1627 Claims Adjudication Jobs - Page 49

Positions General Duties and Tasks: Process Insurance Claims timely and qualitatively Meet & Exceed Production, Productivity and Quality goals Review medical documents, policy documents, policy history, Claims history, system notes and apply the trained client level business rules to make appropriate Claims decisions, call out claims trends and flag fraud activities Stay up to date on new policies, processes, and procedures impacting the outcome of Claims processing Be a team player and work seamlessly with other team members on meeting customer goals Preferences for this role include: 1.5+ years of experience processing insurance claims in the health, life, or disability disciplines that re...

RESPONSIBILITIES *Responding to Customers' Needs. ~Keeping an Eye on Trends and Monitoring Competition. *Communicating work and brand values with Marketing Team. *Developing a Growth Strategy.

Greetings from Access Healthcare Minimum 1year of experience required Should have Knowledge in payer or provider experience Candidate should have good communication skills Basic knowledge on Revenue cycle management Salary as per company norms Ready to work in night shift Location : Chennai Interested candidates can drop your resume through WhatsApp - 9944497268/9043315031

Key Responsibilities: Assist in developing and implementing sales and marketing strategies to drive business growth. Conduct market research to identify potential clients and market trends. Support the creation of promotional materials, including presentations and social media content. Engage with clients through various channels, understanding their needs and providing product information. Participate in sales meetings and contribute ideas for improving team performance. Maintain accurate records of sales activities and customer interactions. Collaborate with team members to achieve monthly and quarterly sales targets. Criteria :- Female Candidate only Age - 18-25 Immediate joinner Fresher ...

Caliber Organisation is a leading client servicing company, catering to esteemed organizations such as UNICEF, IndusInd Bank, Axis Bank, AU Small Finance Bank, and HDFC Bank. We are committed to nurturing talent and providing a platform for career growth. As a Business Leader , you will undergo comprehensive on-the-job training to gain in-depth knowledge of our organization and industry, with the opportunity to advance to higher positions based on performance. We are seeking highly motivated and ambitious FRESHERS to join our team as Marketing Team Leader. The role involves intensive training, exposure to various aspects of the organization, and the potential to lead a team based on individu...

Here, the only person to stop you from succeeding is you As one of the most progressive sales and marketing companies we specialise in providing the clients we represent with an outsourced sales solution. With expanding demand comes expansion and we are currently opening 5 new offices around Mumbai in the coming 12 months and are recruiting for Business Management Officer Unlimited career growth Valuable skills that are highly transferable Weekly earnings and attractive incentives Be part of a high charged, motivated & fun environment Be part of a team-oriented and fun environment 1) Training and Developing team members to develop a high performance culture. 2) Training & imparting knowledge...

Dear, Greetings from RND Softech Pvt Ltd!! Job Description: Career Opportunities with RND Softech One day interview process...Immediate offer.... Designation: AR Caller/International voice process/Physician biller/Customer support associate Process: Medical billing , claim and denial managment ,Insurance Verification Process, US healthcare Responsibilities: Inbound and outbound calls and resolving queries. Provide Backend services to Clients Engaged in handling outbound calls of different business Units. End to End Transaction of Reports. Would be engaged in Shared Services of BPO Unit. Eligibility: Should be flexible to work in shifts. Strong Verbal command over English . Graduate fresher's...

You will be handling the specific part of market which will be assigned by the company. You would have to meet the client at their work space and give corporate Presentation about the product, doing negotiation by communicating with patience and by solving their query. Having Strong interpersonal skill is must for dealing with the clients and need to be self motivated. Skills Required: Contributes to team effort by accomplishing related results as needed. Maintains quality service by establishing and enforcing organization standards. Identifies product improvements or new products by remaining current on industry trends, market activities, and competitors. Maintains relationships with client...

