6 Claims Analysis Jobs

The Medical Claims Analyst plays a crucial role in the organization by handling collections, account follow-up, billing, and allowance posting for assigned accounts. Your responsibilities include meeting daily productivity/quality standards, adhering to established policies and procedures, analyzing claims issues to reduce denials, communicating identified trends to management, initiating appeals when necessary, correcting billing errors, and sending accurate appeals with supporting documentation. You will also assist with special A/R projects, demonstrate analytical skills, maintain confidentiality, and act professionally in all interactions. To qualify for this role, you should have completed at least a High School education, possess experience in medical billing/AR collections, exhibit strong interpersonal and problem-solving skills, demonstrate sound judgment, integrity, and dependability, and have excellent written and verbal communication abilities. A gracious and welcoming personality for customer service interactions is essential. Working conditions for this position may require night shifts. The physical demands include occasional movement in the work area, sitting, manual tasks, operation of tools and office equipment, extending arms, kneeling, and effective verbal communication. The mental demands entail following directions, collaborating with colleagues, and managing stress effectively. The work environment typically has minimal noise levels. If you are seeking a challenging yet rewarding role where you can utilize your skills in medical claims analysis and contribute to the organization's success, this position may be the perfect fit for you. Join our team and be part of a dynamic environment dedicated to delivering high-quality service while upholding patient confidentiality and compliance with HIPAA standards.,

We are looking for a skilled Accounts Receivable Analyst with hands-on experience in US healthcare revenue cycle management. The ideal candidate will be responsible for reducing AR days, addressing claim denials, and ensuring timely collections through effective communication and follow-ups with payers. Job Responsibilities Actively follow up with insurance carriers to resolve outstanding claims and minimize AR backlogs. Investigate denied claims, identify causes, and take corrective action including appeals and resubmissions. Liaise professionally with insurance representatives and healthcare providers to resolve claim issues. Work AR aging reports regularly to prioritize high-value or aging accounts for collection efforts. Maintain clear and detailed records of all communications and claim actions in the billing system. Ensure all actions comply with HIPAA and US healthcare regulations. Provide regular updates and summary reports to management on AR performance and recovery trends. Qualifications & Skills 1 o 3 years of experience in US healthcare AR calling (Physician or Hospital Billing). Strong background in denial management and claims resolution. Familiarity with Medicare, Medicaid, and commercial insurance billing guidelines. Experience working with EMR and billing platforms such as Allscripts, AdvancedMD, eClinicalWorks, DrChrono or equivalent. Proficient in Excel, Outlook, and basic data handling tools. Strong verbal and written communication skills. Detail-oriented with good problem-solving abilities. Ability to work night shifts from office premises. Perks and Benefits 5-days Working One Side Cab Drop Performance-based incentives Opportunities for growth and skill development Supportive team environment Note: Immediate joiners preferred. Please share your CV to hr@revsyntech.com

The role involves identifying and understanding risks, preparing RFQs and comparatives, negotiating pricing with insurers, and designing insurer benefits for corporate clients regarding Employee Benefits (EB) products. Sales support is also a key aspect of the role. You will be responsible for: - Preparing RFQs and proposals for EB products such as GPA and GMC, and obtaining competitive quotes from insurers. - Conducting in-depth analysis of claims MIS and terms and conditions to assess risks and present them to insurance companies. - Negotiating pricing with insurers and understanding factors that contribute to cost-saving discounts. - Creating QCRs, placement slips, and presenting quotes to clients. - Collaborating with the sales team to grasp client requirements and offer comprehensive solutions for placing business with insurers, including generating quotes, preparing comparative statements, following up, and vetting policies. - Identifying client risk exposures, understanding insurance needs, and providing suitable insurance solutions. - Holding timely meetings with insurers and client stakeholders to build and maintain strong relationships. - Demonstrating proficiency in dealing with PSU insurers and understanding their operations, including PSU calculators and formats. Desired Candidate Profile: - At least 5 years of experience in the insurance industry, focusing on managing insurer relationships and EB placement. - A minimum of a Graduate degree, with an MBA in insurance considered a plus. - Strong verbal and written communication skills with clarity of thought and expression. - Proficiency in MS Excel and MS Office. - Strong analytical skills to effectively analyze data and information.,

