1604 Claims Adjudication Jobs - Page 39

Position : Operations - Investigation Brief Job Profile : Claims adjudication, fraud and leakage control, client/provider feedback, team training and retention, Investigation Career Level : Medical Officer/ Deputy Manager/ Manager Medical Graduate Minimum Mandatory Qualification : BAMS, BHMS, BDS, For Manager MBBS (Preferred) Experience (in years) : 3 - 7 years of experience in investigation Minimum Mandatory Skill Set : Knowledge of Processing of claims, quality check and adherence to TAT, computer skills, excel. Candidate should be open to work in 24X7X365 shifts Desired Competencies/ Skill Set : MS Excel and MIS skills, Candidate having work experience of claim processing, Investigation, ...

Position : Operations - Investigation Brief Job Profile : Claims adjudication, fraud and leakage control, client/provider feedback, team training and retention, Investigation Career Level : Medical Officer/ Deputy Manager/ Manager Medical Graduate Minimum Mandatory Qualification : BAMS, BHMS, BDS, For Manager MBBS (Preferred) Experience (in years) : 3 - 7 years of experience in investigation Minimum Mandatory Skill Set : Knowledge of Processing of claims, quality check and adherence to TAT, computer skills, excel. Candidate should be open to work in 24X7X365 shifts Desired Competencies/ Skill Set : MS Excel and MIS skills, Candidate having work experience of claim processing, Investigation, ...

Position : Operations - Investigation Brief Job Profile : Claims adjudication, fraud and leakage control, client/provider feedback, team training and retention, Investigation Career Level : Medical Officer/ Deputy Manager/ Manager Medical Graduate Minimum Mandatory Qualification : BAMS, BHMS, BDS, For Manager MBBS (Preferred) Experience (in years) : 3 - 7 years of experience in investigation Minimum Mandatory Skill Set : Knowledge of Processing of claims, quality check and adherence to TAT, computer skills, excel. Candidate should be open to work in 24X7X365 shifts Desired Competencies/ Skill Set : MS Excel and MIS skills, Candidate having work experience of claim processing, Investigation, ...

Responsibilities: Prepare ILAs, Final Survey Reports, and requirement letters Maintain records of claim intimation, surveyor visits, documents, and reports Follow up with insured/internal teams to reduce TAT Enter claims data into CMS software Provident fund Health insurance

Hiring for AR caller profile for One of the leading MNC's. Required 12 months of experience in AR follow-up for US healthcare. Salary Up-to 45K In-hand Saturday Sunday Fix Off Both side Cabs To Apply, Call or WhatsApp CV on ANISHA - 9354076916 Required Candidate profile 1. Minimum 12 months of experience in AR Calling. 2. Excellent communication skills, both verbal and written. 3. Familiarity with medical billing and Denial Management. Perks and benefits Both side Cabs, Meals and Medical Insurance.

SUMMARY We are looking for a dynamic and student - focused Academic Counsellor to join our team. You will play a key role in guiding students towards skill development programs, supporting them in making informed career decisions, and ensuring a smooth enrolment process. Salary: 12,000 20,000 per month Key Responsibilities Counsel students about various skilling and certification programs. Follow up on leads via phone, WhatsApp, and walk-ins to convert into admissions. Understand student profiles and recommend suitable programs. Manage end-to-end admission processes, documentation, and follow-ups. Maintain accurate records of inquiries, admissions, and progress updates. Coordinate with the t...

SUMMARY We are looking for a dynamic and student-focused Academic Counsellor to join our team. You will play a key role in guiding students towards skill development programs, supporting them in making informed career decisions, and ensuring a smooth enrolment process. Salary: 12,000 20,000 per month Key Responsibilities Counsel students about various skilling and certification programs. Follow up on leads via phone, WhatsApp, and walk-ins to convert into admissions. Understand student profiles and recommend suitable programs. Manage end-to-end admission processes, documentation, and follow-ups. Maintain accurate records of inquiries, admissions, and progress updates. Coordinate with the tra...

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 : Computer System Validation (CSV) Good to have skills : AAAP (Accenture Advanced Analytics Platform)Minimum 3 year(s) of experience is required Educational Qualification : be Summary :As a Business Analyst, you will engage in a variety of tasks that involve analyzing organizational processes and systems. Your typical day will include assess...

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 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 expe...

Role & responsibilities Shift timings (05:30 PM - 02:00 AM & 06:30 PM to 03:00 AM) Hybrid Mode - Work from office 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 D...

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...

