1604 Claims Adjudication Jobs - Page 36

We’re Hiring – Customer Service Associate (Night Shift) Location: Mumbai (Airoli) | WFO US Healthcare – International Voice Process 20K in-hand + incentives + night allowance Call HR Khushi – 9389460353 |

We’re Hiring – Customer Service Associate (Night Shift) Location: Mumbai (Airoli) | WFO US Healthcare – International Voice Process 20K in-hand + incentives + night allowance Call HR Khushi – 9389460353 |

Walk In Details Walk In Date- 22nd & 23rd August 2025 Walk In Time- 12:00 PM - 5:00 PM IST Venue- TELUS Digital, DLF World Tech Park, 7th Floor, Tower B2 & B3, Sector 30, Gurugram, Haryana 122001 Job Summary We are hiring for Customer Service International Voice Process focused on the US Healthcare domain . You will be responsible for resolving customer queries via calls, assisting with claims, benefits, authorizations, and billing inquiries, while ensuring compliance with US healthcare regulations and delivering an exceptional experience. Role & responsibilities Respond to inbound and outbound calls related to healthcare insurance, claims, billing, and eligibility. Assist US-based members a...

Hiring for US Health care claims Need 1 year experince in US Healthcare calims US shifts and offs Work from office Work location Bangalore Need immediate joiners Salary max 3.5 LPA Graduation mandate Freshers cannot apply. Need only experience in US Healthcare Claims Intersted candidates can walk in to the below address Brigade Tech Gardens, Kundalahalli, Brookefields Green Avenue, Kundalahalli, ITPL Main Rd, Phase 2, Brookefield, Bengaluru, Karnataka 560037 Contact person HR Bhanumathi 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 @firsts...

Overview The Coding Denial Specialist responsibilities include working assigned claim edits and rejection work ques, Responsible for the timely investigation and resolution of health plan denials to determine appropriate action and provide resolution. Responsibilities Processes accounts that meet coding denial management criteria which includes rejections, down codes, bundling issues, modifiers, level of service and other assigned ques. Resolve work queues according to the prescribed priority and/or per the direction of management in accordance with policies, procedures, and other job aides. Validate denial reasons and ensures coding is accurate. Generate an appeal based on the dispute reaso...

Overview The Coding Denial Specialist responsibilities include working assigned claim edits and rejection work ques, Responsible for the timely investigation and resolution of health plan denials to determine appropriate action and provide resolution. Responsibilities Processes accounts that meet coding denial management criteria which includes rejections, down codes, bundling issues, modifiers, level of service and other assigned ques. Resolve work queues according to the prescribed priority and/or per the direction of management in accordance with policies, procedures, and other job aides. Validate denial reasons and ensures coding is accurate. Generate an appeal based on the dispute reaso...

Responsible for accurate payment posting, reconciliation, denial support, reporting, and communication with insurers/patients. Ensure compliance, maintain confidentiality, and drive process improvements in payment posting workflows. Required Candidate profile Graduate preferred with 1-2 years in healthcare payment posting/RCM. Skilled in data entry, reconciliation, communication; familiar with billing, insurance, HIPAA, and coding.

About the team: QR & Soundbox is one of Paytms business tools to help merchants grow and manage their business through simplicity and data driven technology. Expectations/ Requirements 1. Must have Smart Phone, Bike & Helmet 2. Candidate must have a zeal for Growth 3. Candidate should have good market knowledge 4. Must have done a Channel Sales Role before with 5 Member Sales Team handled before 5. Must understand concepts of distribution, expansion, metrics 6. Must have experience in getting team earn Lucrative Incentives Education Graduate or above / Post Graduation preferred. Job Descriptions- Responsible for the Sales enrollments/Sales in the city. Do the market race and prepare the list...

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Specialist Qualifications: Any Graduation Years of Experience: 7 to 11 years Language - Ability: English(Domestic) - Advanced About Accenture 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. Visit us at www.accenture.com What would you d...

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Senior Analyst Qualifications: Any Graduation Years of Experience: 5 to 8 years Language - Ability: English(Domestic) - Advanced About Accenture 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. Visit us at www.accenture.com What would yo...

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Specialist Qualifications: Any Graduation Years of Experience: 7 to 11 years About Accenture 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. Visit us at www.accenture.com What would you do We help insurers redefine their customer experi...

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...

H.Sc / Graduate freshers with good communication. US healthcare Exp will be an advantage. Knowledge of basic computer operations. Willingness to work in the late evening and night shifts. Courteous with strong customer service orientation. Good listening and speaking skills. Typing speed 30/90% Work from office only Mandatory Skills: Claims_Processing.

Educational Requirements MBA,MCA,MTech,Bachelor of Engineering,BCA,BTech Service Line Application Development and Maintenance Responsibilities As a Senior Product Manager you will be pivotal to creating roadmap, owning release plan for multiple capabilities that is futuristic and meets industry and client needs. You will be responsible for continuous backlog management, prioritizing the backlog considering the needs and objectives of every stakeholder. As a thought leader in your business domain, bring in industry best practices, learnings from client demos and interactions into designing. You will anchor business pursuit initiatives, sales demo. You will have the opportunity to shape the In...

Role & responsibilities Review and process prior authorization requests in a timely and accurate manner. Communicate with healthcare providers, insurance companies, and patients to obtain necessary information and documentation. Ensure compliance with all regulatory and company policies and procedures. Maintain accurate records of all prior authorization activities and decisions. Provide support and guidance to healthcare providers and patients regarding prior authorization requirements and processes. Collaborate with other team members to improve workflow and efficiency. Stay updated on industry trends, regulations, and best practices related to prior authorization and healthcare operations...

Educational Requirements MBA,MCA,MTech,Bachelor of Engineering,BCA,BTech Service Line Application Development and Maintenance Responsibilities A day in the life of an Infoscion As part of the Infosys delivery team, your primary role would be to interface with the client for quality assurance, issue resolution and ensuring high customer satisfaction. You will understand requirements, create and review designs, validate the architecture and ensure high levels of service offerings to clients in the technology domain. You will participate in project estimation, provide inputs for solution delivery, conduct technical risk planning, perform code reviews and unit test plan reviews. You will lead an...

About Us Zelis is modernizing the healthcare financial experience in the United States (U.S.) across payers, providers, and healthcare consumers. We serve more than 750 payers, including the top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts driving real, measurable results for clients. Why We Do What We Do In the U.S., consumers, payers, and providers face significant challenges throughout the healthcare financial journey. Zelis helps streamline the process by offering sol...

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 performed by the team Resolving...

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 performed by the team Resolving...

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 performed by the team Resolving...

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 performed by the team Resolving...

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 performed by the team Resolving...

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 performed by the team Resolving...

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 performed by the team Resolving...

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 performed by the team Resolving...