1604 Claims Adjudication Jobs - Page 30

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

Roles and Responsibilities Review and process claims adjudication, ensuring accuracy and efficiency. Verify claim details, including policy number, member ID, and provider information. Determine eligible benefits based on policy terms and conditions. Calculate benefit amounts according to established guidelines.

*Please share your resume before coming to the walk-in on 6th Saturday 11:00am - 4:30pm Role: Claims Adjudicators/Sr. Claims Adjudicators Location: Noida Key Skills: Knowledge of US Health Insurance domain, Claims Adjudication, Providers and Members Enrolment, MS Office and good keyboard skills. Experience: 3 + years in Claims Adjudication or in relevant field (Fresher dont apply) Job Description: We are seeking a detail-oriented and analytical Claims Adjudicator to review, evaluate, and process insurance claims in accordance with policy guidelines and regulatory standards. The ideal candidate will have a strong understanding of claims procedures, excellent decision-making skills, and a comm...

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

Prescribing medication Physically administering treatments Interpreting laboratory results Assessing symptoms Diagnosing Providing follow-up care Staying up to date on medical research Problem Solving and Critical Thinking The primary role of an Medical Officer involves problem-solving and critical thinking to find solutions for patients. Doctors mainly use these skills to assess symptoms, diagnose conditions and develop a treatment plan for their patients. These skills help doctors to evaluate information and make decisions according to their observations. Some of the problem-solving and critical thinking skills are: Analytical thinking Creative thinking Solution-oriented thinking Ability t...

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

Sr. Team Member - Compliance: Responsibilities Closely monitoring, analysis and reporting of Operational risks KRIs of the company which may include Operations, Claims, Grievance etc. Assist in identification of key risks and conduct risk assessment for such identified areas Review and carry out the impact assessment for various key risks parameters and determine the inherent and residual risks Participate in cross functional discussion, assist in required processes change for mitigating the risks, and provide necessary training and assistance. Prepare & publish Global compliance risk assessment report, discuss with departments and provide inputs for improvements, analyse trends and identify...

Urgent Hiring Subject Matter Expert (SME) Operations Claims Adjudication (US Healthcare) Location: Indore, Coimbatore, Bangalore Notice Period: Immediate joiners or candidates with less than 30 days notice preferred Department: Claims Operations Experience: Minimum 3.6 years in US healthcare claims adjudication Role Summary: We are seeking a Subject Matter Expert (SME) Operations for US healthcare claims adjudication . The SME will act as the process authority , supporting operations teams in handling complex claim scenarios, resolving escalations, and ensuring process adherence. This role involves mentoring team members, driving operational excellence, and partnering with stakeholders to de...

Urgent hiring for Specialist quality for claims adjudication from US Healthcare. Looking for immediate joiners or less than 30 days' notice period. Interested folks can reach out to below mentions contact persons. Quality Analyst Claims Adjudication (US Healthcare) Experience: 4 years Location: Indore, Coimbatore, Bangalore Department: Claims Operations Role Summary: A results-driven Quality Analyst with 4 years of experience in US healthcare claims adjudication. Proficient in conducting audits, ensuring compliance, and improving accuracy in claims processing. Skilled in applying 7 QC tools, Root Cause Analysis (RCA), Corrective & Preventive Actions (CAPA), and Six Sigma methodologies to dri...

Urgent hiring for Team leader operations for claims adjudication from US Healthcare. Looking for immediate joiners or less than 30 days' notice period. Interested folks can reach out to below mentions contact persons. Job Title: Team Leader Claims Adjudication Location: Indore, Coimbatore, Bangalore Department: Claims Operations Reports To: Manager Claims Adjudication Role Overview: The Team Leader Claims Adjudication is responsible for supervising a team of claims processors/adjudicators to ensure accurate and timely adjudication of healthcare/insurance claims in line with policies, compliance requirements, and service-level agreements (SLAs). The role involves performance management, proce...