Charge entry and Payment Posting Knowledge about ICD 10 and CPT codes Knowledge about Insurances, Denials, Rejections Posting payments and adjustments from ERAs and EOBs Applying refunds on identified overpayments

Degree/Diploma in Mechanical, Electrical, Electronics Engineering claim documents, images, videos, technical reports submitted by field engineers clients Interact with clients insured parties, brokers, email clarify loss details and resolve queries

Book your interview slot WhatsApp your profile @ 9623462146 / 7391077622 or Dipika@infiniteshr.com ******Hiring for P & C Insurance Team Manager / Sr TM , Salary upto 14.00L*** ****Hiring Team Manager Insurance process**** Salary upto 10 LPA Exp: 6 to 15 Yrs Salary : Upto 14 Lacs Regards Dipika Sharma 9623462146 7391077622 8888850831

We are Hiring hybrid wfh Back office Process Backoffice Marine/Motor Claims Insurance (Min 3yr To 9yrs BPO),Sal 8.00 LPA ( Pune ) Process : UK Marine Insurance Process : WhatsApp call only Dipika- 9623462146 / 7391077622 / 8888850831 Regards Dipika 9623462146

Fairmont Hotels & Resorts is looking for Finance Associate (Fresher) - Navi Mumbai to join our dynamic team and embark on a rewarding career journey Assisting with the preparation of operating budgets, financial statements, and reports 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 ...

We are looking for a skilled AR Caller to join our team at Prodat IT Solutions, responsible for medical billing and ensuring timely payments. The ideal candidate will have 1-6 years of experience in the field. Roles and Responsibility Manage and resolve outstanding accounts receivable issues. Conduct thorough reviews of patient records and billing information. Develop and implement effective strategies to improve cash flow. Collaborate with internal teams to ensure accurate and efficient billing processes. Identify and address denials by investigating root causes and resubmitting claims as necessary. Maintain accurate and up-to-date records of all interactions with patients and insurance com...

""" Checks for completeness and appropriateness of source data. Involved in fact finding, information search and data gathering. Verifies and compiles data. Identifies and resolves routine and recurring problems. Skills Required Ability to analyze and process transactions based on rules. Able to integrate knowledge as a skilled specialist. Possess strong domain knowledge in Healthcare and Insurance domain. """

Checks for completeness and appropriateness of source data. Involved in fact finding, information search and data gathering. Verifies and compiles data. Identifies and resolves routine and recurring problems. Skills Required Ability to analyze and process transactions based on rules. Able to integrate knowledge as a skilled specialist. Possess strong domain knowledge in Healthcare and Insurance domain.

Company: Marsh Description: Ensures timely and accurate production/processing of complex documents/information (includes report preparation) Maintains a basic understanding of the core aspects of relevant Insurance and related legislation (customer awareness) and strengthen established relationships Adheres to Company policies and performance standards Contributes to the achievement of Operations team Service Level Agreements (SLA) , Key Performance Indicators (KPI) and business objectives Marsh McLennan is committed to embracing a diverse, inclusive and flexible work environment. We aim to attract and retain the best people and embrace diversity of age, background, caste, disability, ethnic...

Company: Marsh Description: Position Overview: We are seeking a dedicated and detail-oriented Claim Servicing Executive to join our Employee Benefits team in Marsh India. The ideal candidate will be responsible for managing and servicing claims related to employee benefits, ensuring a seamless experience for our clients and their employees. This role requires strong communication skills, a customer-centric approach, and the ability to work collaboratively within a team. Key Responsibilities: Claims Management: Process and manage employee benefits claims efficiently and accurately. Review and assess claims documentation to ensure compliance with policy terms and conditions. Liaise with client...

The Billing Head will be responsible for overseeing the billing operations of Manipal Hospitals, ensuring efficient and accurate billing processes. This role involves managing a team of billing professionals, developing billing policies and procedures, and ensuring compliance with healthcare regulations. The Billing Head will also collaborate with various departments to improve billing practices, reduce discrepancies, and enhance revenue cycle management. Key responsibilities include analyzing billing data, identifying areas for improvement, and implementing strategies to optimize revenue collection. Roles and Responsibilities About the Role: - Lead the billing and revenue cycle management f...

Role & responsibilities Good knowledge in Claims Adjudication - US healthcare With Basic Competency Level: 1. Excellent interpersonal skills 2. Ability to understand and interpret policy provisions. 3. Product knowledge 4. Typing Skills 5. Problem Solving Skills Education, Experience and Flexibility: Under-Graduate or Any Graduate Minimum of 1 2 years of Customer Service experience. Flexible to work in US Shifts with rotational week offs. Preferred candidate profile pls share your CV to nishidha.kumar@sagilityhealth.com

You are a fresher who will be gaining experience in Health Claims by undergoing a few days of training. Your main responsibility will be to accurately process and adjudicate medical claims in compliance with company policies, industry regulations, and contractual agreements. In this role, you will review and analyze medical claims submitted by healthcare providers to ensure accuracy, completeness, and adherence to insurance policies and regulatory requirements. You will also verify patient eligibility, insurance coverage, and benefits to determine claim validity and appropriate reimbursement. Assigning appropriate medical codes such as ICD-10 and CPT to diagnoses, procedures, and services ac...

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...