19 Claims Analyst Jobs

About the Role We are looking for experienced and detail-oriented professionals to join our Claims Case Management Team . The role involves reviewing and analyzing health insurance claims, ensuring accuracy, compliance, and cost-effectiveness while maintaining a strong customer-centric approach . You will collaborate closely with hospitals, TPAs, and internal teams to identify irregularities, prevent financial losses, and uphold the integrity of the claims process . Key Responsibilities 1. Claim Review & Analysis Assess claims for admissibility, medical necessity, and identify irregularities or overbilling. Conduct root-cause analysis using claims data, treatment records, and clinical guidel...

Job Description Claims Analyst ; ;Job Name:Claims Analyst ;Position Title: ;Senior Executive - Claims ; ;Band:A2 ;Domain:Healthcare ; ; ;Reporting to:Assistant Manager ;Location/Site:EXL India, Chennai ; ;Job Description:Reviewing medical records and producing an accurate summary, ;Ability to analyze, Look at each medical record to check for missing documentationsPriorities workloads to ensure expedited cases are processed within defined timelinesEnsures that medical records are up to compliance.Qualifications: ;Any ;Graduate/ PostgraduateWorking Hours: ;40 hours /week, Full Time EmployeeWork Model: Training from office for 2 - months and hybrid there afterTelecommuter/Internet requirements,...

Exp- 1-2 years of US Mortgage Default Mortgage Claims Essential Functions Perform Claims processing as per Investor and Industry guidelines. Pulling all relevant Servicing document Pulling all relevant Origination/ collateral documents Requesting additional or missing documents. Ensures all documentation, acknowledgement and review done on time. What we're Looking For 1-2 years of FHA, VA, USDA, PMI, Fannie Mae, and Freddie Mac claims experience required. Should have experience of working FHA Part A, Part B-E, PFS CWCOT Experience with FNMA 571 is preferred Knowledge of Microsoft Office, specifically Excel, Word, Outlook Knowledge of Excel related to formulas, formatting, and data sorting Ba...

The Extended Service Business (ESB) Claim Analyst is responsible for evaluating claims related to Extended Service Business (Extended Warranty Contracts, Service Contracts etc) in accordance with the Terms and conditions of Contracts and as per Ford recommended repair / service procedures, thereby ensuring that quality repair / service has been performed at optimum cost. The Analyst is required to process claims as per the daily workload allocation with required quality levels to ensure timely settlement of claims to the dealer. As a requirement of the role the analyst is supposed to respond to claim process queries & ensure to take adequate measures to reduce / eliminate processing errors. ...

Review, analyze, adjudicate US healthcare claims in line with payer policies regulations Handle complex claims adjustments, ensuring compliance with guidelines Collaborate with cross-functional teams to ensure NSA compliance in claims processing Required Candidate profile Investigate and resolve discrepancies in claims data and documentation Support audit and quality assurance functions related to claims Stay updated with NSA regulations healthcare compliance standards Perks and benefits Perks and Benefits

ROLE RESPONSIBILITIES Take ownership of Guidewire ClaimCenter development to implement and adapt to evolving business requirements. Collaborate with Business Analysts , Development, and QA teams to scope, size, plan, develop, implement, and support projects within the Claims portfolio . Ensure solutions include robust unit and functional testing with a high level of code coverage. Oversee the support and maintenance of the ClaimCenter ecosystem , including integrations with Policy, Financial, CRM systems , external bureaus, third-party vendors, and service providers. Develop, manage, and maintain comprehensive technical and solution documentation, such as architecture diagrams, sequence diag...

- Offer comprehensive support through both phone and email communications. - Address complaints effectively, delivering suitable solutions and alternatives within established timeframes. - Conduct follow-ups to guarantee resolution. - Supply accurate and relevant information utilizing the appropriate tools. - Document and update notes for each call or email interaction. - Exceed expectations to prevent any inconvenience. Allianz Group is one of the most trusted insurance and asset management companies in the world. Caring for our employees, their ambitions, dreams, and challenges, is what makes us a unique employer. Together we can build an environment where everyone feels empowered and has ...

Job Description Your mission at IntegriChain: To help ensure success of high quality and on time delivery of rebate claims processing for IntegriChain s BPSaaS Customers. What this role entails: Processing of Managed Care and/or Medicaid Rebates Download, log and track data and contract submissions Run and create reports/analysis in Excel spreadsheets and other software packages to support payment reviews and approvals Ensure calculations are in compliance with contractual terms Reconcile and document any rebate variances Resolve errors and disputes within the rebate system based on defined set of rules and procedures Follow and ensure compliance with defined business processes and pre-estab...

Medical background with a minimum of 2 years experience Proven customer support experience Excellent communication written skills Ability to respond to different type of queries Ability to multitask, prioritize manage tasks effectively Strong customer handling skills active listening 65409 | Customer Services Claims | Entry Level | Allianz Partners | Full-Time | Permanent Warning: When posting this job advertisment on an external job board, the length of the following fields combined must not exceed 3950 characters: "External Posting Description", "External Posting Footer" Allianz Group is one of the most trusted insurance and asset management companies in the world. Caring for our employees...