Greetings!! Openings for " Immediate Openings-Claims Adjudication-Quality Analyst " -Coimbatore Required Skills: Subject matter expert in Claims process. Able to perform Quality Audits. Exceptional interpersonal, customer service, problem-solving, verbal and written communication, and conflict resolution skills. Proficiency with the necessary technology, including computers, software applications, phone systems, etc. Ability to improve and/or transform teams processes across functions within the organization. Ability to understand basic data and take appropriate action. Ability to drive individual and team efficiency and productivity through effective and efficient metric management. Ability...

Job Title: Team Leader-Claims Adjudication (US Healthcare)-Coimbatore Experience: 5-8 years Qualification: Bachelors degree Shift: Night shift Transportation: Pick up and drop would be provided Job Summary: Team Leader - Claims Adjudication will oversee a team of healthcare professionals responsible for processing member enrollments and adjudicating claims in compliance with US healthcare regulations, client-specific guidelines, and quality standards. The role ensures efficient workflow, team performance, process improvement, and client satisfaction. Key Responsibilities: Team Management & Leadership: Lead, mentor, and manage a team handling enrollment, Provider configuration- Coimbatore and...

Greetings!!! Openings at Sagility for Process Trainer-(US Healthcare) Minimum of 4 years of experience as a Process Trainer in an International BPO. Excellent written and verbal communication skills, with strong interpersonal abilities. Proven experience as a Trainer in an International BPO environment. Strong presentation and Excel skills. Sound knowledge of basic training methodologies. Ability to work in US rotational shifts. Immediate joiners are mostly preferred. Interested candidates can share your resume to anitha.c@sagilityhealth.com

Role & responsibilities Looking for Immediate Joiner (IC Role) Shift timings- 05:30 PM to 02:00 AM (Night Shift) Life Claims Adjudicator: The Individual Insurance Claims department plays a crucial role with our clients as we offer them financial help when they most need it. We are looking for a motivated individual who is eager to learn to hold the position of Claims Adjudicator. The position offers the possibility to progress internally through our career ladder. Life Claims Adjudicator Role summary: The Claims Adjudicator is responsible for the assessment of claims for individual insurance. Main Accountabilities: Assess the documentation received for a claim in order to reach a decision De...

Role Summary Key Accountabilities/ Responsibilities Stakeholder interfaces Experience Education

Role Summary Key Accountabilities/ Responsibilities Stakeholder interfaces Experience Education

Role Summary Key Accountabilities/ Responsibilities Stakeholder interfaces Experience Education

Responsible for generating leads through Calling. Research, identify key students and generate interest in our online courses services. Contact potential students via phone to establish report convert leads into enrollment. Responding to the various inquiries received regarding courses available Tackle the different academic challenges and guide the students to reach their academic goals

Madify is looking for Influencer Marketing Associate - Fresher to join our dynamic team and embark on a rewarding career journey Processing requisition and other business forms, checking account balances, and approving purchases. Advising other departments on best practices related to fiscal procedures. Managing account records, issuing invoices, and handling payments. Collaborating with internal departments to reconcile any accounting discrepancies. Analyzing financial data and assisting with audits, reviews, and tax preparations. Updating financial spreadsheets and reports with the latest available data. Preparation of operating budgets, financial statements, and reports. Reviewing existin...

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

Essential Functions: Process design: To understand clients business processes, draw up As-Is and design To-be processes Requirements Documentation: To collect, analyze, and document process related artifacts (functional as well as non-functional). Collaboration: Liaison with development teams on managing requirements, participate in UAT, and realize proposed/estimated benefits. Presales support: Support pre-sales activities for new opportunities via process discovery and requirements gathering sessions. Monitor project progress and report project results Responsible for supervising a project until it is completed Coordinating the activities of a team of professionals and tech teams for the p...

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

We are looking for candidates with experience in Voice processing for International Call centre with excellent communication skills in English. The role is completely on calls and the candidates will receive phone calls and emails for the same. The shift is Rotational shift (Both day and night). The candidate should have experience in insurance company.

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

Fortis Hospital Mohali is hiring Head TPA on urgent basis, interested candidates can share resume at baljinder.singh@fortishealthcare.com immediate joiner will be given preferance