595 Claims Adjudication Jobs - Page 21

Skill required: Group Core Benefits- Claims Case Mgmt. Group Disability Insurance Designation: Claims Management Associate Qualifications: Any Graduation Years of Experience: 1 to 3 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 expected interactions are within your own team and direct supervisor You will be provided detailed to moderate level of instruction on daily work tasks and detailed instruction on new assignments The decisions that you make would impact your own work You will be an individual contributor as a part of a team, with a predetermined, focused scope of work Please note that this role may require you to work in rotational shifts Qualification Any Graduation

Skill required: Reinsurance - Life Insurance Designation: Claims Management Analyst Qualifications: BBA/BCom Years of Experience: 3 to 5 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.Canceling and rewriting insurance policies and endorsementsDevelop and deliver solutions related to life insurance or life assurance-contracts between policy owners and insurers where the insurer agrees to pay a sum of money upon the occurrence of the insured s death or other event such as terminal or critical illness. What are we looking for ReinsuranceStrong analytical skillsAbility to manage multiple stakeholdersDetail orientationThe primary focus is of placing treaties, reviewing high value claims, and policy administration for Life Insurance and reinsurance products. The position will be responsible for ensuring the accuracy and quality on the TAI reinsurance system. Roles and Responsibilities: In this role you are required to do analysis and solving of lower-complexity problems Your day to day interaction is with peers within Accenture before updating supervisors In this role you may have limited exposure with clients and/or Accenture management You will be given moderate level instruction on daily work tasks and detailed instructions on new assignments The decisions you make impact your own work and may impact the work of others You will be an individual contributor as a part of a team, with a focused scope of work Please note that this role may require you to work in rotational shifts Qualification BBA,BCom

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 : Innovation Strategy & Management Good to have skills : PartnershipsMinimum 2 year(s) of experience is required Educational Qualification : 15 years full time education Summary :As a Business Analyst, you will engage in a dynamic environment where you will analyze organizational processes and systems. Your typical day will involve assessing the current business model, identifying customer requirements, and defining future states or business solutions. You will conduct thorough research, gather relevant information, and synthesize your findings to support strategic decision-making. Collaborating with various stakeholders, you will play a crucial role in ensuring that technology aligns with business objectives, ultimately driving innovation and efficiency within the organization. Roles & Responsibilities:- Expected to perform independently and become an SME.- Required active participation/contribution in team discussions.- Contribute in providing solutions to work related problems.- Facilitate workshops and meetings to gather requirements and feedback from stakeholders.- Develop comprehensive documentation to support project initiatives and ensure clarity in communication. Professional & Technical Skills: - Must To Have Skills: Proficiency in Innovation Strategy & Management.- Strong analytical skills to assess business processes and identify areas for improvement.- Experience in stakeholder management and effective communication.- Ability to synthesize complex information into actionable insights.- Familiarity with project management methodologies and tools. Additional Information:- The candidate should have minimum 2 years of experience in Innovation Strategy & Management.- This position is based at our Bengaluru office.- A 15 years full time education is required. Qualification 15 years full time education

Role & responsibilities Responsibilities: Follow up with the payer to check on claim status. Responsible for calling insurance companies in the USA on behalf of doctors/physicians and following up on outstanding accounts receivable. Identify the reason for the denial and work on a resolution. Save claims from getting written off by timely following up. Candidates must be comfortable with calling on denied claims. Desired Candidate Profile: Candidate must possess good communication skills. Provident Fund (PF) Deduction is mandatory for the organization. B. Tech/B.E/LLB/B.SC Biotech isn't eligible for the Interview. Candidates having Healthcare experience. Undergraduate with a minimum. 12 Months Exp is mandatory. Benefits and Amenities: 5 days of work. Both Side Transport Facility and Meal. Apart from development and engagement programs, R1 offers transportation facilities to all its employees. There is a specific focus on female security personnel 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

