6244 Claims Jobs - Page 17

Graduate from recognized universities. (B Tech CSE/IT not eligible). Freshers and experienced candidates from 2.5 to 4 years are eligible Preferred candidates with Claims/Claims Adjudication Experience with BPO sector/ domain are preferrable Possess strong Problem solving skills, analytical knowledge and communication skills- both written and verbal. Collaborative, high-energy and diligent work ethics to be displayed at all times. Strong ability to multi-task and support different functions based on business requirements. Complete tasks according to the established standards with limited instruction and supervision. Should possess team-based working style coupled with the zeal to expand the ...

1. General Insurance a Must. 2. Test Designing. 3. Test Execution. 4. Defect Management. 5. Understand client requirements, queries, issues and respond. 6. Providing Status as per set Governance to Lead &/or Client. 7. Raising Issues/Risks and providing Mitigation/Solution. 8. Candidate should have experience in Health Claims.

About The Role This job involved leading a team whose primary role involved in supporting the data entry updates/ gathering required information / documents to support claim finalization. As part of the role the teams review images and documentation received with regards on the claims and as per guidelines update the information into the system and perform follow ups with vendor for the required information. Managing tasks and workflows in accordance to set standards and ensuring necessary claims processing guidelines are being adhered to through the process. Handling new hire training and transitions for the scope of services. Will need to have a high interest in driving domain certificatio...

Trade Support Job Description Shift - 6:00 PM -3:30 AM Location - Gurugram Designation - Analyst Process OverviewTrade Support Trade Support Team is responsible for Bookings, Confirmation Settlement of Bonds and Term Loans Products. Team is responsible for multiple activities for Middle office and Back-office operations. Team support settlement Activities for DTC, FED, Euroclear, CEDEL Market, ClearPar for Term Loan. Trade Support closely work with Data Governance and Asset Servicing Team. Also Responsible Post settlements activities such as Failed Trades and Claims Management, Also ensuring Timely matching of unconfirmed Trades from Previous business day. Job Description* This role is prima...

Oversee daily nursing operations, ensuring high-quality patient care.Develop and implement nursing policies and procedures to maintain excellence.Collaborate with medical staff to develop and implement patient care plans Required Candidate profile Proven experience as a Nursing Superintendent or Nursing Incharge. Strong leadership and management skills, with the ability to motivate teams. Excellent communication and interpersonal skills

Collaborate with the Claims head, claims processing and provider management team to gather and analyse business requirements related to claims processing. Required Candidate profile Conduct in-depth analysis of the existing claims systems and processes, identifying areas for improvement and optimization. Experience in understanding and working with ICD, PCS, and CPT codes

Job Description Job Description: Objective: To achieve the sales (Primary and Secondary), distribution and merchandising objectives for the specified routes, through a team of Market Growth Representatives for a key market (volume and image) Title: Executive - Sales Function: Sales Location: Surat Job Responsibilities Job Responsibilities: 1.Sales Plan Execution: a.Coordinate and achieve sales objectives for assigned Territory routes by brand and pack on a daily basis for secondary, primary volumes (Physical Cases & unit Cases), Gross revenue (GR) & Net revenue (NR). b.Define route plans of the Market Growth Representatives, Account Developers to optimize coverage cost effectively and ensure...

Perform orthopedic surgeries with precision and care. Conduct thorough examinations and diagnoses to determine the best course of treatment.Develop and implement effective treatment plans for patients Required Candidate profile Strong knowledge of medical services and hospital operations. Excellent communication and interpersonal skills. Ability to work well under pressure and make quick decisions.

The Care Project Manager (CaPM) ensures specific entitlement and acts so that maintenance business services are conducted in an efficient, accurate, cost-effective, timely, and customer-friendly manner. Maintenance business services and delivery are dependent on the work of many areas and teams. The CaPM will work closely with management of the different functional areas to ensure that all aspects of the deliverables, which enable maintenance services, are provided in a cohesive and seamless manner. HOW YOU WILL CONTRIBUTE AND WHAT YOU WILL LEARN Monthly/Weekly care reviews with Bharti management (Mostly In-person) Operations Governance with Customer/Bharti Operations and NOC ( Mostly In-Per...

Partners Management / Partners & Alliances Experience: 9 Yrs Location: Pan India Role: Partners Management / Partners & Alliances Location: Preferred Bangalore / Roles & Responsibilities: - Developing the Hyperscale Funding e2e Process to include claiming incentives, streamlining internal activities, and capturing in Partner Systems. - Ensure the designed process for Deal/Funding registrations is implemented effectively across SBU NCE and submissions happen within defined timelines. - Collaborating and coaching the relevant stakeholders like Account Leads (GCP), Solution Architects, Delivery Managers, Partner Managers etc for them to understand the claim process to help with details to initi...

