1627 Claims Adjudication Jobs - Page 45

Greeting from Medi assist TPA Pvt ltd. Hiring Medical officer for Insurance Claim processing Profile Location- Mumbai -Andheri East. Role - Medical officer Exp : 0-8 years Job description : * Check the medical admissibility of claim by confirming diagnosis and treatment details * Verify the required documents for processing claims and raise an information request in case of an insufficiency * Approve or deny claims as per T&C within TAT Interested candidate can drop there resume in my Mail ID : varsha.kumari@mediassist.in We are looking for fresher or exp candidates BAMS, BHMS, B.sc Nursing, BPT mail id - varsha.kumari@mediassist.in Thanks & Regards Email: varsha.kumari@mediassist.in

Greeting from Medi assist TPA Pvt ltd. Hiring Medical officer for Insurance Claim processing Profile Location- Mumbai -Andheri East. Role - Medical officer Exp : 0-8 years Job description : * Check the medical admissibility of claim by confirming diagnosis and treatment details * Verify the required documents for processing claims and raise an information request in case of an insufficiency * Approve or deny claims as per T&C within TAT Interested candidate can drop there resume in my Mail ID : varsha.kumari@mediassist.in We are looking for fresher or exp candidates BAMS, BHMS, B.sc Nursing, BPT mail id - varsha.kumari@mediassist.in Thanks & Regards Email: varsha.kumari@mediassist.in

Operations role Pune/Hybrid Permanent Job Description. The Role Must have experience in the insurance domain, specifically in Property & Casualty, claims processing, and operations. Create, update, and maintain operational and SOP documents; manage system access for the Claims leadership team and provide accurate data. Able to work effectively at all levels from managing frontline employees to engaging with executives. Demonstrated ability to identify and implement process improvements within an operations environment. Skilled in managing operational inventory to meet defined Service Level Agreements (SLAs). Ensure all activities are accurately documented in the appropriate client systems. C...

Process health insurance claims. Should have knowledge of cashless and reimbursement. Location - Chembur. Should have knowledge of excel. Graduation mandatory. Call or send your resumes on 8097516521. TPA experience Mandatory

Responsibilities: * Manage accounts receivable calls: denial management & handling * Execute revenue cycle processes: claims processing, payment posting, charge posting * Adhere to HIPAA compliance standards Cafeteria Travel allowance House rent allowance Office cab/shuttle Accessible workspace Health insurance Provident fund

Responsibilities: * Manage patient care in emergencies * Conduct claim investigations * Process health claims * Adjudicate claims fairly * Collaborate with TPAs on case resolution

Verify documents received from internal teams and Ensure timely updation of account details Share account details with insurance companies as per the agreed TAT Proactively address issues arising from account detail errors Coordinate with Medi Assist branches to get necessary documents required for account updation Follow up with internal teams to ensure data collection and issue resolution. Manage grievances and follow-up with internal stakeholders. Report daily on updated and pending account details updation Identify and implement process improvements for efficient account detail updation. Knowledge and Skill Requirement: Knowledge of Excel formulas Soft-spoken yet firm in interactions Kee...

We are seeking an experienced and highly motivated professional to join our team as a Revenue Cycle Services Manager , focusing on Inpatient Rehabilitation Facility (IRF) and Long-Term Acute Care Hospitals (LTACHs) billing. The ideal candidate will bring strong domain knowledge, leadership ability, and a track record of driving results through effective revenue cycle operations. Excellent communication, stakeholder coordination, and compliance management are essential. Role & responsibilities Manage full scope of RCM operations, including billing, denials, collections, AR management, and reporting. Collaborate with clients to define goals, resolve escalations, and improve service delivery. T...

As a Process Analyst – Insurance (Claims), you will be involved in the Processing of Life and Annuity Insurance, Claims processing. You should be flexible to work in shifts. Your primary responsibilities include: Handling claims investigation, processing, and payments Claims document validation, calculating benefit amount, and releasing same to the beneficiary Meet productivity and quality targets on a daily, weekly, and monthly basis Required education Bachelor's Degree Preferred education Master's Degree Required technical and professional expertise Graduate (except B.Tech/Technical Graduation/Law) with a minimum of 1.5 years of experience in Life/Annuities products in Claims Good Communic...