About the jobKey Responsibilities:Perform day-to-day billing activities with accuracy and adherence to firm policies Conduct thorough reviews of billing activities, ensuring accurate, reliable data Follow-up on billing for managed care/private insurances and Medicare for skilled nursing facilities to resolve outstanding balances, denials and discrepancies Verify claims accuracy by ensuring alignment with Medicaid, Medicare, and private insurance guidelines Process co-insurance, Medicare Part B, and therapy filings Maintain organized records and documentation for audits and compliance purposes Exhibit professionalism, accountability, and a drive for innovation in all tasks Support team goals by taking on additional duties as needed Qualifications:1–5 years of billing experience, with a focus on long-term care facilities or healthcare settings preferred Knowledge of payer processes and claims submission requirements Strong attention to detail and a commitment to accuracy Proficiency in verbal and written communication skills Ability to organize and prioritize tasks in a fast-paced environment Proficiency in organizational skills and time management Ability to maintain confidentiality and handle sensitive information Collaborative skills to work effectively with clients and internal teams at all levels Required Skills and Competencies:Familiarity with insurance industries, managed care programs, Medicaid, and Medicare guidelines Basic knowledge of HIPAA laws and best practices for handling client dataProficiency in medical billing software and related tools

Walk-In Drive on 7th June 2025 at Cotiviti -Pune for Healthcare Audit Walk-In Date: 7-June-2025 (Saturday) Time 9:00 Am 1:00 Pm Venue: Cotiviti India Pvt Ltd Plot C, Podium Floor, Binarius/Deepak Complex, Opposite Golf Course, Yerwada, Pune- 411006. We are hiring for the Healthcare Data Audit process at Cotiviti. Please refer to the information below and required skill set for the same. POSITION SUMMARY: Specialist Payment Accuracy position is an entry level position responsible for auditing client data and validating claim accuracy. Communicates audit recommendations and outcomes to supervisory auditor for evaluation, verification and continuous learning. POSITION REQUIREMENTS: Graduation mandatory. Excellent communication skills. US Healthcare experience is preferred. Computer proficiency in Microsoft Office (Word, Excel, Outlook); Access preferred Strong interest in working with large data sets and various databases Must be flexible working in fixed/rotational shifts Immediate joiners preferred Good energy and Positive attitude Long Term Career Orientation If the above profile interests you then please walk-in for the interview. Please refer to the above mentioned walk-in details. Please bring your updated Resume along with an ID Proof. Best regards, Atish Chintalwar Senior Executive Human Resource COTIVITI About Cotiviti: Cotiviti is a leading healthcare solutions and analytics company headquartered in the United States, with more than 10000 employees in offices across the U U.S., Canada, Australia, India, Nepal, Philippines & Mexico. Cotiviti has been in business for more than two decades (including predecessor companies), and our solutions have been well proven and tested. Our clients are primarily health insurance companies, including U.S. government payers, although healthcare providers, employers, and insurance brokers also use our solutions. In fact, we support almost every major health plan in the U.S. and more than 180 healthcare payers in total. We focus on improving the financial and quality performance of our clients. In healthcare, this means taking in billions of clinical and financial data points, analyzing them, and helping our clients discover ways they can improve efficiency and quality. In addition to healthcare, we support the largest and most influential retailers in the industry, including mass merchandisers, across the U.S., Canada, United Kingdom, Europe and Latin America. Our data management recovery audit services have helped them save hundreds of millions of dollars.

Level : SME Job Location : Chennai Shift : US Shift Experience : 6 Years for SME Notice : Immediate Joiner Qualification : Graduate (non tech) Notice : Immediate Joiner Excellent Communication Share resume on- archi.g@manningconsulting.in Contact-8302372009

Check the medical admissibility of claim by confirming diagnosis and treatment details Verify the required documents for processing claims and raise an information request in case of an insufficiency Approve or deny claims as per T&C within TAT If candidates are interested please drop your update resume/CV on my Mail ID - varsha.kumari@mediassist.in Thanks & Regards Varsha Kumari Email - varsha.kumari@mediassist.in

