1508 Claims Adjudication Jobs - Page 6

Dear Candidates, Greetings from HealthIndia Insurance TPA Service Pvt. Ltd. Company Profile - We are provide highest level of quality health care by creating a platform which is entirely dedicated to service excellence, patient care and health education to the members . For more details kindly go through company website: https://www.healthindiatpa.com Currently we're having opening in Cashless Department for Medical Officer Profile. Role & Responsibilities: Cashless Claim Management: Review and process pre-authorization requests for cashless hospitalization, ensuring all required documentation is complete and accurate. Medical Scrutiny: Analyze medical records and reports to validate claims ...

Were Hiring for Insurance Claims Associate! Interested candidates can drop your resume to the mentioned contact - 7569452008 Are you detail-oriented and passionate about maintaining a safe and respectful online space? Join our team as a claims associate in Bangalore! WE ARE HIRING FOR: *Immediate joiner required *Excellent Verbal communication skills Position: Insurance Claims Associate Minimum Qualification: Non-Technical education background required (Eg.BA,B.com,BBA) Experience: Minimum in between 1 year experience into claims processing. Shifts: Rotational Shifts. Week Offs: Rotational offs. 2-way transportation will be provided. Candidate must stay in the 20kms from the work location Lo...

International US - Voice Process Work From Office | Immediate Joiners Excellent Communication Skills In English 5 Days Working, Rotational Shifts 2 Way Cab Till 25Kms Radius Recent Passed Out Graduate For More Info Contact HR HARI : 7618776218

Essential Duties and Responsibilities: - Serve as functional lead for implementation projects across all capabilities. - Work with clients and end users to gather, understand, and define business requirements. - Develop user stories and to-be process flows for complex and/or multi-capability solutions to support the design and development of solutions for our clients. - Lead interactions with our customers, internal Operations teams, and external government clients. - Lead solutioning initiatives such as design thinking, scouting, RFP responses, etc. - Identify waste and digital enhancement opportunities. - Frequently responsible for providing guidance, coaching and training to other technic...

Overview The Coding Denial Specialist responsibilities include working assigned claim edits and rejection work ques, Responsible for the timely investigation and resolution of health plan denials to determine appropriate action and provide resolution. Responsibilities Processes accounts that meet coding denial management criteria which includes rejections, down codes, bundling issues, modifiers, level of service and other assigned ques. Resolve work queues according to the prescribed priority and/or per the direction of management in accordance with policies, procedures, and other job aides. Validate denial reasons and ensures coding is accurate. Generate an appeal based on the dispute reaso...

Analyze, validate, and process transactions as per Desktop procedures (L3 L4) Analyze and research all discrepancies. Research investigate and resolve outstanding items Determine eligibility and applicable plan provisions while meeting timeliness goals Clear and accurate written and verbal communication (Scripted and Templatized) with employee, employer stateside resources by email Establish action plans for each file to bring claims to resolution Utilize internal and external specialty resources to maximize impact on each claim file Utilize Intellis and ACS (SIR) to update and maintain accurate data record Use PC programs to increase productivity and performance Ensure that the assigned tar...

Job Description Summary We are looking for a detail-oriented and analytical Quantity Surveyor to manage all aspects related to project costs across various stages of development. The role involves cost estimation, budgeting, contract administration, and ensuring value for money while meeting project quality and compliance standards. 1. Cost Planning & Estimation Monitor project budgets, cash flows, and cost forecasts. Conduct cost-benefit analysis during pre-contract stages. 2.Tendering & Procurement Manage tendering processes including pre-qualification, bid evaluation, and negotiations. Review vendor quotations, rate analyses, and recommend cost-effective solutions. Draft, review, and admi...

SUMMARY Retail Staff Job Description Our client, a UAE-based multinational conglomerate headquartered in Dubai, is seeking freshers to join their retail staff team. The group is involved in the retailing of various products such as apparel, footwear, consumer electronics, cosmetics & beauty products, home improvement, and baby products. Additionally, the group focuses on hospitality & leisure, healthcare, and mall management. Responsibilities: Folding and stacking at a basic table. Timely display of received stocks. Upkeep of section. Ensuring a carton-free floor. Maintaining display standards, including signage. Merchandise clearance from the trial room. Ensuring the right product is displa...

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...

About The Role Skill required: Operations Support - Pharmacy Benefits Management (PBM) Designation: Health Operations New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years What would you do? Embedding digital transformation in healthcare operations end-to-end, driving superior outcomes and value realization today, and enabling streamlined operations to serve the emerging health care market of tomorrowYou will be a part of the Healthcare Claims team which is responsible for the administration of health claims. This team is involved in core claim processing such as registering claims, editing & verification, claims evaluation, and examination & litigation.The business ...

About The Role Skill required: Operations Support - Pharmacy Benefits Management (PBM) Designation: Health Operations New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years What would you do? Embedding digital transformation in healthcare operations end-to-end, driving superior outcomes and value realization today, and enabling streamlined operations to serve the emerging health care market of tomorrowYou will be a part of the Healthcare Claims team which is responsible for the administration of health claims. This team is involved in core claim processing such as registering claims, editing & verification, claims evaluation, and examination & litigation.The business ...

