clear communication to clients about the status of their claims. Educate clients on the claims process and employee benefits policies. Documentation and Reporting: Maintain accurate records of all claims transactions and communications. Prepare and submit reports on claims activity and trends to management. Ensure all documentation is compliant with regulatory requirements and company policies. Marsh, a business of Marsh McLennan (NYSEMMC), is the worlds top insurance broker and risk advisor. Marsh McLennan is a global leader in risk, strategy and people, advising clients in 130 countries across four businessesMarsh, Guy Carpenter, Mercer and Oliver Wyman. With annual revenue of $24 billion and more than 90,000 colleagues, Marsh McLennan helps build the confidence to thrive through the power of perspective. For more information, visit marsh.com, or follow on LinkedIn and X. Marsh McLennan is committed to embracing a diverse, inclusive and flexible work environment. We aim to attract and retain the best people and embrace diversity of age, background, caste, disability, ethnic origin, family duties, gender orientation or expression, gender reassignment, marital status, nationality, parental status, personal or social status, political affiliation, race, religion and beliefs, sex/gender, sexual orientation or expression, skin color, or any other characteristic protected by applicable law. Marsh McLennan is committed to hybrid work, which includes the flexibility of working remotely and the collaboration, connections and professional development benefits of working together in the office. All Marsh McLennan colleagues are expected to be in their local office or working onsite with clients at least three days per week. Office-based teams will identify at least one anchor day per week on which their full team will be together in person.

Job Description Oversee the entire revenue cycle process, including patient registration, insurance eligibility & Benefits verification, charge capture, coding, billing, and payment collection/posting (Must have good hands-on Basic Claims Adjudication, AR & Denial Management/Appeals Process). Manage a team of accounts receivable and billing professionals, including hiring, training, and performance evaluations. Ensure that all coding and billing practices are compliant with government regulations and industry standards, including HIPAA and CMS guidelines. Monitor and analyze revenue cycle metrics to identify areas of improvement and implement process improvements to optimize revenue cycle performance. Work with internal and external stakeholders, including healthcare providers, insurance companies, and patients, to resolve billing and payment-related issues. Work with team on the identified roadblocks / potential problems for processes/procedures and implement possible solutions to avoid any delivery impact. Collaborate with clinical staff, billing staff, and other stakeholders to improve the revenue cycle management process. Monitor key performance indicators and adjust processes as needed to meet goals. Conduct regular training and education sessions to keep staff up to date on changes in regulations and best practices.

Current Working: WFO Shift time- 8 AM- 5 PM Education- Graduate Exp- 0.6 Months- 2 Years US Healthcare ( Claims Adjudication) CTC: - 2.7 – 3.5 LPA Reach me- Tripti.srivastava@silverskills.com

Hiring Alert WNS Pune hiring for the Insurance process. Walk-in Drive: Insurance Process [Back office] Dates: 2nd June 2025 to 06th June 2025 Time: 10:00 AM 1:00 PM Venue: WNS Office - C Block, Weikfield Sakore Nagar, Viman Nagar, Pune Role: Insurance Process Shift: Rotational / night Location: WNS, Pune, Maharashtra Cab Facility: Available Requirements: Excellent English communication skills. Eligibility: Any graduate with insurance experience can apply Skills- Excellent communication skills in English and Insurance experience ( Healthcare, P&C, General, Life & pension, reinsurance, Annuities experience ) Interested candidate can come for walkin interview from 2nd June 2025 to 6th June 2025 between 11:00 AM to 1:00 PM