About Us At CIGNA Healthcare we are guided by a common purpose to help make financial lives better through the power of every connection. Responsible Growth is how we run our company and how we deliver for our clients, teammates, communities, and shareholders every day. One of the keys to driving Responsible Growth is being a great place to work for our teammates around the world. We are devoted to being a diverse and inclusive workplace for everyone. We hire individuals with a broad range of backgrounds and experiences and invest heavily in our teammates and their families by offering competitive benefits to support their physical, emotional, and financial well-being. CIGNA Healthcare believes both in the importance of working together and offering flexibility to our employees. We use a multi-faceted approach for flexibility, depending on the various roles in our organization. Working at CIGNA Healthcare will give you a great career with opportunities to learn, grow and make an impact, along with the power to make a difference. Join us! Process Overview* International insurance claims processing for Member claims. * Delivers basic technical, administrative, or operative Claims tasks. Examines and processes paper claims and/or electronic claims. Completes data entry, maintains files, and provides support. Understands simple instructions and procedures. Performs Claims duties under direct instruction and close supervision. Work is allocated on a day-to-day or task-by-task basis with clear instructions. Entry point into professional roles. Responsibilities- Adjudicate international pharmacy claims in accordance with policy terms and conditions to meet personal and team productivity and quality goals. Monitor and highlight high-cost claims and ensure relevant parties are aware. Monitor turnaround times to ensure your claims are settled within required time scales, highlighting to your Supervisor when this is not achievable. Respond within the time commitment given to enquiries regarding plan design, eligibility, claims status and perform necessary action as required, with first issue/call resolution where possible. Interface effectively with internal and external customers to resolve customer issues. Identify potential process improvements and make recommendations to team senior. Actively support other team members and provide resource to enable all team goals to be achieved. Work across International business in line with service needs. Carry out other ad hoc tasks as required in meeting business needs. Work cohesively in a team environment. Adhere to policies and practices, training, and certification requirements. Requirements*: Working knowledge of the insurance industry and relevant federal and state regulations. Good English language communication skills, both verbal and written. Computer literate and proficient in MS Office. Excellent critical thinking and decision-making skills. Ability to meet/exceed targets and manage multiple priorities. Must possess excellent attention to detail, with a high level of accuracy. Strong interpersonal skills. Strong customer focus with ability to identify and solve problems. Ability to work under own initiative and proactive in recommending and implementing process improvements. Ability to organise, prioritise and manage workflow to meet individual and team requirements. Experience in medical administration, claims environment or Contact Centre environment is advantageous but not essential. Education* Graduate (Any) - medical, Paramedical, Pharmacy or Nursing. Experience Range* Minimum 1 year of experience in healthcare services or processing of healthcare insurance claims. Foundational Skills* - Expertise in international insurance claims processing Work Timings* 7:30 am- 16:30 pm IST Job Location* Bengaluru (Bangalore) About The Cigna Group Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.

Coordinating and communicating with the stakeholders, which may include suppliers, and internal teams members. Closely following up, monitoring, updating the progress of activities, and identifying the areas of improvement to take necessary steps in order to achieve the targets, in the defined timeline. Solving the various queries and/or doubts received from stakeholders (predominantly suppliers), and providing them all the necessary required supports. Working on internal necessary applications associated with the activities. Preparing accurate summary of the latest status of the activities on daily and/or weekly and/or monthly basis. Qualifications Bachelors degree (B.A., B.Sc. BCA etc.) from an accredited college or university or Equivalent Should have two or more years of experience in relevant or equivalent field. Having the knowledge of the apparel industry (experience in production or quality audits background will be a plus) Basic knowledge of Microsoft applications including Word, Excel, PowerPoint etc Additional Information Focused and self-driven personality. Delivers commitment towards work, department, and theorganization. Personality with Honesty & Integrity. Flexibility and ability to work closely on timelines. Excellent planner and Organizer. Effective Communicator in English with convincing abilities.