Scrutinizing dental claim documents & settlements Process claims as per the set healthcare guidelines Follow HIPAA guidelines Accurate processing of Dental claims and meeting productivity targets Good understanding of Claims adjudication fundamentals Good understanding of ICT & CPT Codes Knowledge of policy concepts like Deductible, coinsurance, copay, out of pocket Able to learn, adapt, implement process guideline into practice, work as a natural team-player in the process Handle escalations Need to ensure quality and productivity targets are met Ensure compliance with internal policies and procedures, external regulations and information security standards

Job Summary Join our team as a Subject Matter Expert in Claims HC where you will leverage your expertise in Facets Claims and Claims Adjudication to optimize our claims processing systems. With a focus on Dental and Commercial Claims you will play a pivotal role in enhancing operational efficiency and ensuring compliance with industry standards. This office-based role offers the opportunity to work in a dynamic environment contributing to impactful projects that benefit both the company and society. Responsibilities Lead the analysis and optimization of claims processing workflows to enhance efficiency and accuracy. Oversee the implementation of Facets Claims and Claims Adjudication systems ...

Job description Trainer - Claims Adjudication Location : Chennai - Navalur Roles & Responsibilities: In-depth Knowledge and experience in the US Healthcare. 4-9 years of experience in Claims Adjudication/Payment Integrity/Adjustments/Prepay, Post Pay audit . With over 1 year of experience as a Trainer. Conducting multiple trainings for new hires and managed nesting along with certification process Maintain the training effectiveness above the required threshold by holding strong governance process in training Ability to read through various standard operating procedures and communicate the extracts to the trainees clearly Identify gaps between internal process and customers expectations to h...

Gainwell Technologies LLC Gainwell Technologies is the leading provider of technology solutions that are vital to the administration and operations of health and human services programs. We are the key player in the Medicaid space with a presence in 51 of the 56 U.S. states and territories with offerings including Medicaid Management Information Systems (MMIS), Fiscal Agent Services, Program Integrity, Care Management, Immunization Registry, and Eligibility Services. We generate over $2 billion in annual revenue, and we’ve been innovating in the industry for more than 50 years. Powered by more than 14,000 employees, Gainwell solutions support more than 60 million Medicaid beneficiaries natio...

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 admissibili...

Role & responsibilities Process cashless and reimbursment claims (Should have knowledge of processing retail policies of National/United/New India/Oriental insurance companies. Preferred candidate profile BAMS/BUMS/BHMS Fresher or max 2 years experience in the similar field. Ready to work in shifts

HIRING US Healthcare Medical Records Openings for experienced in any US Healthcare Process at Advantum Health, Hitech City, Hyderabad. Should have experience of atleast 2 years in any US Healthcare Voice process. Salary upto 50k Per Month based on experience. One way cab + Rs. 2000 Transportation allowance is provided. For 2 way, Rs. 4000 is the Transport allowance Job Description Assigned Facilities : The Medical Records Specialist has a set of facilities to manage. Bi-Weekly Work Schedule : The Medical Records Specialist needs to work on these facilities every two weeks. Facility Touchpoints : Each facility needs to be visited or worked on every 10 days to ensure the necessary documents (t...

Greeting from Medi assist TPA Pvt ltd. Hiring Medical officer for Insurance Claim processing Profile Location- Mumbai -Andheri East. Role - Medical officer Exp : 0-8 years Job description : * Check the medical admissibility of claim by confirming diagnosis and treatment details * Verify the required documents for processing claims and raise an information request in case of an insufficiency * Approve or deny claims as per T&C within TAT Interested candidate can drop there resume in my Mail ID : varsha.kumari@mediassist.in We are looking for fresher or exp candidates BAMS, BHMS- 7631162388 Whatsapp CV mail id -varsha.kumari@mediassist.in

Job Description: Processing of Claims Health files. Claim Registration and Claim Adjudication. Identifying the Fraud. Adhering to SLAs and processing the claims with in the TAT as per policy terms and conditions. Supporting CRM, provider, sales and grievance teams. Eligibility Criteria: Pharm-D, BSc Nursing, B .Pharmacy freshers only(Qualified Graduates with all certificates in hand). Any Graduate with minimum 2+ years of Claims Health processing experience. Salary Budget - up to 4 lakhs. Job location Ameerpet, Hyderabad. Evaluation would be based on competency, age, experience, stability

