1604 Claims Adjudication Jobs - Page 38

Insurance Verification Associate Desired Candidate Profile: Should be having excellent communication skills with Dental billing experience and willing to work in night shift. Minimum 1 Year of experience in AR is Mandatory. Only Experience from US Healthcare Medical or Dental Billing Will be Considered. Location : Mohali ( TDI Business Center near VR Punjab Mall) Exp : 1 ?? 3 Years Week Off : Saturday & Sunday Salary : Best In The Industry/Night Meals and refreshments Notice Period : One Month Preferable Shift : Night Shift Apply Now

Job Summary Claims Adjudication Responsibilities Process claims using ClaimsExchange and Facets ensuring accuracy and compliance with company standards. Collaborate with team members to resolve any discrepancies or issues related to claims processing. Maintain up-to-date knowledge of industry regulations and company policies to ensure compliance. Provide timely and accurate responses to inquiries from internal and external stakeholders. Analyze claims data to identify trends and areas for improvement in processing efficiency. Assist in the development and implementation of process improvements to enhance claims processing. Participate in training sessions to stay informed about new technolog...

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

Job Details: Job Process/Role: Claims Adjudication (US Healthcare) Experience: 1 - 3 Years of Relevant experience in Claims adjudication Skillset: CPT Codes, HIPAA, Co-pay and Co-insurance, Medicaid and Medicare, Denial claims, UB and CMS forms. Shift: Night shift Location: Chennai Mode of Work: Work from the office Notice Period Eligible: Immediate to 30 Days of Notice period is acceptable. Roles and Responsibilities: Process Adjudication claims and resolve for payment and Denials. Knowledge in handling authorization, COB, duplicate, pricing, and the corrected claims process. Knowledge of healthcare insurance policy concepts, including in-network, out-of-network providers, deductible, coins...

Candidate should have experience working as a Team Leader OR Quality analyst for US healthcare process. Shift - US rotational shifts Work Location - Hyderabad Required Candidate profile Immediate Joiners OR Max 1 month notice period candidates can apply Call HR Swapna @ 7411718707 for more details.

Candidate should be working as a Manager / Assistant Manager on papers in US Healthcare process. Qualification - Graduate Shift - US Shifts Work Location - Hyderabad Immediate Joiners OR Max 1 month notice period candidates can apply Required Candidate profile Call HR Manager Reejo @ 9886360719 for more details.

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...

Scope Of WorkPrimary Shared Across Functionally Establish procedures for meeting Health, Safety and Environment standards for project execution Implement policies, systems and procedures and ensuring compliance to standards through all phases of the Project Authorize project-specific deviations to the standard HSE Project Guidelines Prepare monthly HSE MIS for review by RCM & Project Manager Liaise with clients, consultants, and Yard construction teams relating to HSE issues Liaise with statutory bodies, certification agencies and consultants Attend important client meetings where safety is an item on the agenda Investigate all accidents and recommend appropriate corrective action/ measures ...

Job Title: Insurance Desk Executive TPA Coordination / Claims Specialist Location Options: Cloudnine hospital Sarjapura branch (BLR) BBMP Khata No: 1907/Sy No: 26/1, 26, 2nd Main Rd, Kaikondrahalli, Haralur, Bengaluru, Karnataka 560035 - Sarjapur Cloudnine hospital Thanisandra branch (BLR) Address: Sy No: 86/2 and 86/3, Thanisandra Village, Thanisandra Main Rd, RK Hegde Nagar, Bengaluru, Karnataka 560077 Organization: Ayu Health Hospitals Experience Required: 02 years (Freshers are welcome to apply) Preferred Gender: Male Candidates Preferred Location: Candidates residing near hospital locations will be given preference About Ayu Health: Ayu Health is one of Indias fastest-growing healthcare...

You would be responsible for managing the end-to-end claims process for clients, ensuring seamless handling from claim intimation to settlement follow-ups. You will be the key point of contact for clients and AMCs regarding claim processes. You should be strategic and detail-oriented, ensuring timely documentation, filing, and resolution of claims while also contributing to business growth through lead generation and upselling. Requirements You have a bachelors degree in administration, commerce, or a related field. 2-3 years of hands-on experience in insurance claims processing. Ability to communicate correctly and clearly with all customers. Maintain a positive attitude with a focus on cus...

HIRING For Motor Claims & Body Injury Claims Location - Whitefiled 5 days working & Sat sun fixed off Graduates salary - 6.5LPA CONTACT Gopika - 7411782490

Role & responsibilities Must have atleast1 year of experience in Claim adjudication. Immediate joiner Preferred. Please share your CV to ramkumar12.r@nttdata.com TA: Ramkumar Rajarajan

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...