Job description Team Executive - Payment Integrity Location : Bangalore Roles & Responsibilities: In-depth Knowledge and Experience in the US Health Care Payer System. 4 - 9 years of experience in Claims Adjudication(Payment Integrity,PrePay audit,Postpay audit) . With over 1 year of experience as a Team leader Proven track record in managing processes, streamlining workflows and excellent people management skills. Need to be a people centric manager who could articulate the employee challenges to the management as well as motivate the team towards desired project goals. Circulate quality dashboards at agreed periodic intervals to all relevant stake holders Adhering to various regulatory and compliance practices. Maintaining and Ownership of reports both internal as well as for the clients. Presenting the data and provide deep insights about the process to the clients as well as Internal Management. Managing and co - ordinating training programs. Excellent in Coaching and providing feedback to the team. Take necessary HR actions as part of the Performance Improvement Process Key Performance Indicators Ensuring that the key Service Level Agreements are met consistently without any exceptions. Leverage all Operational metrices to ensure that the Revenue and Profitability targets are met and exceeded . Work in tandem with all Business functions to ensure smooth business process. Retention of key team members Interested Candidates share your CV - deepalakshmi.rrr@firstsource.com / 8637451071 Disclaimer: Firstsource follows a fair, transparent, and merit-based hiring process. We never ask for money at any stage. Beware of fraudulent offers and always verify through our official channels or deepalakshmi.rrr@firstsource.com

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. This is a hybrid role with both calling and non-calling responsibilities. Key Responsibilities: Retrieve medical records from healthcare facilities, ensuring accuracy and completeness of records. Ensure compliance with HIPAA and other regulatory standards regarding the privacy and security of medical records. Process release of information requests for authorized parties such as patients, legal entities, insurance companies, and other healthcare providers. Organize and maintain medical records in both paper and electronic formats, ensuring they are accessible and easily retrievable. Coordinate with other departments (e.g., billing, insurance) to provide requested information while safeguarding patient confidentiality. Review and verify records for completeness and accuracy before releasing them. Perform audits of medical records to ensure accuracy and compliance with regulatory standards. 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. Comfortable with night shift. Salary & Benefits: Competitive salary based on experience Health and Accidental insurance ( Call or Whatsapp -9650506346) Sufiya

Long Term Disability Claim Manager Role Overview: The LTD Claim Manager will manage an assigned caseload of Long-Term Disability cases. This includes management of claims with longer duration and evolving medical conditions. LTD Claim Managers will have meaningful and transparent conversations with their customers and clinical partners in order to gather the information that is most relevant to each claim. It also requires potentially complex benefit calculations on a monthly basis. The candidate will also evaluate customer eligibility and interact with internal and external customers including, but not limited to, customers, employers, physicians, internal business matrix partners and attorneys etc. to gather the information to make the decision on the claim. What You'll Do: Proactively manage your block of claims by regularly talking with and knowing your customers, their level of functioning, and having a command of case facts for each claim in your block Develop and document Strategic Case Plans that focus on the future direction of the claim using a holistic viewpoint Find customer eligibility by reviewing contractual language and medical documentation, interpret information and make decisions based on facts presented Leverage claim dashboard to manage claim inventory to find which claims to focus efforts on for maximum impact Have discussions with customers and employers regarding return to work opportunities and communicate with an action-oriented approach. Work directly with clients and Vocational Rehabilitation Counselors to facilitate return to work either on a full-time or modified duty basis Ask focused questions of internal resources (e.g. nurse, behavioral, doctor, vocational) and external resources (customer, employer, treating provider) in order to question discrepancies, close gaps and clarify inconsistencies Network with both customers and physicians to medically manage claims from initial medical requests to reviewing and evaluating ongoing medical information Execute on all client performance guarantees Respond to all communications within customer service protocols in a clear, concise and timely manner Make fair, accurate, timely, and quality claim decisions Adhere to standard timeframes for processing mail, tasks and outliers Support and promote all integration initiatives (including Family Medical Leave, Life Assistance Programs, Integrated Personal Health Team, Your Health First, Healthcare Connect, etc.) Clearly articulate claim decisions both verbally and in written communications Understand Corporate Compliance, Policies and Procedures and best practices Stay abreast of ongoing trainings associated with role and business unit objectives What You'll Bring: High School Diploma or GED required. Bachelor's degree strongly preferred. Long Term Disability Claims experience preferred. Experience in hospital administration, medical office management, financial services and/ or business operations is a (+) Comfortable talking with customers and having thorough phone conversations. Excellent organizational and time management skills. Strong critical thinker. Must be technically savvy with the ability to toggle between multiple applications and/ or computer monitors simultaneously. Ability to focus and excel at quality production Proficiency with MS Office applications is required (Word, Outlook, Excel). Strong written and verbal skills demonstrated in previous work experience. Specific experience with collaborative negotiations. Proven skills in positive and effective interaction with customers. Experience in effectively meeting/exceeding personal professional expectations and team goals. Must have the ability to work with a sense of urgency and be a self-starter with a customer focus mindset. Comfortable giving and receiving feedback. Flexible to change. Demonstrated analytical and math skills. Critical Competencies: Decision Quality Communicate Effectively Action Oriented Manages Ambiguity Customer Focus