Medical background with a minimum of 2 years experience Proven customer support experience Excellent communication written skills Ability to respond to different type of queries Ability to multitask, prioritize manage tasks effectively Strong customer handling skills active listening 65408 | Customer Services Claims | Entry Level | Allianz Partners | Full-Time | Permanent Warning: When posting this job advertisment on an external job board, the length of the following fields combined must not exceed 3950 characters: "External Posting Description", "External Posting Footer" Allianz Group is one of the most trusted insurance and asset management companies in the world. Caring for our employees...

Claims Analyst India Mumbai Functional Title: Claims Analyst Reporting to: Team Lead L&H Claims India Location: Mumbai About Swiss Re This is your opportunity to join one of the worlds leading reinsurers. Our reinsurance business at Swiss Re is about understanding and analyzing the major risks that concern the world - from natural catastrophes to climate change, from ageing populations to cybercrime. We cover both Property & Casualty and Life & Health. We combine experience with expertise and innovative thinking to create new opportunities and solutions for our clients. And we enable the risk-taking essential to enterprise and progress. This is only possible with around 15,000 truly exceptio...

Roles and Responsibility Analyze complex data sets to identify trends and patterns in health-related claims. Develop and implement effective analytical models to predict future claim outcomes. Collaborate with cross-functional teams to design and implement process improvements. Provide expert guidance on health-related risk assessment and mitigation strategies. Conduct thorough analysis of medical records to determine claim validity. Develop and maintain comprehensive reports on claim performance metrics. Job Requirements Strong knowledge of insurance industry regulations and standards. Proficient in analyzing large datasets using advanced statistical techniques. Excellent communication and ...

Claims Analyst The job profile for this position is Claims Analyst, which is a Band 2 Senior Contributor Career Track Role. Excited to grow your career? We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply! Our people make all the difference in our success. YOUR JOB As an SME you will support the supervisor and team manager in your relevant process. Key to the role will be building/maintaining an in-depth knowledge of (part of) the process to continuously improve the processes and share that knowledge...

Analyst, Sr Analyst, Claims As a Claims Analyst, you ll perform various functions which primarily involve analyzing, advising, and managing claims for various lines of business The emphasis of your job is on reviewing claims filed by policyholders for completeness and accuracy, as well as establishing that the damages are covered by their policies It also entails maintaining updated records and preparing required documentation What you ll be doing What will your essential responsibilities include? Make sure the eligibility for claims is reasonable and correct by analyzing claims and supporting documentation Adjudicate claims activities like setting up new claims, making payments, refunds, up...

- Ensure timely and accurate investigations are conducted to validate overpayments. - Conduct investigations into complex overpayment claims. - Develop and implement policies and procedures to enhance the overpayment process. - Provide leadership and mentorship to claimsstaff. - Analyze complex overpayment cases, including reviewing data, identifying discrepancies and determining appropriate recovery actions. - Partner with other departmentsto achieve company goals and objectives. - Collaborate with onshore leadership to align offshore team operations with strategic objectives, ensuring seamless execution of payment integrity initiatives. Claims Analyst Qualifications & Skills: - Masters deg...

Lennox (NYSE: LII) Driven by 130 years of legacy, HVAC and refrigeration success, Lennox provides our residential and commercial customers with industry-leading climate-control solutions. At Lennox, we win as a team, aiming for excellence and delivering innovative, sustainable products and services. Our culture guides us and creates a workplace where all employees feel heard and welcomed. Lennox is a global community that values each team member s contributions and offers a supportive environment for career development. Come, stay, and grow with us. Job Description Marketing Claims Analyst/Admin: Review and validate marketing claims for accuracy, compliance, and regulatory alignment. Collabo...

Expense Claim Analyst JOB PURPOSE: The Analyst is responsible to perform monthly Audits allocated to Him/her basis the compliance policies, report out the non-compliances and complete the operational activities as per the defined timelines YOUR TASKS AND RESPONSIBILITIES: Complete the Assigned audits within the timeline and report out the non-compliances to the stakeholders Ensure that i-docs / Accruals / Cash advance Report generation are completed as per the timelines defined Support on Clearing E-vendor open items for SPA on requirement basis To demonstrate Problem Solving Skills while addressing critical issues within the process Respond to the queries within the TAT agreed To have an ey...

Proven customer support experience Excellent communication & written skills Ability to respond on different type of queries Ability to multitask, prioritize & manage tasks effectively Strong customer handling skills & active listening

Job Description Your mission at IntegriChain: To help ensure the success of high-quality and on-time delivery of rebate claims processing for IntegriChain s BPSaaS Customers. What this role entails: Processing of Managed Care and/or Medicaid Rebates Validate formulary compliance against contracted terms Download, log, and track data and contract submissions Run and create reports/analyses in Excel spreadsheets and other software packages to support payment reviews and approvals. Ensure calculations are in compliance with contractual terms Reconcile and document any rebate variances Resolve errors and disputes within the rebate system based on a defined set of rules and procedures. Follow and...