I nterview details: Role Name: Great Britain - Insurance Claims Date : 04 June , 2025 Time: 11.30 AM- 1.00 PM Venue : WTW Global Delivery and Solutions India Private Limited WTW, 7th floor, A&B Wing, ithink Techno Campus, Pokharan Road 2, Subhash Nagar, Thane- 400606. Landmark Beside Viviana Mall Shift timing : Rotational Day Shift (6.30AM to 3:30PM & 1.30PM & 10:30PM) Work Mode : Hybrid Experience : 0-4 years *Candidate Address should fall withing WTW's transport boundary Role & responsibilities About Great Britain - Claims Great Britain Claims, a line of business within the Corporate Risk and Broking segments operates to deliver the best client outcomes by fully integrating and mobilizing Willis Towers Watsons relationships with their Clients, third parties and insurers / reinsurers and providing specialist expertise throughout the client experience. Our services include: Claims and Settlement Notification System set-up Correspondence with external parties via email / calls Renewal Stats creation Managing queries Client Service Documentation and evidencing Managing financials (Debts, Refunds etc.) Principal Duties/Responsibilities Adopt and adhere to all Willis Towers Watson values without compromise Delivery on performance standards: - Productivity to be maintained at 100% - Quality standards to be maintained in excess of 99.5% - Deliver all standard units of production within the stipulated timelines - Responsible for managing assigned portfolios. To flag immediately with the Line Manager if any concerns or issues on the account To develop effective relationships with stakeholders (Internal and external) Maintain data security standards as defined within the Information Security policy Flexible, able to shift priorities to accommodate changing business demands Adapt to flexible shift rotation policy (Weekly/Bi-weekly) as per business demands Develop a sound understanding of the business process Ensure adherence to compliance and operate within the guidelines of internal and external regulators Ensure that all statutory and company procedures are followed while processing work to protect clients, colleagues, and the business interests of the company Top Competencies Focusing on Clients Working in Teams Driving Excellence Fostering Innovation Developing Talent Adjusting to Change Required Skills, Knowledge, Experience Skills: Good verbal and written communication skills Attention to detail is vital to succeed in this role Logical thinking is a must Ability to learn new processes and systems, also should have the ability to adapt to changes Ability to seek out and learn from unfamiliar situations/experiences Ability to prioritize and organize tasks, work within stiff timelines Ability to work independently and as part of a team Knowledge: Basic knowledge of the Microsoft office, particularly Word & Excel Qualification: Any Graduate or Postgraduate No gap in education

I nterview details: Role Name: Great Britain - Insurance Claims Date : 04 June , 2025 Time: 11.30 AM- 1.00 PM Venue : WTW Global Delivery and Solutions India Private Limited WTW, 7th floor, A&B Wing, ithink Techno Campus, Pokharan Road 2, Subhash Nagar, Thane- 400606. Landmark Beside Viviana Mall Shift timing : Rotational Day Shift (6.30AM to 3:30PM & 1.30PM & 10:30PM) Work Mode : Hybrid Experience : Graduate Freshers *Candidate Address should fall withing WTW's transport boundary Role & responsibilities About Great Britain - Claims Great Britain Claims, a line of business within the Corporate Risk and Broking segments operates to deliver the best client outcomes by fully integrating and mobilizing Willis Towers Watsons relationships with their Clients, third parties and insurers / reinsurers and providing specialist expertise throughout the client experience. Our services include: Claims and Settlement Notification System set-up Correspondence with external parties via email / calls Renewal Stats creation Managing queries Client Service Documentation and evidencing Managing financials (Debts, Refunds etc.) Principal Duties/Responsibilities Adopt and adhere to all Willis Towers Watson values without compromise Delivery on performance standards: - Productivity to be maintained at 100% - Quality standards to be maintained in excess of 99.5% - Deliver all standard units of production within the stipulated timelines - Responsible for managing assigned portfolios. To flag immediately with the Line Manager if any concerns or issues on the account To develop effective relationships with stakeholders (Internal and external) Maintain data security standards as defined within the Information Security policy Flexible, able to shift priorities to accommodate changing business demands Adapt to flexible shift rotation policy (Weekly/Bi-weekly) as per business demands Develop a sound understanding of the business process Ensure adherence to compliance and operate within the guidelines of internal and external regulators Ensure that all statutory and company procedures are followed while processing work to protect clients, colleagues, and the business interests of the company Top Competencies Focusing on Clients Working in Teams Driving Excellence Fostering Innovation Developing Talent Adjusting to Change Required Skills, Knowledge, Experience Skills: Good verbal and written communication skills Attention to detail is vital to succeed in this role Logical thinking is a must Ability to learn new processes and systems, also should have the ability to adapt to changes Ability to seek out and learn from unfamiliar situations/experiences Ability to prioritize and organize tasks, work within stiff timelines Ability to work independently and as part of a team Knowledge: Basic knowledge of the Microsoft office, particularly Word & Excel Qualification: Any Graduate or Postgraduate No gap in education

