4480 Claims Jobs - Page 12

About Lumen Technologies Lumen Technologies is a global technology company that delivers innovative communication and network solutions. Our mission is to empower businesses and individuals to connect, grow, and thrive in the digital age. With a focus on customer experience and operational excellence, we strive to provide cutting-edge solutions that meet the evolving needs of our customers. The Role (Position Objective/ Summary): The role will oversee all public and private web properties and supporting infrastructure including content management system, web analytics, and marketing automation platform. This is a hand-on and operational role. It includes website content management(WCM), sear...

Data Engineer / ML Engineer Pertinent Healthcare Business Solutions Position Summary : DentTracks is looking for a Data Engineer / ML Engineer to design secure data pipelines and deploy ML models for claims automation, eligibility checks, and Voice AI insights. The role combines HIPAA-compliant data engineering with ML deployment. Key Responsibilities: Build ETL/ELT pipelines for claims, eligibility data, and VoIP transcripts. Manage HIPAA-compliant data lakes/warehouses (S3, Glue, Lake Formation). Build and maintain data models in MongoDB Atlas and analytical stores (Redshift/Snowflake, optional). Develop & deploy ML models (Whisper, LLMs, anomaly detection). Containerize and scale models o...

As a Senior Associate, you will work closely with internal and external stakeholders and deliver high quality analytics solutions to real-world Pharma commercial organization s business problems. You will bring deep Pharma / Healthcare domain expertise and use cloud data tools to help solve complex problems Key Responsibilities: Collaborate with internal teams and client stakeholders to deliver Business Intelligence solutions that support key decision-making for the Commercial function of Pharma organizations. Leverage deep domain knowledge of pharmaceutical sales, claims, and secondary data to structure and optimize BI reporting frameworks. Develop, maintain, and optimize interactive dashbo...

JOB DESCRIPTION DESIGNATION : Executive - AP Shared Service Unit: Finance Shared Services GRADE : E1/E2/E3 LOCATION : Bangalore Role: The person would be responsible to ensure seamless service delivery of AP processes as per the agreed Service Levels. Further, ensure the accuracy in processing the data and strict adherence to SLAs Responsibilities: Handle Vendor setup and modifications including verification of Bank details, tax information etc., Pre-validation of invoices, in co-ordination with AP team of the sellers Invoice processing in ERP along with timely communication to concerned team, on rejected invoices and missing Invoices reconciliation of GRN. Handling and resolution of Vendor ...

Execution Analyze the customer segmentation, sales trends in terms of demographics, geography, characteristics etc. to assess the potential for business Conduct trainings at the branch for all banking partners around regulatory guidelines and products. Plan for activation of branches through R&R activities to increase the penetration in active branches to realize full potential of the bank partner in the given geography Relationship Management Drive the campaign/contest for the Partner Bank to drive sales in profitable segments. Assist banking partners in pitching product to crucial customers & driving sales closure for the same. Identify cross sell opportunities for existing customers New A...

Execution Analyze the customer segmentation, sales trends in terms of demographics, geography, characteristics etc. to assess the potential for business Conduct trainings at the branch for all banking partners around regulatory guidelines and products. Plan for activation of branches through R&R activities to increase the penetration in active branches to realize full potential of the bank partner in the given geography Relationship Management Drive the campaign/contest for the Partner Bank to drive sales in profitable segments. Assist banking partners in pitching product to crucial customers & driving sales closure for the same. Identify cross sell opportunities for existing customers New A...

Management Profile: Provider Management/Healthcare Purchasing Roles & Responsibilities: Tariff Negotiations and cost management Conducting surprise audits and checks of the claims and case to case negotiations Manage workload of both field and office effectively Experience in dealing with providers (Hospitals/Diagnostics & OPD Clinics) Understanding of Health Claims and claim related processes Good understanding of Health Insurance and related products Managing relationship with the providers Flexible to travel across locations based on the organizational requirements Managing internal (Claims Team, Sales and Central Teams and external stakeholders (Brokers, Channel partners & Corporates) Ma...

Medical Biller Summary GM Analytics Solutions is looking for a driven, dedicated and experienced Medical Biller , proficient in US healthcare, who are comfortable working in Night shift(US time ) Job Description Minimum 1-3 years experience is required in Medical Billing for US Healthcare mandatory minimum 1 year in Charge entry Responsible for making billing charge entry for compiling billing information, assisting with coding and ensuring all charges are posted accurately and timely. Work in teams that process medical billing transaction and strive to achieve team goal. Accurate processing and completion of medical claims. Evaluates medical records for consistency and adequacy of documenta...