We train and develop freshers at different level of BUSINESS giving them an exposure in marketing,management, team handling, client servicing, training & Development, Accounts and Finance. Job Role- * Working for business management and development profile for clients. * Training and developing people in business management and development * Managing clients and providing the best services * Doing B2B campaigns for business management and development * Organizing events, seminars and workshop at corporate level * Maintaining relationship with HNI Clients and customers * Handling a team of 20-25 associate Required Candidate profile *Graduates & post Graduates who aspires to build themselves a...

Required Candidate profile Caliber Organisation is a leading client servicing company, catering to esteemed organizations such as UNICEF, IndusInd Bank, Axis Bank, AU Small Finance Bank, and HDFC Bank. We are committed to nurturing talent and providing a platform for career growth. As a Management Trainee, you will undergo comprehensive on-the-job training to gain in-depth knowledge of our organization and industry, with the opportunity to advance to higher positions based on performance. Location- Thane,Navi Mumbai,Mumbai,Dombivli,Panvel,Karjat,mumbai all areas, MUMBAI SUBURBS, kalyan Desired Candidate Profile *Dynamic & Hardworking *Freshers *Excellent Interpersonal and Communication skill...

Management freshers into sales marketing PR -Brand awareness/ customer acquisition -Developing team and providiing and providing effective trainiing -mentoring & managing team to achieve desired performance -understanding financial aspects REQUIRED CANDIDATE PROFILE -Creative & positive -well groomed -GOOD ETIQUETTE -willingness to learn -training provided -has a smile & great leadership qualities *Age 18-27 *Freshers can apply *Immediate joiner Locations : thane, navi mumbai, mumbai all areas, MUMBAI SUBURBS, MUMBAI, kalyan, dombivli, panvel,

Job description Quality Auditor - Claims Adjudication Location : Navalur,Chennai Roles & Responsibilities: In-depth Knowledge and Experience in the US Health Care Payer System. 3-8 years of excellent knowledge on client specifics and experience in all types of Claims Adjudication. Good experience in Quality team handling. Perform quality review of claims based on the documentation provided by client to ensure claim output meets all customer specifications Collects all findings during the audits and perform effective root cause analysis along with examiners & ops supervisors Generate multiple level of analysis from the audit findings and identify opportunities to improve overall process Circu...

Responsibilities: • Analyze and evaluate workers's compensation claim payments using client 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 workers compensation fee schedule and/or PPO contract. Research, request and acquire all pertinent medical records, implant manufacturers invoices and any other supporting documentation necessary and then submit with hospital claims to insurance companies to ensure prompt correct claims reimbursement. Conduct timely and thorough telephone follow-up with payers to ensure claims with supporting documentation have been recei...

We are hiring!! HR Recruiter: Arun Kumar Industry: ITES/BPO Category: International Non-Voice Division: Healthcare International Business We are looking for enthusiastic candidates with excellent communication to join our team as Customer Support Associates in the International Non-Voice Process for Healthcare. Job Title: CSA and Senior CSA Grade: H1/H2 Function/Department: Operations Reporting to: Team Lead Role Description: Roles & Responsibilities (Indicative not exhaustive) A claims examiner needs to analyse multiple documents / contracts and decide to pay / deny the claim submitted by member or providers with respect to client specifications. The claims examiner should also route the cl...

Interested Candidates may connect with Ms.Zoya Shamsi +91 7251000195 (11am-5pm) About the Role: We are seeking a highly motivated and experienced individual with a medical background to join our dynamic team as a Medical Claims Call Center Representative. In this role, you will be the frontline of our customer service, handling inbound calls related to medical claims and rejections. Your primary focus will be to provide exceptional customer service while resolving inquiries and concerns effectively, ensuring a positive experience for every Niva Bupa member. Key Responsibilities: Answer incoming customer calls promptly and professionally. Assist customers with navigating medical claims, inclu...