Must be MBBS certified or have 2+ yr exp with Claim processing and be a BHMS Shift - UK Shift Female - 3-9 from office (9pm-12pm from home) Male - 3pm-12 work from office CTC upto 8.5 LPA

Accuracy in Inpatient Billing. Effectively monitoring of day-to-day activities. Resolve customer complaints or answer customers' questions regarding policies and procedures. Supervise the work of office, administrative, or customer service employees to ensure adherence to quality standards, deadlines, and proper procedures, correcting errors or problems. Provide employees with guidance in handling difficult or complex problems or in resolving escalated complaints or disputes. Implement corporate or departmental policies, procedures, and service standards in conjunction with management. Discuss job performance problems with employees to identify causes and issues and to work on resolving prob...

Role Overview: You will be responsible for managing and retaining top corporate clients in the region along with your team at a L1 level. You will need to review reports on top corporate/insurance companies/brokers with the Leadership Team and take proactive actions to address any issues before they escalate. Fulfillment of SLAs and overseeing the timely submission of MIS reports to insurance companies and corporate clients will be a key part of your role. You will also oversee department functions like Customer Care, Claims, Preauth, and related functions. Coordination with brokers, insurance companies, and corporate clients will also be part of your responsibilities. Key Responsibilities: ...

About the role Review patient medical records following PHI, HIPPA and convert into medical coding code as per ICD-10-CM and PCS guidelines. Complete daily assign tasks within time with expected quality, on time communication to internal/external stakeholders and adhere to organization policies. We are looking to hire an experienced Medical Coders / Senior Medical Coders with coding certifications (CIC or CCS) hands on experience on Inpatient DRG (MS-DRG/APR-DRG) coding. Eligibility Criteria 1 to 7+ Years of work experience in IP DRG medical Coding Education Any Graduate, Postgraduate Successful completion of a certification program from AHIMA (CCS) or AAPC (CIC) Must be active during joinin...

Role Objective: To bill out medical accounts with accuracy within defined timelines and reduce rejections for payers. Essential Duties and Responsibilities: Process Accounts accurately basis US medical billing within defined TAT Able to process payer rejection with accuracy within defined TAT. 24*7 Environment, Open for night shifts Good analytical skills and proficiency with MS Word, Excel, and PowerPoint Qualifications: Graduate in any discipline from a recognized educational institute. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Good communication Skills (both written & verbal)Skill Set: Candidate should have good healthcare knowledge. Candidate should have...

Role Objective: To bill out medical accounts with accuracy within defined timelines and reduce rejections for payers. Essential Duties and Responsibilities: Process Accounts accurately basis US medical billing within defined TAT Able to process payer rejection with accuracy within defined TAT. 24*7 Environment, Open for night shifts Good analytical skills and proficiency with MS Word, Excel, and PowerPoint Qualifications: Graduate in any discipline from a recognized educational institute. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Good communication Skills (both written & verbal)Skill Set: Candidate should have good healthcare knowledge. Candidate should have...

About The Role Project Role : Business Architect Project Role Description : Identify opportunities to deliver tangible business value by assessing the current state, capturing high-level requirements, and defining business solutions. Translate business needs into technology-enabled solutions and operating models. Support transformation by developing business cases and guiding implementation of key initiatives. Must have skills : Medicare Advantage Good to have skills : Health Insurance Operations, Electronic Medical Records (EMR) Minimum 5 year(s) of experience is required Educational Qualification : 15 years full time education Summary :As a Configuration Lead, you will identify opportuniti...

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Senior Analyst Qualifications: Any Graduation Years of Experience: 5 to 8 years Language - Ability: English(Domestic) - Advanced 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 yo...

Skill required: HM- Utilization Management - Healthcare Management Designation: Customer Service Associate Qualifications: Any Graduation Years of Experience: 1 to 3 years 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 you do Embedding digital transformation in healthcare operations...

About The Role Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 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 mod...

About The Role Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Associate Qualifications: Any Graduation Years of Experience: 1 to 3 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 t...

About The Role Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Specialist Qualifications: Any Graduation Years of Experience: 7 to 11 years What would you do? As Team Manager, you will lead and oversee a claims adjudication team focused on Commercial Linesincluding Marine, Workers Compensation (WC), and Property insurance. You will ensure timely, accurate claim decisions while driving vertical-specific process improvements, compliance, and strategic performance reporting.Lead, mentor, and manage a team of claims adjudicators across Marine, WC, and Property portfolios.End-to-end adjudication authority:make final decisions on claim appro...

About The Role 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(Domestic) - Intermediate 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 ...

About The Role Project Role : Application Developer Project Role Description : Design, build and configure applications to meet business process and application requirements. Must have skills : Duck Creek Claims Good to have skills : NA Minimum 7.5 year(s) of experience is required Educational Qualification : 15 years full time education Summary :As an Application Developer, you will design, build, and configure applications to meet business process and application requirements. A typical day involves collaborating with various teams to understand their needs, developing innovative solutions, and ensuring that applications are aligned with business objectives. You will engage in problem-solv...

About The Role Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 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 mod...