What are my responsibilities? Order handover from acquisition team as per standard processes Collection of site inputs. If required visit the site for collection of mechanical dimensions, understanding of electrical schematics and protection requirements from the customer. Implementation of collected inputs for finalization of drawings and documents. Preparation of GA, FV, MSLD, Wiring drawings in line with input received from acquisition team, order requirements / specifications / order contract documents and customer site requirements Knowledge of Testing of MV products and Numerical relays Clear understanding of customer requirement with effective communication with all the order stakehol...

Roles and Responsibilities: Process Adjudication claims and resolve for payment and Denials Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process Knowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of pocket, maximum inside limits and exclusions, state variations Ensuring accurate and timely completion of transactions to meet or exceed client SLAs Organizing and completing tasks according to assigned priorities. Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team Resolving...

Shift : UK Shift Job Summary: We are seeking a highly driven Senior Sales Manager with 12-15 years of success in non-technical B2B service sales, particularly within ITES, BPO/BPS, Healthcare, Banking, Logistics, Education, and Commercial sectors. The ideal candidate should bring a well-established industry network, a portfolio of personal clientele, and a strong track record in staff augmentation and no-code/low-code service sellingspecifically in business process outsourcing and managed services. This role is not suitable for candidates with a background in technical software or IT product sales. Key Responsibilities: Lead and own end-to-end sales efforts for service-led solutions across i...

Overview We are seeking a dedicated and experienced Healthcare RCM Supervisor, Accounts Receivable, to oversee our accounts receivable department. The ideal candidate will possess strong leadership skills, a comprehensive understanding of healthcare revenue cycle management, and a proven track record of optimizing accounts receivable processes. The Supervisor will be responsible for managing a team of AR specialists, ensuring timely and accurate billing, claims processing, payment posting, and denial management. Responsibilities Lead and manage a team of accounts receivable specialists, providing guidance, support, and coaching to ensure high performance and productivity. Develop and impleme...

Hiring for US Healthcare - Claims & Premium Billing Education: BE/B.Tech/MCA/M.Tech/MSc./MS ,Bcom Responsibilities A day in the life of an Infoscion As part of the Infosys consulting team, your primary role would be to actively aid the consulting team in different phases of the project including problem definition, effort estimation, diagnosis, solution generation and design and deployment You will explore the alternatives to the recommended solutions based on research that includes literature surveys, information available in public domains, vendor evaluation information, etc. and build POCs You will create requirement specifications from the business needs, define the to-be-processes and d...

Looking for US Healthcare - Claims & Premium Billing with experience range 2 to 3 years Education: BE/B.Tech/MCA/M.Tech/MSc./MS ,B.com Responsibilities A day in the life of an Infoscion As part of the Infosys consulting team, your primary role would be to actively aid the consulting team in different phases of the project including problem definition, effort estimation, diagnosis, solution generation and design and deployment You will explore the alternatives to the recommended solutions based on research that includes literature surveys, information available in public domains, vendor evaluation information, etc. and build POCs You will create requirement specifications from the business ne...

Role & responsibilities International healthcare Process. Requirements: Candidates with a minimum of 2 years of experience in Claims/Insurance/Health Care will be considered for the role Good English Communication Skills (Written & Verbal) Willingness to work in 24/7 rotational shifts Graduates/Postgraduates can apply Must be comfortable working from office Immediate joiners only No virtual interviews In-person interview process Outstation candidates are not eligible Transport Policy: Two-way cab facility provided only for night shifts Cab service available within 20 kms radius from office location Registration Link: https://smrtr.io/sCc_C Location Office: Sutherland Global Services, Centenn...

Mega Walk-in Drive US Healthcare (Claims Adjudication) Date: 19th & 20th September 2025 Time: 11:30 AM 4:00 PM Venue: Sagility, KCT Tech Park, Thudiyalur Rd, Saravanampatti, Coimbatore, Tamil Nadu 641049 We Are Hiring Experienced Professionals! Join our growing team in US Healthcare Claims Adjudication Minimum Requirement 3.6+ years of experience in US Healthcare (Claims Processing & Adjudication) Additional Opportunities in Sagility : We have openings for WFM & Training functions Also for Internal Contact Center Operations (Inbound calls) Open Positions Team Leader Operations Quality Specialist Subject Matter Expert (SME) Process Trainer Quality Team Leader Assistant Manager Operations Depu...