Quality Patient Care: They play a crucial role in maintaining and improving the quality of patient care. This includes ensuring that patients receive the appropriate care, medications, and treatments based on their conditions. Nursing Protocols and Standards: Implementing and enforcing nursing protocols and best practices within the healthcare facility, making sure that nursing staff follows proper procedures and adheres to medical guidelines. Budget Management: Managing the budget for the nursing department, including resource allocation, procurement of supplies, and cost control. Patient and Family Relations: Interacting with patients and their families, addressing their concerns, and prov...

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...

Role & responsibilities Contribute to renewal portfolio expansion through relationship building with the insurance companies and surveyors to ensure optimum claim settlement in the minimum time. During the processing of the claim analyze the following and communicate to underwriters: adequacy of coverage wrt. location specifications e.g.. Earthquake /flood etc. adequacy of the sum insured anomalies in the policy scope of additional policies other related information Control expenses Business Process Facilitate proper settlement of the claim in the shortest possible time to the satisfaction of the client by ensuring the following: Obtain complete information of loss from the client after init...

Cognizant conducting Walk-In Interview for US Healthcare process (PDM/Claims) in Chennai Location. Skill(s): Payer Healthcare, PDM, Claims for Sourcing Interview Date: 26-July-2025(Saturday) Interview Time: 10:00 AM to 12:30 PM Venue : Cognizant Office. SEZ Ave, Elcot Sez, Sholinganallur, Chennai Building Details - Cafeteria block 1st floor A wing, Contact Person - Babu Anand Experience - 1+ Year to 4 Years Job Location - Chennai Shift - Night Shift (US Shifts) Work Mode - Work from Office Desired Profile: Minimum 1+ year to 4 years of experience in US Healthcare Domain . Must have experience in US Healthcare PDM process or Payer healthcare Should be willing to Work from Office Should be wil...

Vidal is hiring for claim Processor Designation: Executive-Claims Location: Gurgaon, Key Responsibilities: Review and validate claim documents submitted by hospitals or insured members Scrutinize medical records and bills for completeness and accuracy Apply policy terms, conditions, and exclusions to adjudicate claims Perform ICD and procedure coding as per ailment and treatment Coordinate with medical officers for clinical opinion when required Maintain claim logs and update CRM systems with claim status Ensure adherence to defined SLAs and minimize processing errors Flag suspicious or potentially fraudulent claims for investigation Communicate with stakeholders for clarifications or missin...

Candidate should have experience working as a Process Trainer in Claims adjudication process for US Healthcare Shift - US rotational shifts Work Location - Hyderabad Required Candidate profile Immediate Joiners OR Max 1 month notice period candidates can apply Call HR Swapna @ 7411718707 for more details.

Location : Ahmedabad Process: International Voice Support( US Healthcare ) Salary: Up to 4.2LPA Immediate joiners Freshers and Experience Both can apply Shift: Night Shift Working Days: 5 days/week

Job Details: Job Process/Role: Claims Adjudication (US Healthcare) Experience: 1 - 3 Years of Relevant experience in Claims adjudication Skillset: CPT Codes, HIPAA, Co-pay and Co-insurance, Medicaid and Medicare, Denial claims, UB and CMS forms. Shift: Night shift Location: Chennai & Coimbatore Mode of Work: Work from office Notice Period Eligible: Immediate to 30 Days of Notice period is acceptable. Roles and Responsibilities: Process Adjudication claims and resolve for payment and Denials. Knowledge in handling authorization, COB, duplicate, pricing, and the corrected claims process. Knowledge of healthcare insurance policy concepts, including in-network, out-of-network providers, deductib...

operations of the healthcare claims processing team (Mediclaim, RCM, and denial management) Ensure claims, including verification, validation, coding .Monitor & manage denials, rejections, and appeals in accordance with Payer & Provider guidelines. Required Candidate profile knowledge of healthcare claims, RCM workflows, & denial management. Should have Team Management , Client Management. Analyze RCM data to identify trends, gaps, & opportunities for process improvement

Greeting from Gainwell! JD 5+ years of experience as a Product Owner or in a related product management role. Strong knowledge of US healthcare systems, pharmacy workflows, and regulatory requirements (e.g., Medicaid, Medicare, PBMs, e-prescribing, and pharmacy claims processing). Experience working in Agile environments (SAFe, Scrum, or Kanban) with expertise in backlog management tools like Azure DevOps (ADO), Jira, or Rally. Proven ability to translate complex business needs into clear, actionable user stories. Experience collaborating with engineering, QA, business, and compliance teams. Strong analytical and problem-solving skills, with the ability to manage competing priorities. Excell...

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...

Team Management:Supervise and mentor a team of customer service/financial advisors, ensuring high engagement and performance. Process Oversight:Monitor day-to-day operations of the BFSI process, ensuring adherence to SLAs, compliance call 7697428237 Required Candidate profile Prior exp in healthcare in Claims process Experience: Minimum 3+ years in a BPO Healthcare process, with at least 1 year as a Assistant Manager.