Greeting from Medi assist TPA Pvt ltd. Hiring Medical officer for Insurance Claim processing Profile Location- Mumbai -Andheri East. Role - Medical officer Exp : 0-8 years Job description : * Check the medical admissibility of claim by confirming diagnosis and treatment details * Verify the required documents for processing claims and raise an information request in case of an insufficiency * Approve or deny claims as per T&C within TAT Interested candidate can drop there resume in my Mail ID : varsha.kumari@mediassist.in We are looking for fresher or exp candidates BAMS, BHMS mail id - varsha.kumari@mediassist.in Thanks & Regards Email: varsha.kumari@mediassist.in

Manager Membership --> --> Location, Designation --> LocationNoida DesignationMembership Manager Experience6- 12 Years Job Details/ Criteria Basic Functions/ Job Responsibility: Will be responsible for a portfolio of key members, building strong relationships and acting as a single point of contact for their requirements. Proactively manage and nurture member relationships, understanding their specific requirements and challenges to deliver exceptional service and engagement. Develop trusted relationship with senior leaders and CXOs of the organizations. Develop and implement strategies to drive member engagement with nasscom initiatives, events, and programs. And execute planned initiatives...

Dear Aspirants, Greeting from Sagility!! Immediate hiring for AM-Process Training in Bangalore-Work from office Job description: Role and Responsibilities The resource would be part of a dynamic team. Would be working with the other members of the training, operations and the quality teams to manage conduct of new hire training, while also being responsible for the quality performance of the newly trained resources by planning and executing various interventions during the on the job training phase. An approximate list of responsibilities is appended below (but not limited to): Should have experience working in Claims, PB, PDM & Credentialing Managing attrition and ensuring the batch through...

We are looking for a skilled professional with 8 to 14 years of experience to join our team as an Assistant Manager - Delivery in Chennai. Roles and Responsibility Manage and oversee the delivery of healthcare services to ensure high-quality patient care. Coordinate with healthcare professionals to develop and implement effective treatment plans. Monitor and analyze patient outcomes to identify areas for improvement. Collaborate with cross-functional teams to resolve issues and improve service quality. Develop and maintain relationships with key stakeholders, including patients, families, and healthcare providers. Identify and mitigate risks associated with healthcare service delivery. Job M...

Looking to onboard a skilled Quality Control Analyst with 3-5 years of experience to join our team in Trichy. The ideal candidate will have a strong background in quality control and assurance, with excellent analytical and problem-solving skills. Roles and Responsibility Develop and implement quality control processes to ensure high standards of service delivery. Conduct regular audits and reviews to identify areas for improvement and provide recommendations for enhancement. Collaborate with cross-functional teams to resolve issues and improve overall process efficiency. Analyze data and trends to identify opportunities for quality improvement and develop reports to track key performance in...

Looking for a motivated AR Associate to join our team in Bangalore. The ideal candidate will have 0-1 years of experience and be able to work effectively in a fast-paced environment. Roles and Responsibility Manage accounts receivable, including invoicing and payment follow-up. Analyze financial data to identify trends and areas for improvement. Develop and implement effective billing strategies to increase revenue. Collaborate with the sales team to resolve billing discrepancies. Maintain accurate records of customer interactions and payments. Identify and pursue opportunities to improve cash flow and reduce bad debts. Job Strong understanding of accounting principles and practices. Excelle...

Job Description Job Claims Processing Title Executive (CPE) Shift 6:30pm 3:30am (US Day Location Chennai, India shift) . Responsibilities: • Analyse and evaluate workers compensation claim payments using Enable Comps proprietary software, systems, and tools. Use payment documentation provided by payers to determine if the medical provider has been reimbursed in compliance with the applicable state worker’s compensation fee schedule and/or PPO contract. • Research, request and acquire all pertinent medical records, implant manufacturer’s invoices and any other supporting documentation necessary and then submit with hospital claims to insurance companies to ensure prompt correct claims reimbur...