1604 Claims Adjudication Jobs - Page 41

Eurofins Assurance India Pvt Ltd is a leading certification body providing Audit & Certification , Inspections , and other services covering the broad spectrum of sustainable supply chain. Eurofins will help the customers to mitigate risks in their supply chain and to ensure the benchmarking performance with operations, processes, systems, people or capabilities. Whether you are in Food, Cosmetics, Consumer products or Health care sector, our global auditor and technical expert network will help to mitigate/eliminate your risks against supply chain and distribution flows: Regulatory and Industrial standards . We have accreditations for a number of different industry standards/memberships to ...

Key Responsibilities : Lead Generation & Sales: Proactively identify and engage potential members through various channels, including walk-ins, inbound inquiries, and outbound outreach Membership Sales & Conversions: Present and sell membership options, upsell additional services such as personal training, and close sales to meet or exceed monthly targets Customer Engagement & Retention: Provide personalized tours, address member inquiries, and ensure a welcoming environment to enhance member satisfaction and retention CRM Management: Utilize CRM tools to track leads, manage follow-ups, and update member records to maintain accurate and up-to-date information Community Outreach: Build relati...

Aster Medcity is looking for Deputy Manager Revenue Cycle Managementto join our dynamic team and embark on a rewarding career journey Developing and implementing revenue cycle management policies and procedures that ensure accurate billing, timely collections, and compliance with regulatory requirements Monitoring and analyzing revenue cycle data to identify areas for improvement and implement process improvements Collaborating with other departments to ensure that revenue cycle activities are aligned with organizational goals and objectives Managing the accounts receivable to ensure timely and accurate billing and collections Ensuring compliance with regulatory requirements related to reven...

Prepare ILAs, Final Survey Reports, and requirement letters. Maintain records of claim intimation, surveyor visits, document status, and report. Follow up with insured and internal teams to minimize TAT Update data in CMS software Health insurance Provident fund

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Associate Manager Qualifications: Any Graduation Years of Experience: 10 to 14 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 "As a Travel Claims Team Manager, you w...

Skill required: Reinsurance - Collections Processing Designation: Claims Management Senior Analyst Qualifications: Any Graduation Years of Experience: 7 to 11 years Language - Ability: English(International) - Intermediate 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 You wi...

Clients business problem to resolve : At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees are key factors in our companys growth, market presence and our ability to help our clients stay a step ahead of the competition. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here.Clients Business problem to solve?Our Client is one of Leading Health Plan in US providing services in Florida state , NTT are getting into contract with Client to manage End to End Claims Administration services. Our NTT Business Process O...

POSITION: MEDICAL OFFICER/CONSULTANT PA/RI APPROVER PURPOSE OF ROLE: To scrutinize and process the claims within the agreed TAT by having an understanding of the policy terms & conditions while applying their domain medical knowledge. Designation Function Medical Officer/Consultant Claims PA/RI Approver Reporting to Location Assistant Manager Claims Mumbai Educational Qualification Shift BHMS, , BAMS, MBBS(Indian registration Required) Rotational Shift (for female employee shift ends at 8:30 PM) 6 rotational week offs Provided per month Week offs Related courses attended None Management Level Junior Management Level Industry Type Hospital/TPA/Healthcare/Insurance Roles and Check the medical ...

Role & responsibilities : Claims Processing: Managing and processing insurance claims, including verifying patient information, coding procedures accurately, and submitting claims to insurance companies. Follow-up on Unpaid Claims: Monitoring the status of submitted claims, identifying unpaid or denied claims, and following up with insurance companies to resolve issues and ensure timely payments. Appeals and Disputes : Handling claim denials and rejections by preparing and submitting appeals to insurance companies and resolving billing disputes. AR Aging Management : Managing accounts receivable aging reports and actively working to reduce outstanding balances. Preferred candidate profile: E...

Job description Team Executive - Claims Adjudication Location : Chennai, Navalur Roles & Responsibilities: In-depth Knowledge and Experience in the US Health Care Payer System. 4 - 9 years of experience in Claims Adjudication . With over 1 year of experience as a Team leader Proven track record in managing processes, streamlining workflows and excellent people management skills. Need to be a people centric manager who could articulate the employee challenges to the management as well as motivate the team towards desired project goals. Circulate quality dashboards at agreed periodic intervals to all relevant stake holders Adhering to various regulatory and compliance practices. Maintaining an...

