1604 Claims Adjudication Jobs - Page 32

Job Summary Join our team as a PE-Default Servicing specialist where you will utilize your skills in MS Excel to manage and support mortgage loan processes. This role involves working from our office during night shifts ensuring efficient handling of foreclosure claim filing and bankruptcy procedures. Your contributions will directly impact our companys success and societal well-being. Responsibilities Manage and support default servicing processes for mortgage loans ensuring accuracy and efficiency. Utilize MS Excel to analyze data and generate reports that aid in decision-making processes. Collaborate with team members to streamline foreclosure and claim filing procedures. Ensure complianc...

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

Greetings from NTT DATA, Roles and Responsibilities: Process Adjudication claims and resolve for payment and Denials Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process Knowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of pocket, maximum inside limits and exclusions, state variations Ensuring accurate and timely completion of transactions to meet or exceed client SLAs Organizing and completing tasks according to assigned priorities. Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes perfor...

Roles and Responsibilities: 2-3 years of experience in processing claims adjudication and adjustment process Experience in professional (HCFA) and institutional (UB) claims Knowledge in handling authorization, COB, duplicate and pricing process Knowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of pocket, maximum inside limits and exclusions, state variations Audit claims as outlined by Policies and Procedures. Utilize appropriate system-generated reports applicable for specialty claims. Document, track findings per organizational guidelines for reporting purpose. Based upon trends, determine ongoing Claims E...

Min 4+ yr exp in credentialing package upto 7L grad/ug 24*7 shift 1 side cab Strong communication skills (verbal & written Both) Familiarity with CAQH, PECOS & insurance enrollment portals. DM- yashika.imaginator@gmail.com / 7289094130 Required Candidate profile * Strong understanding of the US healthcare credentialing process & payer requirements. * Ability to manage multiple tasks & meet deadlines in a fast-paced environment. * Proficient in MS Office

Key Responsibilities: Review and process insurance claims submitted by policyholders, providers, or third parties. Verify the accuracy and completeness of submitted claims and supporting documents. Investigate and validate claims using internal systems and guidelines. Coordinate with internal departments (e.g., underwriting, customer service) for clarification or additional information. Maintain accurate and organized records of all claims and transactions. Communicate claim decisions to stakeholders clearly and professionally. Escalate complex or disputed claims to senior team members or supervisors. Meet individual and team KPIs such as turnaround time, accuracy rate, and productivity. Ens...

Greetings From Scorelabs Inc ! Validate medical necessity and check eligibility Ensure accurate claim coding for inpatient, outpatient, and day-care procedures. Should Have Exp In 1-4 years of in claims Required Candidate profile Handle claim resubmissions, rejections, and audits from insurance providers. Collaborate with physicians, billing teams, and insurance officers for clarification or denials. Hr Mounika - 8688334476

Check the medical admissibility of a claim by confirming the diagnosis and treatment details. Scrutinize the claims, as per the terms and conditions of the insurance policy Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiation of open billing and package, etc. Understand the process difference between a PA and an RI claim and verify the necessary details accordingly. Verify the required documents for processing claims and raise an IR in case of an insufficiency. Coordinate with the LCM team in case of higher billing and with the provider team in case of non-availability of tariff. Approve or deny the claims as per the ...

Review medical charts under the diagnosis and procedure to ascribe the related CPT and ICD-10 Ensure that you assign codes based on coding and customer guidelines Proficient coding of outpatient/Inpatient charts across a variety of specialties with over 97% accuracy and as per the turnaround time Strong knowledge of CPT and ICD-10 guidelines Assign correct codes and perform edits as per the correct coding initiative Work as part of a team and achieve the team quality and productivity standards Support billers and AR analysts. Participate in ongoing local chapter meetings of AAPC and other industry bodies Understand the causes of claim denials and continually improve coding standards Document...

Job Title: Advisor / Sr Advisor Job Location: Vikhroli Job Range: 1 Years to 5 Years Max Work Style: Hybrid Shift Timing : 6:30PM Onwards Note: Candidate who have worked in night shift are eligible for this role Role & Responsibility Deliver as per the KPIs defined for the role. To always maintain set SLA Accuracy/quality, TAT standards prescribed by the Business Unit. Manage volumes and delivery expectations as per business requirement Being apt in managing time sensitive work with high level of eye for detail and in collaboration with colleagues across geographies Active engagement with stakeholders to ensure effective delivery of service to our clients Schedule adherence and punctuality T...

Check the medical admissibility of a claim by confirming the diagnosis and treatment details. Scrutinize the claims, as per the terms and conditions of the insurance policy Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiation of open billing and package, etc. Understand the process difference between a PA and an RI claim and verify the necessary details accordingly. Verify the required documents for processing claims and raise an IR in case of an insufficiency. Coordinate with the LCM team in case of higher billing and with the provider team in case of non-availability of tariff. Approve or deny the claims as per the ...

Role & Responsibilities Handling TPA related all process from billing to co-ordinate with TPA companies. Responsible for counseling patient's family & pre-Auth process. Maintaining & uploading patient's files on the portal. Couriering the hard copy of patient's medical file to the Insurance companies. Responsible for all co-ordination activities from patient's admission to discharge. Handling billing Department, Implants bill updating & reconciliation. Daily co-ordination with the patient and Hospital staff. Outstanding follow-up with TPA. To obtain and review referrals and authorizations for treatments. Must be aware of norms of the insurance sector. Daily follow up with Insurance companies...

