1508 Claims Adjudication Jobs - Page 4

Key Responsibility: Meet Quality and productivity standards. • Contact insurance companies for further explanation of denials & underpayments • Should have experience working with Multiple Denials. • Take appropriate action on claims to guarantee resolution. • Ensure accurate & timely follow up where required. • Should be thorough with all AR Cycles and AR Scenarios. • Should have worked on appeals, AR Follow up, refiling and denial management. Role / Responsibilities: Understand the client requirements and specifications of the project. Ensure that the deliverable to the client adheres to the quality standards. Must be spontaneous and have high energy level. A brief understanding on the ent...

Walk-In Interview Alert! Join us at WTW Vikhroli Office for an exciting opportunity with our Global Certification Centre ! Date: Monday, 3 November 2025 Time: 1:30 PM 3:00 PM Location: WTW, Vikhroli Job Title : Advisor / Sr Advisor Job Shift Timing : US Evening shift Experience - 2 - 7 Years Note: Candidate who have worked in Evening shift or Night Shift are eligible for this role Role Role & responsibilities 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 ...

Responsibilities: * Manage medical billing process from start to finish * Ensure accurate coding and compliance with HIPAA * Identify denials, appeal disputes, and optimize payments Provident fund

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...

TATA AIG General Insurance Company Limited is looking for Manager - Health Claims to join our dynamic team and embark on a rewarding career journey Collaborate with cross-functional teams to achieve strategic outcomes Apply subject expertise to support operations, planning, and decision-making Utilize tools, analytics, or platforms relevant to the job domain Ensure compliance with policies while improving efficiency and outcomes

TATA AIG General Insurance Company Limited is looking for Deputy Manager - Legal Claims to join our dynamic team and embark on a rewarding career journey Collaborate with cross-functional teams to achieve strategic outcomes Apply subject expertise to support operations, planning, and decision-making Utilize tools, analytics, or platforms relevant to the job domain Ensure compliance with policies while improving efficiency and outcomes

Role & responsibilities Review incoming healthcare claims for accuracy and completeness, ensuring all necessary information is provided for adjudication. Analyze claims data against payer policies and industry regulations to determine eligibility for payment or denial. Communicate effectively with healthcare providers, policyholders, and internal teams to resolve discrepancies or gather additional information. Utilize claims processing systems and software to enter, update, and retrieve claims information accurately. Identify and report any trends or patterns in claims submissions that may indicate potential fraud or abuse. Ensure timely processing of claims to meet internal and external dea...

Key Responsibilities: Review and audit healthcare claims for accuracy, completeness, and compliance with payer policies. Identify and resolve discrepancies, errors, and inconsistencies in claims adjudication. Ensure adherence to HIPAA and other regulatory requirements. Work with internal teams to improve claims processing accuracy. Generate reports and document audit findings. Provide feedback and training to claims processing teams. Required Skills & Qualifications: Bachelor's degree or equivalent experience in healthcare or related fields. Must have: Facet tool experience. Experience in claims adjudication, auditing, or US healthcare payer operations. Strong analytical skills and attention...

Location: Nagpur Shifts: US shifts Education: Graduate Domain: US Healthcare Roles & Responsibilities: Strong understanding of US Healthcare RCM lifecycle especially Claims Adjudication and Denial Management. Strong analytical, reporting, and problem-solving skills. Hands-on experience with RCM tools / payer portals / claim adjudication systems (e.g., Facets, QNXT, EZ-CAP, or similar). Excellent communication and stakeholder management skills. Proficiency in MS Excel and dashboard preparation. Ability to manage performance in a high-volume, SLA-driven environment. Leadership qualities coaching, motivation, conflict resolution, and team development. Experience in client handling and people ma...

Hands-on experience in Revenue Cycle Management (RCM) Proven experience in Denial Management and Claim Adjudication Experience in Claim Processing and overall Claim Management lifecycle Prior exposure to US Healthcare domain (Payer or Provider environment) Contact - 9561724254, Rajpreetb@hexaware.com

We are looking for a skilled Surgery Coder to join our team, with 2.5-6 years of experience in the field. Roles and Responsibility Accurately code surgical procedures using various coding systems. Collaborate with healthcare professionals to ensure accurate coding compliance. Develop and implement efficient coding processes to enhance productivity. Analyze and resolve coding discrepancies and denials promptly. Stay updated with industry coding guidelines and regulations. Maintain confidentiality and adhere to HIPAA policies. Job Requirements Strong knowledge of medical terminology and anatomy. Experience with surgery coding software and systems. Excellent analytical and problem-solving skill...

Responsibilities: * Process claims from intake to payment * Collaborate with stakeholders on claim resolution * Ensure accurate adjudication & payment processing * Meet service level agreements (SLAs) for turnaround time

Warm Greetings from RIVERA MANPOWER SERVICES!!!! Kindly Note : We are looking @ Minimum 4 Years of an experience into International Voice Process(Health Care/ US Insurance) Excellent Communication Skills. For more clarification about this job role, please feel free to reach out to us on the below mentioned number: Maria - 9986584828 (Please send us a message on WhatsApp in case the numbers are busy) Primary Responsibilities Act as the primary point of contact for the branch (US onshore), providing comprehensive support. Understanding and implementation of US Health Insurance regulatory standards, guidelines, policies and procedures. Ensure end-to-end support of the policy lifecycle services....