Role & responsibilities We are looking for an accomplished Doctors with significant ICU experience and a strong ability to manage both clinical and non-clinical responsibilities. The ideal candidate will excel in patient care, clinical documentation, and possess in-depth knowledge of medical documentation essential for insurance claims processing. Key Responsibilities: Patient Documentation: Manage patient medical history and progress notes with precision. Claims Processing: Handle preauthorization and reimbursement claims, including validation and processing. Clinical Records: Maintain accurate clinical documentation in compliance with healthcare standards. Collaboration: Work closely with ...

Assistant Manager / Deputy Manager - Claims -2+ Years - Pune Are you a highly motivated claims professional looking to make an impact in the insurance industry? We are seeking an experienced Assistant Manager / Deputy Manager - Claims with over 2 years of expertise in managing and processing claims. This is your chance to work in a role where you can bring value, drive process improvements, and enhance customer satisfaction. If you are ready to embark on an exciting journey of professional growth, this is the perfect opportunity for you! Location:- Pune Your Future Employer A leading organization in the insurance domain, known for its dynamic work environment and commitment to professional e...

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 Analyze customer queries to provide timely response that are detailed and ordered in logical sequencing Cognitive Skills include language, basic math skills, reasoning ability with excellent written and verbal communication skills Stay up to date on new policies, processes, and procedures impacting the outcome of Claims processin...

Positions General Duties and Tasks: Process Insurance Claims timely and qualitativelyMeet & 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 Requirements for this role include: Both Under Graduates and Post Graduates can apply. Excellent communication (verbal and written) and custome...

Roles and Responsibilities: 2-3 years of experience in processing claims adjudication and adjustment process Experience in professional (HCFA) and institutional (UB) claims Knowledge in handling authorization, COB, duplicate and pricing process Knowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of pocket, maximum inside limits and exclusions, state variations Audit claims as outlined by Policies and Procedures. Utilize appropriate system-generated reports applicable for specialty claims. Document, track findings per organizational guidelines for reporting purpose. Based upon trends, determine ongoing Claims E...

This position is located within the Transformation Practice Group in GOSC, which provides actionable reporting & BI reporting solutions. The incumbent would work as part of this team to support the projects and engagements with Excel, Power BI, SQL, Cognos Support Customer related reports and work closely with US Group Business - Claims stateside partners / SPOCs for validation, delivery of regular and adhoc reports Identify issues/risks and bring them to closure before report out Support activities to ensure data analysis & reporting availability with 100% accuracy & timeliness Flexibility to work on multiple projects as required time to time

TATA AIG General Insurance Company Limited is looking for Senior Manager - Health Claims to join our dynamic team and embark on a rewarding career journey Analysis for the current business practice. Find out the different operational strategies. Work on developing the current operational strategy applied to the company with the most recent technology. Coordinate with the operations manager to take the required steps after brainstorming and research. Optimize the operations in the company. Put the suitable operational strategy to fit with the companys culture. Implement the operational strategy in the different departments of the company. Supervise the strategy, and make sure that all the emp...

TATA AIG General Insurance Company Limited is looking for Deputy Manager - Health Claims to join our dynamic team and embark on a rewarding career journey Assist the Manager in the day-to-day operations of the business, including setting goals, developing strategies, and overseeing the work of team members Take on leadership responsibilities as needed, including managing team members and making decisions in the absence of the Manager Identify and address problems or challenges within the business, and develop and implement solutions Collaborate with other departments and teams to ensure smooth and efficient operations Maintain accurate records and documentation Contribute to the development ...

CuraScript SD a wholesale pharmaceutical distributor that provides customized business solutions and access to specialty drugs to community physicians, specialty pharmacies, and health systems; it is a wholly owned subsidiary of Evernorth a Cigna Company. CuraScript SD is seeking an experienced and highly motivated SAP Vistex analyst/configurator to join its technology team. This role will be supporting the SAP S4/HANA cloud ERP implementation/solution. Responsibilities : Configure and test End-to-End business scenarios for vendor rebates, customer rebates, Chargebacks, Claims & Transaction, Pricing/Pricing Catalogs, Pharma Billing and Agreements to meet business and functional requirements ...