JOB DESCRIPTION Designation/ Role: Trainee Department : Accounts Receivable Work Timing: Night Shift Qualifications: Minimum HSC/10+2 Equivalent (Any Graduate Preferred) Skills: Good verbal and written communication Skills. Able to build rapport over the phone. Strong analytical and problem-solving skills. Be a team player with positive approach. Good keyboard skills and well versed with MS-Office. Able to work under pressure and deliver expected daily productivity targets. Ability to work with speed and accuracy. Medical billing AR or Claims adjudication experience will be an added advantage. Experience 01-year experience US calling process will be an added advantage. Job Description The jo...

Royal Sundaram General Insurance Co is looking for Specialist - Legal & TP Claims to join our dynamic team and embark on a rewarding career journey Diagnosing and treating illnesses, medical conditions, and injuries. Ordering, performing, and interpreting diagnostic tests. Collecting, recording, and maintaining patients' information and histories. Prescribing and administering treatments, therapies, medications, vaccinations, and other specialized medical care. Explaining procedures and discussing test results or prescribed treatments with patients and family members. Monitoring patients' conditions and progress. Directing, coordinating, consulting with, and referring patients to nurses, stu...

About The Role Skill required: Claims Services - Payer Claims Processing Designation: Health Operations New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years What would you do? Embedding digital transformation in healthcare operations end-to-end, driving superior outcomes and value realization today, and enabling streamlined operations to serve the emerging health care market of tomorrowYou will be a part of the Healthcare Claims team which is responsible for the administration of health claims. This team is involved in core claim processing such as registering claims, editing & verification, claims evaluation, and examination & litigation.Business solutions that sup...

About The Role Skill required: Claims Services - Payer Claims Processing Designation: Health Operations New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years What would you do? Embedding digital transformation in healthcare operations end-to-end, driving superior outcomes and value realization today, and enabling streamlined operations to serve the emerging health care market of tomorrowYou will be a part of the Healthcare Claims team which is responsible for the administration of health claims. This team is involved in core claim processing such as registering claims, editing & verification, claims evaluation, and examination & litigation.Business solutions that sup...

About The Role Skill required: Membership - Life Sciences Regulatory Operations Designation: Health Operations New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years What would you do? Embedding digital transformation in healthcare operations end-to-end, driving superior outcomes and value realization today, and enabling streamlined operations to serve the emerging health care market of tomorrowYou will be a part of the Healthcare Management team which is responsible for the administration of hospitals, outpatient clinics, hospices, and other healthcare facilities. This includes day to day operations, department activities, medical and health services, budgeting and r...

Education Mandatory: Any Graduate (BSC/BCOM/BA) Desirable: Nil Experience Minimum 6 Months eligibility/enrolment experience (preferred) Technical Competencies: (Job related) Exceptional data entry skills with high attention to detail, strong organization skills and ability to multi-task Should have working knowledge of MS-Office: (Teams, Outlook, Excel, Word, OneNote) Soft Skills: (Job related) Effective verbal and written communication skills and excellent interpersonal skills Ability to work effectively with team members, employees/members, providers, and clients and vendors Ability to use common sense understanding to carry out instructions furnished in oral, written or diagram form Flexi...

We are looking for a skilled professional to join our team as a Non Customer Service Healthcare Claims Adjudication Team Member-BPS in Hexaware Technologies Ltd. The ideal candidate will have a strong background in healthcare claims adjudication and excellent customer service skills. Roles and Responsibility Manage and process healthcare claims according to company policies and procedures. Conduct thorough analysis of claims documents to determine claim validity and accuracy. Collaborate with internal teams to resolve complex claims issues and ensure timely resolution. Develop and maintain knowledge of industry regulations and guidelines related to healthcare claims. Provide exceptional cust...

Overview Strategy Coordinator Analyst Location: Bangalore, Chennai, Hyderabad, Mumbai, Gurgaon Skills: - Oncology, Desk research, Output decks Experience: 2+ years in research, marketing, or strategy support (healthcare required, oncology preferred) Education: Bachelor’s or master’s in marketing, Business, Life Sciences, Communications, or Anthropology Overview About Omnicom Global Solutions Omnicom Global Solutions is an integral part of Omnicom Group, a leading global marketing and corporate communications company. Omnicom’s branded networks and numerous specialty firms provide advertising, strategic media planning and buying, digital and interactive marketing, direct and promotional marke...

The Medical Billing Supervisor to oversee our daily billing and claims operations. responsible for the performance of the billing team, ensuring accuracy, efficiency, and compliance throughout the revenue cycle, specifically for Medicaid claims. Health insurance Provident fund Annual bonus

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

Candidate should be currently working as a Manager / Assistant Manager on papers in US Healthcare for Provider Data Management. Work Location - Hyderabad Shift - US rotational shifts Required Candidate profile Immediate Joiners OR Max 1 month notice period candidates can apply Call HR Kenedy at 9620999035 for more details.

Your tasks Design and implement applications within Microsoft Technology Stack Resolve incidents and implement change requests Conduct testing and quality control perform deployments and release management regularly meet/align with IT PM/PO and DevOps Team Your Qualifications Computer Science studies and/or similar education Deep and longterm Experience of 4-7 years with Microsoft Technologies on-prem/cloud MS Office Products SharePoint Power Platform (Power Apps, Power Automate, Power BI) Azure Services Dataverse Deep Experience with Web and Cloud Technologies (e g AWS, Azure, ) Deep Experience with Web Programming, HTML, JavaScript, CSS, React, Angular Experience with third party tools lik...

Candidate should be currently working as a Manager / Assistant Manager on papers in US Healthcare for Claims adjudication process. Work Location - Chennai / Hyderabad Shift - US rotational shifts Required Candidate profile Immediate Joiners OR Max 1 month notice period candidates can apply Call HR Kenedy at 9620999035 for more details.