Hello Visionary! We empower our people to stay resilient and relevant in a constantly changing world. We’re looking for people who are always searching for creative ways to grow and learn. People who want to make a real impact, now and in the future. Does that sound like you? Then it seems like you’d make an outstanding addition to our vibrant team. Siemens Mobility is an independently run company of Siemens AG. Its core business includes rail vehicles, rail automation and electrification solutions, turnkey systems, intelligent road traffic technology and related services. In Mobility, we help our customers meet the need for hard-working mobility solutions. We’re making the lives of people w...

About The Role Skill required: Operations Support - Pharmacy Benefits Management (PBM) Designation: Health Operations New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years What would you do? Embedding digital transformation in healthcare operations end-to-end, driving superior outcomes and value realization today, and enabling streamlined operations to serve the emerging health care market of tomorrowYou will be a part of the Healthcare Claims team which is responsible for the administration of health claims. This team is involved in core claim processing such as registering claims, editing & verification, claims evaluation, and examination & litigation.The business ...

About The Role Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Associate Manager Qualifications: Any Graduation Years of Experience: 14 Years to 16 Years What would you do? We are seeking a highly experienced and results-driven Claims Associate Manager with a strong background in Property & Casualty (P&C) insurance claims operations. The ideal candidate will have a minimum of 14 years of experience, including proven leadership in managing large teams (~40 FTEs) across First Notice of Loss (FNOL), claims adjudication, and payment processing functions.This role demands strong capabilities in people leadership, client relationship managem...

About The Role Skill required: Reinsurance - Collections Processing Designation: Claims Management Manager Qualifications: Any Graduation Years of Experience: 13 to 18 years What would you do? We help insurers redefine their customer experience while accelerating their innovation agenda to drive sustainable growth by transforming to an intelligent operating model. Intelligent Insurance Operations combines our advisory, technology, and operations expertise, global scale, and robust ecosystem with our insurance transformation capabilities. It is structured to address the scope and complexity of the ever-changing insurance environment and offers a flexible operating model that can meet the uniq...

Vorins Technology is looking for Fresher/Internship 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 available data. Reviewing...

About The Role Skill required: Group Core Benefits- Claims Case Mgmt. Group Disability Insurance Designation: Claims Management Senior Analyst Qualifications: Any Graduation Years of Experience: 5 to 8 years What would you do? We help insurers redefine their customer experience while accelerating their innovation agenda to drive sustainable growth by transforming to an intelligent operating model. Intelligent Insurance Operations combines our advisory, technology, and operations expertise, global scale, and robust ecosystem with our insurance transformation capabilities. It is structured to address the scope and complexity of the ever-changing insurance environment and offers a flexible oper...

Department: Health Claims (Cashless) Location: Hyderabad 1, Indore 1 Reporting To: Chief Manager Health Management Team Key Responsibilities: Claims Assessment: Evaluate and process health insurance claims in accordance with policy terms and conditions. Medical Review: Identify and flag potential cases of medical abuse or discrepancies in treatment protocols. Admissibility Decision: Determine claim eligibility based on thorough review of medical documentation and policy guidelines. Tariff Adjudication: Review and authorize cashless approvals, ensuring alignment with applicable tariffs and negotiated rates. Stakeholder Coordination: Liaise effectively with internal teams, network hospitals, a...

Handle customer inquiries and resolve issues efficiently Provide accurate information to customer Process transactions and maintain customer records Deliver excellent customer service and enhance customer satisfaction. Hr connect Riya - 63980 09438 Required Candidate profile Voice Inbound process Preferably customer service experience Excellent Spoken English Computer Skills /experience using computer applications Call Handling Etiquette Immediate joining Rotational Shift

Immediate joiners Calling insurance Company on behalf of healthcare providers for claim status and denial management. Salary & Quarterly Appraisal - Best in Industry Contact Gayathri HR 7010900395 1 round of Interview easy selection

HIRING FOR REVENUE CYCLE MANAGEMENT PROFESSIONALS WITH 9 MONTHS 6 YEARS EXPERIENCE Good Knowledge in AR Follow-up / Denial Management Follow up with the payer to check on claim status Identify the denial reason and work on the resolution Undergraduate / Graduate with a minimum of 1 Year of experience in AR follow-up Good Communication Skills Willing to work on the Night Shift Preferred candidate profile

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! HR Ananya 8884496986 (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 inter...

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 Brief Job Profile Claims adjudication, Fraud and leakage control, Client/provider feedback, Team training and retention, Investigation Desired Competencies/ Skill Set MS Excel and MIS skills, Candidate having work experience of claim processing, Investigation, computer skills. Preferred Industry Health Insurance, TPA, Hospitals, Healthcare

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 Brief Job Profile Claims adjudication, Fraud and leakage control, Client/provider feedback, Team training and retention, Investigation Desired Competencies/ Skill Set MS Excel and MIS skills, Candidate having work experience of claim processing, Investigation, computer skills. Preferred Industry Health Insurance, TPA, Hospitals, Healthcare

Job description : Freshers with commerce educational background can apply. We are seeking graduates or qualified legal professionals to join our UK motor claims support team. This role involves assisting UK insurer clients with the technical handling and legal processing of motor insurance claims, particularly around liability resolution, litigation prep, and document review. Training in UK motor insurance law and procedural frameworks (e.g., RTA, OIC, MOJ Portal, Credit Hire Portal) will be provided Role & Responsibilities : Review motor accident claim files to assist in liability determination Draft and review case summaries, driver statements, and incident versions Support preparation of ...