Key Responsibilities: Should manage a large team and coordinate with other functions Floor walk regularly to supervise, coordinate and monitor day-to-day operations & metrics Should lead a team of associates and motivate them to achieve the team SLA. Should consistently achieve all SLAs set by the client Manages inventories and Reports. Provides encouragement to team members, including communicating team goals and identifying areas for new training or skill checks. Answers team member questions, helps with team member problems, and oversees team member work for quality and guideline compliance Communicates deadlines and goals to team members Develops strategies to promote team member adheren...

Role & responsibilities 1) Preparing and submitting billing data and medical claims to insurance companies 2) Generate revenue by making payment arrangements, collecting accounts and monitoring and pursuing delinquent accounts 3) Collect delinquent accounts by establishing payment arrangements with patients, monitoring payments and following up with patients when payment lapses occur 4) Utilize collection agencies and small claims courts to collect accounts by evaluating and selecting collection agencies, determining the appropriateness of pursuing legal remedies and testifying in court cases, when necessary 5) Ensuring each patients medical information is accurate and up-to-date 6) Preparin...

Job Summary Join our dynamic team as a PE-Claims HC specialist where you will play a crucial role in processing and adjudicating claims with precision and efficiency. This hybrid role requires a keen understanding of Medicare and Medicaid claims ensuring compliance and accuracy. With a focus on night shifts you will contribute to our mission of delivering exceptional healthcare solutions without the need for travel. Responsibilities Process claims with a high degree of accuracy ensuring compliance with Medicare and Medicaid regulations. Analyze claims data to identify discrepancies and resolve issues promptly. Collaborate with team members to streamline claims adjudication processes. Maintai...

Job Summary We are seeking a dedicated Senior Process Executive for our B&L team with 2 to 4 years of experience. The ideal candidate will have strong technical skills in MS Excel and preferably domain experience in Frclsr Claim File&srv(MortgLn) and Default Report&Analytic-MortLn. This is a night shift role based in our office with no travel required. Responsibilities Senior Process associate is expected to meet or exceed the set agreed target both during the training period and in the period following training. The productivity targets will be revised based on the tenure and any such changes will be made known to the associate. Quality Process associate is expected to meet and exceed the m...

Job Description: Medical Record Retrieval and Release of Information Specialist Position Overview: We are seeking dedicated and detail-oriented Medical Record Retrieval and Release of Information (ROI) Specialists to join our healthcare team. The position is responsible for efficiently and accurately retrieving, processing, and releasing medical records in accordance with healthcare regulations and policies. This is a hybrid role with both calling and non-calling responsibilities. Key Responsibilities: Retrieve medical records from healthcare facilities, ensuring accuracy and completeness of records. Ensure compliance with HIPAA and other regulatory standards regarding the privacy and securi...

Role & responsibilities Tariff Negotiations and cost management Conducting surprise audits and checks of the claims and case to case negotiations Manage workload of both field and office effectively Experience in dealing with providers (Hospitals/Diagnostics & OPD Clinics) Understanding of Health Claims and claim related processes Good understanding of Health Insurance and related products Managing relationship with the providers Flexible to travel across locations based on the organizational requirements Managing internal (Claims Team, Sales and Central Teams and external stakeholders (Brokers, Channel partners & Corporates) Managing and controlling of cost for the portfolio assigned Timely...

Job description In-depth Knowledge and Experience in the US Health Care Payer System. 4-9 years of experience in Dental Claims . With over 1 year of experience as a supervisor. Proven track record in managing processes, streamlining workflows and excellent people management skills. Need to be a people centric manager who could articulate the employee challenges to the management as well as motivate the team towards desired project goals. Circulate quality dashboards at agreed periodic intervals to all relevant stake holders Adhering to various regulatory and compliance practices. Maintaining and Ownership of reports both internal as well as for the clients. Presenting the data and provide de...