Location: Chennai Shift : US Shift Timing (6.30PM 3.30AM) Job Qualification : Looking for voice process only. Experience in Claims Operations Candidate should have good communication skills. Responsibilities : End to End domain knowledge on US Healthcare and Payer Services life Cycle. Knowledge on Payer workflows like Enrollment, Claims Adjudication, Appeals and Grievances, Payment Integrity & Authorization Expertise on Payer terminologies (Related to Medicare Advantage programs) and concepts like Credentialing, Authorization, Out of network and In Network concepts & Subrogation. Basic knowledge on Revenue Cycle Management Interested candidates Contact : Lithan Kumar HR (7339696444) Those wh...

Location: Chennai Shift : US Shift Timing (6.30PM 3.30AM) Job Qualification : Experience in Claims Operations Candidate should have good communication skills. Responsibilities : End to End domain knowledge on US Healthcare and Payer Services life Cycle. Knowledge on Payer workflows like Enrollment, Claims Adjudication, Appeals and Grievances, Payment Integrity & Authorization Expertise on Payer terminologies (Related to Medicare Advantage programs) and concepts like Credentialing, Authorization, Out of network and In Network concepts & Subrogation. Basic knowledge on Revenue Cycle Management Interested candidates Contact : Varsha HR (8056370297) Those who have experience in Non voice please ...

Role & responsibilities Handle end-to-end RCM (Revenue Cycle Management) processes efficiently. Manage AR (Accounts Receivable) follow-up through voice-based communication. Work on claims related to Workers Compensation, Claims Adjudication, and Liability. Experience: Minimum 1 year in AR Voice Process Shift: Night shift (Free pickup & home drop provided) Communication : Excellent spoken English is mandatory Location: Chennai Interested candidates can share their CV to Shobana K 8248223875 Note: non voice experienced candidate kindly don't apply for voice process

Selected Intern's Day-to-day Responsibilities Include. Assist with Lead GenerationEngage with CXOs via cold calls, emails, and LinkedIn. Do Consultative PitchingUnderstand business needs and present tailored solutions. Deliver Concept PresentationDeliver impactful presentations to secure business opportunities. Write ProposalsDevelop compelling techno-commercial proposals. Help with Deal ClosureNegotiate and finalize contracts for seamless onboarding. Support Account ManagementBuild and maintain strong client relationships. Ensure Business Lifecycle ManagementWork with business leads to optimize processes. Keep Market AwarenessStay updated on industry trends and technology advancements. Abou...

Arzion RCM is looking for Senior AR Caller to join our dynamic team and embark on a rewarding career journey Tellecaller is responsible for various tasks including planning, execution, and management of related duties They should possess relevant skills and experience to excel in this role Duties include teamwork, problem-solving, and achieving organizational goals Candidates must have strong communication and technical abilities Responsibilities include project management, strategy execution, and performance optimization (More details as per role requirements )

About Client Hiring for One of the Most Prestigious Multinational Corporations! Job Title : P&C Claims Management Qualification : Any Graduate and Above Relevant Experience : 1 to 5 years Must Have Skills : 1.Experience in P&C Claims Management, preferably with BPO/Insurance process exposure. 2.Strong experience handling FNOL (First Notice of Loss) or FROI (First Report of Injury) cases. 3.Knowledge of claims systems like Guidewire, Duck Creek, Majesco, or similar platforms. 4.Familiarity with ISO, NCCI, and WCIRB reporting requirements. 5.Proficient in MS Office (Excel, Word) and data entry with attention to detail. 6.Strong communication and interpersonal skills with a customer-centric app...

Responsibilities: * Manage claims from intake to settlement. * Adjudicate medical necessity & settle claims fairly. * Ensure timely claim payment & employer satisfaction. * Process mediclaim & health insurance claims accurately.

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 : GuideWire Integration Good to have skills : NAMinimum 2 year(s) of experience is required Educational Qualification : 15 years full time education 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 assessing the current state of bu...

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 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...

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Analyst Qualifications: Any Graduation Years of Experience: 3 to 5 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 ...