As a leading financial services and healthcare technology company based on revenue, SSC is headquartered in Windsor, Connecticut, and has 27,000+ employees in 35 countries. Some 20,000 financial services and healthcare organizations, from the worlds largest companies to small and mid-market firms, rely on SSC for expertise, scale, and technology. DomaniRx is a newly formed organization focused on shaping the future of Pharmacy Benefit Management by delivering a cloud-native, API-driven claims adjudication platform. Our team is made up of engineers with varying levels of professional experience and backgrounds, from new graduates to 20-year veterans of the healthcare industry. We are looking for creative engineers and technologists: relevant industry experience is important, but less so than your demonstrated abilities, passion and attitude. We re always improving and looking for individuals that enjoy being challenged and have a strong desire to make the engineering experience better for our users. Unless explicitly requested or approached by SSC Technologies, Inc. or any of its affiliated companies, the company will not accept unsolicited resumes from headhunters, recruitment agencies, or fee-based recruitment services. SSC Technologies is an Equal Employment Opportunity employer and does not discriminate against any applicant for employment or employee on the basis of race, color, religious creed, gender, age, marital status, sexual orientation, national origin, disability, veteran status or any other classification protected by applicable discrimination laws.

Job title Knowledge Specialist (Band 5, Level 2) Reports to Unit Manager / Asst Unit Manager Provides customer service support for third party administrators, Health Maintenance organizations, preferred provider organizations, managed care organizations and many more in US healthcare insurance market by identifying and updating information. The ultimate motive is to ensure commendable service standards and maintain very high customer satisfaction. Technical Skills: Minimum 1 - 2 years experience in examining and processing Healthcare claims required. Medical claims processing experience is a must. Provider Maintenance, Enrollment experience required. Proficiency with computers. Process Skills: Listed below are the primary job duties and responsibilities that are required: Review claims for legitimacy and accuracy Adjudicate claims by approving or denying them according to established guidelines. Conducts investigation of pended claims and follow up with respective departments to finalize claims resolution. Staying current with knowledge of products/ processes services offered by the client, Review and process medical claims according to guidelines within established turnaround time frames Maintain accurate records/notes of claims related documentation. Ensure full adherence to all the quality parameters. Ensure 100% adherence to schedule. Meeting all defined targets like Productivity, quality, Maintenance of required reports in Excel. Behavioral Skills : Look up for relevant information and update (type into) the client systems as per set procedures and policies. Attention to detail while accomplishing tasks, meeting Weekly / Daily targets with required quality in the given timelines. Enter updates relating to pertinent healthcare data into the computer system in a timely manner ensuring accuracy, completeness, and adherence to department procedures. Review data for deficiencies or errors, correct any incompatibilities if possible. Adhere to the team norms for making the overall team a cohesive one. Ability to prioritize and manage workload. Must be ready to work in night shifts. Certification: Undergraduate (10+2)/Diploma / Graduate (Only Arts or Science) - Non-Technical Only Typing speed 35 to 40 wpm with 95% accuracy (without looking at the keyboard) Good communication skills.