We are Hiring hybrid wfh Back office Process Backoffice Marine/Motor Claims Insurance (Min 3yr To 9yrs BPO),Sal 10.00 LPA ( Pune / Mumbai Location) Process : Back office Process /UK Insurance Process Min 1yr to 4yrs exp. International BPO !!!Easy Selection and Spot Offer!!! Salary upto 4.5 Lacs + Incentives. Walk in at Infinites HR Services, Cerebrum IT Park, B3, 1st Floor, Kalyani Nagar Pune 411014. Call : Call : WhatsApp call only Dipika- 9623462146 / 7391077623 / 7391077624 Fenkin Empire off no 404, 4th Floor, Thane West, 400601. Land Mark: Bhanushali Hospital, Station Road. Walkin Distance from Thane Railway Station. Meet Ali : 8888850831 / 8888850831 Regards Dipika 9623462146

Openings for SME/TL/Quality/Trainer roles Need candidates with exp in US health care claims adjudication -payment integrity process 5 days working/rotational shifts Chennai/Bangalore location Interested Candidates do call Sadiq @ 8904378561 Required Candidate profile Openings for SME/TL/Quality/Trainer roles Need candidates with exp in US health care claims adjudication -payment integrity process Interested Candidates do call Sadiq @ 8904378561

We are hiring!! HR Recruiter: Arun Kumar Industry: ITES/BPO Category: International Non-Voice Division: Healthcare International Business We are looking for enthusiastic candidates with excellent communication to join our team as Customer Support Associates in the International Non-Voice Process for Healthcare. Job Title: CSA and Senior CSA Grade: H1/H2 Function/Department: Operations Reporting to: Team Lead Role Description: Roles & Responsibilities (Indicative not exhaustive) A claims examiner needs to analyse multiple documents / contracts and decide to pay / deny the claim submitted by member or providers with respect to client specifications. The claims examiner should also route the claim to different department or provider / member for any missing information that required for claims adjudication. The claims needs to be completed adhering to required TAT and quality SLA. Key Results Production, Quality Shift and Schedule adherence Process Knowledge Minimum Eligibility: Candidates should have minimum 1 year Experience in Claims Adjudication & Claims Adjustment or Claims Adjudication with Appeals & Grievances. Shift Details: Night shift / Flexible to work in any shift and timing Cab Boundary Limit: Up to 30 km (One way drop cab) Job Location: Firstsource Solution Limited, 5th floor ETA Techno Park, Block 4, 33 OMR Navallur, Chennai, Tamil Nadu 603103. Landmark near Vivira Mall. Contact: Arun HR Phone: 6374232238 Email: arun.kumar9@firstsource.com If you are interested please share your updated CV to the arun.kumar9@firstsource.com or 6374232238. Join us to be part of a dynamic team with career growth opportunities. We look forward to seeing you at the interview! You can refer your friends as well! Disclaimer: Firstsource follows a fair, transparent, and merit-based hiring process. We never ask for money at any stage. Beware of fraudulent offers and always verify through our official channels or arun.kumar9@firstsource.com