====================================================================== Walk-in Details:- Job Mode:- Work from Office Interview Dates:- 16-Jul-25 (Wednesday) to 31-Jul-25 (Thursday) (Except Sundays) Interview Timings:- 03:00 PM to 08:30 PM Interview Location:- Confiance House Near Shree Punjabi Seva Samaj, Behind Navrangpura Bus Stop, Swastik Society, Navrangpura, Ahmedabad, Gujarat 380009 ====================================================================== Role & responsibilities Performing outbound calls to insurances regarding medical claims (in the US) to collect outstanding Accounts Receivables. Ensuring accurate and timely completion of transactions to meet or exceed client SLAs. Resp...

HI Warm Greetings from Rivera Manpower Services , WORK LOCATION : Bangalore /Kochi Note : Candidates who are willing to Relocate to Bangalore Can apply. Minimum 3 YEARS Experience in Property and Casualty Insurance /Motor Insurance for US market Can apply Call and book your Interview slots 9986267393 /9380300644 JD for Senior Process Analyst In this role, Underwriter Assistant assists the Branch Underwriter & plays a vital role in maintaining customer relationship through timely & accurate services. A person will act as a liaison between multiple parties including Branch Underwriter, Policy Servicing Team, Insurance Carriers, and Insurance Brokers, etc. by answering questions & providing det...

RCM AR Caller with 2-4 years exp in US healthcare AR medical billing, claim process, claim settlement Night shift good in English communication

Graduate Medical background, MR (B pharma), BHMS, BAMS/ MBA in Hospital Adminstration 2+ Years working experience in health insurance/health insurance TPA at Hospital handling/audit Candidate must have excellent knowledge of health insurance / Health TPA domain. Candidate must have excellent bill/medical negotiation skills & customer handling skills. Good communication skills in Hindi/English and regional language of the state/region. Ready to relocate himself/herself at location within India as may be required according to the job requirement Candidate must own vehicle to travel in various hospital assigned to him Candidate must be computer literate and shall possess skills including but no...

About the work - Member Services for Seniors: Medicare and Retiree programs serve a vulnerable demographic, seniors who often have complex health conditions, limited digital literacy, and require extra care and patience over the phone. Segments we will support (Phase 1) : Medicare Advantage (Part C) : End-to-end plans covering hospitalization, medical services, and prescriptions. Group Retiree Plans : Tailored benefits for retired employees of corporations, government, or unions, often with layered entitlements and detailed queries. D-SNP (Dual-Eligible) : For members eligible for both Medicare and Medicaid. These are low-income or disabled seniors, requiring high sensitivity and multi-agenc...

Greetings from Firstsource Solution!!! We have an exciting opportunity for experienced candidates for with good communication skills for claims adjudication process. Walk-in Time : 11:30 AM to 2:00 PM Mode of Interview: 1. F2F HR round 2. Assessments 3. Live chat 4. Operations manager round. Eligibility Criteria: Minimum 6 months experience is required in Claims/ Insurance or healthcare. Processing and data entry for routine types of physician and contract linkage transactions such as: Load new physician demographics and contract linkage using the appropriate loading instruction guidelines (i.e. Managed Care Forms, Provider Data Loading Templates, etc.) Perform physician demographics and con...

Paytm is India's leading mobile payments and financial services distribution company. Pioneer of the mobile QR payments revolution in India, Paytm builds technologies that help small businesses with payments and commerce. Paytm’s mission is to serve half a billion Indians and bring them to the mainstream economy with the help of technology. About the teamQR & Soundbox is one of Paytm‘s 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...

Job TitleFinance reporting (Refund Claims and analysis) Location[Bangalore] Experience RequiredMinimum 3–4 years Employment Type[Full-time] Job SummaryWe are looking for a detail-oriented and proactive Refund Claims & Collections Executive with prior experience in the travel industry, who has knowledge in airline refund collections. The ideal candidate will have a strong understanding of industry practices, familiarity with GDS tools, MS office and the ability to manage the refund claim transaction volume on a daily basis. Key Responsibilities: Handle refund processes related to bookings and transactions within the travel domain. Manage end-to-end claims processing, ensuring timely validatio...