Job description R1 RCM India is proud to be recognized amongst India's Top 50 Best Companies to Work Fo2023 by Great Place To Work Institute. We are committed to transform the healthcare industry with our innovative revenue cycle management services. Our goal is to make healthcare simpler and enable efficiency for healthcare systems, hospitals, and physician practices. With over 30,000 employees globally, we are about 14,000 strong in India with offices in Delhi NCR, Hyderabad, Bangalore, and Chennai. Our inclusive culture ensures that every employee feels valued, respected, and appreciated with a robust set of employee benefits and engagement activities. Responsibilities: Follow up with the payer to check on claim status. Responsible for calling insurance companies in USA on behalf of doctors/physicians and follow up on outstanding accounts receivables. Identify denial reason and work on resolution. Save claim from getting written off by timely following up. Candidates must be comfortable with calling on denied claims. Interview Details: Interview Mode: Face-to-Face Interview Walk-in Days : Monday to Friday Walk in Timings : 1PM to 4 PM Walk in Address: Candor Tech Space Tower No. 3, 6th Floor, Plot 20 & 21, Sector 135, Noida, Uttar Pradesh 201304 Contact Information: Alina Zaman-9289544594/Keshav Kaushal-9205669978/ Nasar Arshi 9266377969/Arpita Mishra-8840294345, Anushka- 8317044614/ Vishal-9560031640 Desired Candidate Profile Candidate must possess good communication skills. Only Candidate with relevant experience in AR Follow UP in US Healthcare are eligible. Provident Fund (PF) Deduction is mandatory from the organization worked. B.Tech/B.E/LLB/B.SC Biotech aren't eligible for the Interview. Undergraduate with Min. 12 Months Exp is mandatory. Benefits and Amenities: 5 days working. Both Side Transport Facility and Meal. Apart from development, and engagement programs, R1 offers transportation facility to all its employees. There is specific focus on female security who work round-the-clock, be it in office premises or transport/ cab services. There is 24x7 medical support available at all office locations and R1 provides Mediclaim insurance for you and your dependents. All R1 employees are covered under term-life insurance and personal accidental insurance.

Preferred candidate profile Minimum 1 year experience in Workers Compensation / Property casulty /Auto Insurance Immediate Joiners / 1 month Notice Good english communications is a mandatory

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years About Accenture 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 embrace the power of change to create value and shared success for our clients, people, shareholders, partners and communities.Visit us at www.accenture.com 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 that can meet the unique needs of each market segment.Claim processing team collects end-end data dataDevelop and deliver business solutions that support the claims process across its lifecycle, including first notice of loss, claims investigation, payment administration or adjudication, provider reimbursement (health care), subrogation and recovery. What are we looking for Ability to establish strong client relationshipAbility to handle disputesAbility to manage multiple stakeholdersAbility to meet deadlinesAbility to perform under pressure- Roles and Responsibilities: In this role you are required to solve routine problems, largely through precedent and referral to general guidelines Your primary interaction is within your own team and your direct supervisor In this role you will be given detailed instructions on all tasks The decisions that you make impact your own work and are closely supervised You will be an individual contributor as a part of a team with a predetermined, narrow scope of work Please note that this role may require you to work in rotational shifts Qualification Any Graduation

Skill required: Group Core Benefits- Claims Case Mgmt. Group Disability Insurance Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years About Accenture 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 embrace the power of change to create value and shared success for our clients, people, shareholders, partners and communities.Visit us at www.accenture.com 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 that can meet the unique needs of each market segment.Team prepares a case studyGroup disability coverage is tied to employment. If change or loss of job, the coverage is not portable. The cost of group coverage can also change from year to year. It is a sort of insurance that pays out if a policyholder is unable to work and earn an income due to a disability. What are we looking for Problem-solving skillsWritten and verbal communicationCollaboration and interpersonal skillsAbility to meet deadlinesProcess-orientation Roles and Responsibilities: In this role you are required to solve routine problems, largely through precedent and referral to general guidelines Your primary interaction is within your own team and your direct supervisor In this role you will be given detailed instructions on all tasks The decisions that you make impact your own work and are closely supervised You will be an individual contributor as a part of a team with a predetermined, narrow scope of work Please note that this role may require you to work in rotational shifts Qualification Any Graduation