Job Summary We are seeking a dedicated Senior Process Executive - HC with 1 to 3 years of experience in Claims Adjudication. The ideal candidate will have expertise in Medicare and Medicaid Claims and it is advantageous if they also have experience in Commercial Claims. This is a work-from-home position with night shifts. Responsibilities Process and adjudicate Medicare and Medicaid claims efficiently and accurately. Ensure compliance with all relevant regulations and guidelines. Analyze and resolve claim discrepancies and issues promptly. Collaborate with team members to improve claim processing workflows. Maintain up-to-date knowledge of industry standards and changes. Provide exceptional customer service to internal and external stakeholders. Utilize technical skills to enhance claims adjudication processes. Monitor and report on claim processing metrics and performance. Identify and implement process improvements to increase efficiency. Conduct regular audits to ensure accuracy and compliance. Train and mentor junior team members on claims adjudication processes. Communicate effectively with other departments to resolve claim issues. Participate in continuous learning and development opportunities. Qualifications Possess strong technical skills in claims adjudication. Have in-depth knowledge of Medicare and Medicaid claims. Experience in Commercial Claims is a plus. Demonstrate excellent analytical and problem-solving abilities. Exhibit strong attention to detail and accuracy. Show proficiency in relevant software and tools. Display effective communication and teamwork skills. Maintain a high level of professionalism and integrity. Be adaptable to night shifts and work-from-home model. Have a proactive approach to learning and development. Demonstrate the ability to work independently and manage time effectively. Show commitment to delivering high-quality work consistently. Possess a customer-focused mindset and dedication to service excellence.

Job Track Description Requires formal education and relevant expertise 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. Ability to complete work self-guided. A college or university degree required. General Profile Requires knowledge and experience in own field. Will acquire higher-level knowledge and skills while on the job. Develops an understanding of the company, processes, and customers. Uses existing procedures to solve standard problems. Requires moderate guidance and direction from others. Functional Knowledge Requires expanded conceptual understanding of theories, practices, and procedures. Business Expertise Uses an understanding of key business drivers to accomplish work. Impact Impacts a team, by example, through the quality service and information provided. Follows standardized practices and procedures to achieve objectives and meet deadlines. Leadership No supervisory responsibilities. Provides guidance to new team members. Problem Solving Uses existing procedures and technical experience to solve problems. Interpersonal Skills Exchanges complex information and ideas effectively. Responsibility Statements Partners with 1 client depending on scale and scope. Serves as liaison between end-users and product development teams. Works closely with end-users to analyze, define, model, and document project requirements and communicates to development teams. Analyzes requirements and defines technology solutions. Leverages a blend of proven domain knowledge system understanding to define a go-to approach for system construction. Mentors a small team of business analysts for a client portfolio. Produces detailed component specifications and translates these into detailed designs for implementation. Partners with the development team to identify solutions. Ensures designs follow regulatory requirements. Works without supervision with extensive latitude for decision making. Performs other duties as assigned. Complies with all policies and standards. Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law. People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by submitting their request through this form that must be downloaded:click here to access or download the form. Complete the form and then email it as an attachment toFTADAAA@conduent.com.You may alsoclick here to access Conduent's ADAAA Accommodation Policy. At Conduent we value the health and safety of our associates, their families and our community. For US applicants while we DO NOT require vaccination for most of our jobs, we DO require that you provide us with your vaccination status, where legally permissible. Providing this information is a requirement of your employment at Conduent.

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 and preparation of annual calendar, as applicable. Execute & Manage the assigned tasks {Data Analysis, Vendor files, Requirement Analysis} specific to your Tower HW Domain knowledge is good to have. Process Ability to think and conceptualize and/or implement ideas of process automation. Follow the standard practices and procedures specific to your Tower. Accountability/Communication Work independently on tasks assigned. Should be able to Coach & mentor team members. Demonstrate ownership on work assigned to self and immediate sub-ordinates. Manage Offshore/Onshore interaction and stakeholder communication as per the business needs. Update all documentation with task details and provide regular updates to team. All other tasks as assigned. Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law. People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by submitting their request through this form that must be downloaded:click here to access or download the form. Complete the form and then email it as an attachment toFTADAAA@conduent.com.You may alsoclick here to access Conduent's ADAAA Accommodation Policy. At Conduent we value the health and safety of our associates, their families and our community. For US applicants while we DO NOT require vaccination for most of our jobs, we DO require that you provide us with your vaccination status, where legally permissible. Providing this information is a requirement of your employment at Conduent.