INSCOL Academy is looking for Student Advisor to join our dynamic team and embark on a rewarding career journey. As a Student Advisor, you will play a pivotal role in guiding and supporting students throughout their academic journey. Your primary responsibility is to provide comprehensive advising services to help students achieve their educational and career goals. This role requires a deep understanding of academic programs, university policies, and resources available to students. You will collaborate with faculty, staff, and other stakeholders to ensure students receive the necessary support and guidance to succeed. Responsibilities : Provide academic advising to students regarding cours...

Manager / Assistant Manager Account Management - MediAssist Job Title: Manager / Assistant Manager Account Management Company: Medi Assist Location: Bangalore CTC: 7 to 8 LPA Experience: 4 to 8 years Industry: Health Insurance / TPA / Healthcare Key Responsibilities:- Client Relationship & Strategy: Build and maintain long-term partnerships with insurers, corporate clients, and healthcare providers. Lead high-level review meetings and ensure strong relationship governance. Operations & Service Delivery: Oversee end-to-end account operations including claims, customer service, and issue resolution. Ensure compliance with TATs and SLAs. Performance Analysis & Reporting: Monitor KPIs, analyze c...

About The Role Project Role Application Lead Project Role Description Lead the effort to design, build and configure applications, acting as the primary point of contact. Must have skills Business Requirements Analysis Good to have skills Insurance Claims, Guidewire BillingCenter BA Minimum 5 year(s) of experience is required Educational Qualification 15 years full time education Summary As an Application Lead, you will lead the effort to design, build, and configure applications, acting as the primary point of contact. Your typical day will involve collaborating with various stakeholders to gather and analyze business requirements, ensuring that the applications meet the needs of the organi...

About The Role Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years Language - Ability: English(Domestic) - Intermediate Accenture is a global professional services company with leading capabilities in digital, cloud and security.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 hum...

About The Role Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years Accenture is a global professional services company with leading capabilities in digital, cloud and security.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 ...

Role Objective: To bill out medical accounts with accuracy within defined timelines and reduce rejections for payers. Essential Duties and Responsibilities: Process Accounts accurately basis US medical billing within defined TAT Able to process payer rejection with accuracy within defined TAT. 24*7 Environment, Open for night shifts Good analytical skills and proficiency with MS Word, Excel, and PowerPoint Qualifications: Graduate in any discipline from a recognized educational institute. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Good communication Skills (both written & verbal) Skill Set: Candidate should have good healthcare knowledge. Candidate should hav...

Warm Greetings from RIVERA MANPOWER SERVICES!!!! Kindly Note : We are looking @ Minimum 4 Years of an experience into International Voice Process(Health Care/ US Insurance) Excellent Communication Skills. We are looking @ only Immediate Joiners! Contact: HR JOY 7996004799 (SEND CV ON WHATSAPP IF LINE IS BUSY) Primary Responsibilities Act as the primary point of contact for the branch (US onshore), providing comprehensive support Understanding and implementation of US Health Insurance regulatory standards, guidelines, policies and procedures Ensure end-to-end support of the policy lifecycle services. Conduct end-to-end renewal activities as a US Health Insurance domain expert. Coordinate with...

In this Role you will be Responsible For : Read and understand the process documents provided by the customer. Entry-level administrative operations support performing various basic tasks (mail, file services, reporting, project support, and general account support activities). Analyze the insurance request received from the customer and process as per standard operating procedures. Familiarize, navigate multiple client applications and capture the necessary information to process customer request. Provides basic-level of support on programs, projects, reporting, filing (electronic and hard-copy), confidential materials handling, and issue resolution. Scope of work is routine and decision ma...

As a certified nursing professional, you must hold a valid Indian medical/nursing degree (GNM/B.Sc Nursing/MBBS/BAMS/BHMS). Additionally, you should possess 12 years of experience in a supervisory or quality role within a US healthcare BPO/KPO process, particularly in areas such as claims, RCM, or utilization review. Having a strong understanding of US healthcare workflows, including claims adjudication, prior authorization, clinical documentation, and medical coding, is highly preferred. Your role will require excellent medical judgment and clinical knowledge to support case reviews, escalations, and documentation validations. Effective communication skills are essential for liaising betwee...

This job is with Amazon, an inclusive employer and a member of myGwork the largest global platform for the LGBTQ+ business community. Please do not contact the recruiter directly. Description The Finance Operations organization works with every part of Amazon to provide operations accounting and operations excellence services with the highest level of controllership at the lowest cost to the company. We provide backbone systems and operational processes which completely, accurately, and validly pay Amazon's suppliers, invoice our customers, and report financial results. Amazon is quickly building Finance Operations capabilities in the healthcare industry by creating Healthcare Finance Operat...

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Associate Manager Qualifications: Any Graduation Years of Experience: 14 Years to 16 Years About Accenture Accenture is a global professional services company with leading capabilities in digital, cloud and security.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 world's 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...

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Specialist Qualifications: Any Graduation Years of Experience: 7 to 11 years About Accenture Accenture is a global professional services company with leading capabilities in digital, cloud and security.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 world's 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 ...