Role: Data Scientist / Senior Data Scientist Reports to: Principal Advanced Analytics Profession: Data Science Office Location: Bangalore Job Description This position requires strong Coding Knowledge along with Data handling and Wrangling experience with either SQL/Python. Candidate will work hands-on projects in areas such as advanced analytics, creating reports and metrics out of large complex datasets, solution workbench etc. Individual should possess aptitude to understand business context, create insights from data and willingness to learn application of data handling tools and techniques suitable for the project assigned. Familiarity or Ability to learn and work on healthcare domain along with broad range of quantitative/analytical techniques to help clients improve their business decisions is needed. Responsibilities Expertise in custom projects focused on claims-based reporting using SQL/Python. Partner with the Product and Customer Success teams to deliver informed analyses to customers. Create deliverables to assist with customer engagements. Collaborate with fellow team members to implement optimized solutions. Contribute to internal projects and processes. Collaborate with global team to create deliverables. Mentor junior analysts and help drive best practices. Independently scope client requests Qualifications Data Experts with approximately 2 - 5 years of experience specializing in SQL/Python Hands-on experience with SQL/Python is mandatory. Must possess good interpersonal skills along with excellent presentation and communication skills. Proficient in Microsoft Excel. Ability to work with large data, think out of the box, assess current processes and offer ideas for improvement. Knowledge of Pharma datasets is good to have. ISMS Responsibilities Comply with information security policies and processes Report security weaknesses, events or potential events, or other security risks, to the organization Execute all tasks related to information security management system as appropriate Why we love Analytical Wizards, and why you will too! Industry leading products Work hard, and have fun doing it Incredibly fast growth means limitless opportunity Flexible and dynamic culture Work alongside some of the most talented and dedicated teammates A collaborative and friendly culture with very high employee engagement About Company Company Name: AnalyticalWizards Services Pvt. Ltd,A DH Company Profile: A leading, high growth Analytics Software Development company developing products that touch and positively impact human lives across the globe. We are headquartered in New Jersey and have a software development and delivery center in Bangalore. Our work is mainly focused on Healthcare Industry. We develop core data science products that help our clients draw unique insights from their big data and achieve their business goals. We use advanced algorithms in the space of artificial intelligence and machine learning. Our technology-based software products are being used by the top pharma and biotechnology companies of the world. We have been recognized twice as one of fastest growing private companies of USA. Work Culture: Employee-friendly, collaborative, innovative, fast-paced, and conducive to learning Company Address: AnalyticalWizards Services Private Limited, Fortune Summit Business Park, Ground Floor, Hosur Road, Sector 6, HSR Layout, Roopena Agrahara, Bangalore - 560068 Industry: Software Development and Data Science

Own enterprise account management, build CXO relationships, manage renewals, drive cross-sell of insurance & wellness solutions, lead QBRs/MBRs, collaborate with internal teams for smooth delivery, and ensure high client satisfaction & account health Required Candidate profile 8–15 years in employee benefits broking or group health insurance. Skilled in CXO relationship management, claims analysis, policy benchmarking, renewals, cross-sell, and benefits plan design.

Current Role and Responsibilities: Portfolio Analysis for various Parameters and Key Indicators like Claims Analysis Retention Steering Portfolio into right direction Industry Benchmarking Trend Analysis Cost Saving Analysis Prediction Models for Claims Database management Work with All Stakeholders to streamline data sources for business use and analysis Pull and integrate data from diversified sources; evaluate and pre-process raw information Help in improvement of record keeping systems with procedures, checks and balances Collaborate with management and internal teams to implement and evaluate improvements Required Skills Experience in data analysis and visualization methods Experience: 2/3 Years in Insurance, re-insurance in the required domain Tools: Advanced Excel, SQL, Power BI/Tableau; knowledge of Python/R is a plus Domain: Data Analyst, working on preparation and analysis of data pertaining to PC lines. What Go Digit Gains with a Data Analyst Like You You bring clarity to complexity. Your insight ensures we price better, manage risk smarter, and grow faster. Ready to Turn Data into DirectionIf youre passionate about data storytelling and insurance intelligence, this is your seat at the table.