Skill required: Group Core Benefits- Claims Case Mgmt. Group Disability Insurance Designation: Claims Management Analyst Qualifications: Any Graduation Years of Experience: 3 to 5 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 do analysis and solving of lower-complexity problems Your day to day interaction is with peers within Accenture before updating supervisors In this role you may have limited exposure with clients and/or Accenture management You will be given moderate level instruction on daily work tasks and detailed instructions on new assignments The decisions you make impact your own work and may impact the work of others You will be an individual contributor as a part of a team, with a focused scope of work Please note that this role may require you to work in rotational shifts Qualification Any Graduation

Skill required: Group Core Benefits - Group Disability Insurance Designation: Insurance Operations Associate Qualifications: Bachelor of Dental Surgery/Bachelor of Pharmacy/Bachelor in Physiotherapy Years of Experience: 1 to 3 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.The benefits of having a strong core include injury prevention, reduction of back pain, improved lifting mechanics, balance, stability, and posture, as well as improved athletic performance.Group 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 Ability to establish strong client relationshipAbility to handle disputesAbility to manage multiple stakeholdersAbility to meet deadlinesAbility to perform under pressure0-5 years of experience in Medical Underwriting work.Possess excellent medical knowledge, including a strong grasp of medical terminologies and complex and complex disease condition.Knowledge of MS Office Tools and good computer knowledge.Graduate/Postgraduate in Life Sciences, B. Pharma, Bachelor in Physiotherapy, BHMS.Open to flexible shifts based on business requirements.Good verbal & written communication skillsGood typing skills and attention to detail.Good time management skills. Ability to work independently Roles and Responsibilities: In this role you are required to solve routine problems, largely through precedent and referral to general guidelines Your expected interactions are within your own team and direct supervisor You will be provided detailed to moderate level of instruction on daily work tasks and detailed instruction on new assignments The decisions that you make would impact your own work You will be an individual contributor as a part of a team, with a predetermined, focused scope of work Please note that this role may require you to work in rotational shiftsEvaluating the eligibility of applicants seeking an insurance policy. Reviewing each person s medical history and other factors such as age.Calculating individual risk and determining appropriate coverage and premium amounts.Assessing the risk involved in insuring an individual.Reviewing application files for life & disability products policies and determining eligibility coverage, premium rates, and exclusion policies.Complies with all regulatory requirements, procedures, and Federal/State/Local regulations.Review medical reports, data, and other records to assess the risk involved in insuring a potential policyholder.Ensure Quality Control standards that have been set are adhered to.Excellent organizational skills with ability to identify and prioritize high value transactions.Completing assigned responsibilities and projects within timelines apart from managing daily BAU. Qualification Bachelor of Dental Surgery,Bachelor of Pharmacy,Bachelor in Physiotherapy

Skill required: Group Core Benefits- Claims Case Mgmt. Group Disability Insurance Designation: Claims Management Senior Analyst Qualifications: Any Graduation Years of Experience: 5 to 8 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 do analysis and solving of increasingly complex problems Your day to day interactions are with peers within Accenture You are likely to have some interaction with clients and/or Accenture management You will be given minimal instruction on daily work/tasks and a moderate level of instruction on new assignments Decisions that are made by you impact your own work and may impact the work of others In this role you would be an individual contributor and/or oversee a small work effort and/or team Please note that this role may require you to work in rotational shifts Qualification Any Graduation

Candidate should be working as a Team leader / Quality analyst / Trainer / SME on papers in US Healthcare for Claims adjudication process. Qualification - Graduate Shift - US rotational shifts Work Location - Chennai / Bangalore Required Candidate profile Immediate Joiners OR Max 1 month notice period candidates can apply Call HR Sadiq @ 8904378561 for more details.

Having clinical background, preferably working in the US healthcare domain. Review the medical records and apply for authorization with various insurance companies Calling experience & core authorization background is preferable.

Hiring for Liability, Marine and Medical Malpractices Senior Analyst role End-to-end claims adjusting experience Graduation mandatory Salary: 7.5LPA (depending on last drawn CTC) Call: 8291772291