4480 Claims Jobs - Page 3

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...

JOB SUMMARY Assists in carrying out the daily activities of the Human Resource Office including recruitment, total compensation, and training and development. Additionally, he/she assists in delivering HR services that meet or exceed the needs of employees and enable business success; as well as ensuring compliance with all applicable laws, regulations and operating procedures. CANDIDATE PROFILE Education and Experience High school diploma or GED; 2 years experience in the human resources, management operations, or related professional area. OR 2-year degree from an accredited university in Human Resources, Business Administration, or related major; no work experience required. CORE WORK ACT...

Role Summary In the above context, the RMrole is responsible to supervise the business delivery under Banca team and Tie Ups& primarily grow the business with profits, Channel Management Managing Banks, NBFCs and other Micro Finance companies.Also liaising with Operations & Product tower, Process Excellence group, Claims,Finance,legal, Business Intelligence, marketing & Human Resource teams for the process. Ensuring that we deliver best of our services to client as well as to banks. Key Accountabilities/ Responsibilities Responsible for Achieving overall Gross Written Premium Team Management. Channel Relationship. Visit Branches Conduct Meetings Regular training of Bank employees regarding T...

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...

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...

Drafting and pleading skills will be considered as added advantage. The candidate should be conversant with mail culture and must know basic computer knowledge like Excel, word, Power point etc. , with typing speed Knowledge on Motor vehicle act or exposure in MV act will be considered as added advantage. Tracking of each Matter from Claims Dairy Co-ordination with other department of mandatory requirements - ILM, Operation, Underwriting etc. Smooth Processing of Claim

Lead Causal Inference Studies : Design and implement advanced causal models (e.g., Double Machine Learning, instrumental variables, propensity score analysis) to isolate the causal effects of specific nutritional interventions on health outcomes like glycemic response. Develop Next-Generation Algorithms: Conduct in-depth statistical analysis of clinical and biometric data to build the core logic for personalized health recommendations, ensuring they are grounded in causal evidence. Build & Validate Predictive Models: Develop and validate sophisticated machine learning models for prediction, while also working to distinguish correlational patterns from causal drivers in the data. Design and A...

Provides professional medical, technical, consulting advice, and recommendations in support of claims evaluation, investigation, and assessment for various claims-related departments, while managing assigned caseload of complex case applying specialized training and knowledge to the assessment of cases and acting as a resource on clinical and technical issues. Conducts complex research, review and analysis of medical records, treatment plans and claim information. Provides recommendations regarding claimants current potential functional abilities and develops goal-focused return-to-work plans. Assess training needs and creates, authors, and presents medical training to claim and business par...

Requisition No - R-1165187 Position Title: Senior Hospital Sales Executive Grade:1B Reporting: Zonal Hospital Sales Manager Location: Mumbai Job Purpose: Hospitals are the first point of care for patients in top tier markets because of the need for quality healthcare and assured health services. To harness the opportunity that lies within hospitals, a dedicated Key account management team with customized Marketing interventions. The purpose of this role would therefore be to: Scan the hospital environment for new business opportunities for hospital consumed HUL brands Identify opportunities in different type of hospitals by evaluating risks, formulating action plans, implementing key strateg...

JOB SUMMARY Assists in the management of the daily functions of the department to ensure protection of property assets, employees, guests and property. Maintains logs, certifications and documents required by law and Standard Operating Procedures. Assists in the training of staff in established emergency procedures and implements accident and fire prevention procedures. Position focuses on ensuring guest and employee satisfaction while achieving the operating budget. CANDIDATE PROFILE Education and Experience High school diploma or GED; 3 years experience in the security/loss prevention or related professional area. OR 2-year degree from an accredited university in Criminal Justice or relate...

Responsibilities & Key Deliverables To guide the Service Mechanics in technical problem solving and de-bottlenecking at the dealerships. To increase dealers profitability by service schemes like annual maintenance contracts, service improvements etc. To project the service activities, initiatives taken in the area office in the organization for cross fertilization of ideas To provide a single window between the area office and the other departments of the company on all service matters. To provide feedback on competition new service schemes launched to the head of service and the zonal sales managers. To interface with the marketing service cell and the manufacturing cell at the HO for speed...

Job Description: We are seeking a highly motivated and detail-oriented IP Associate with a strong background in Chemistry and Intellectual Property Rights (IPR) to join our growing team in the pharmaceutical sector. The ideal candidate will be responsible for managing and protecting the company s intellectual property assets, particularly in the areas of drug development and innovation. This role involves close collaboration with R&D, legal, and regulatory teams to ensure alignment of IP strategy with business goals. Key Responsibilities: Patent Drafting & Filing Draft and file patent applications in India and internationally (PCT, USPTO, EPO, etc.). Prepare technical documents and claims in...

JOB SUMMARY Manages the daily functions of the department to ensure protection of property assets, associates, guests and property. Maintains logs, certifications and documents required by law and Standard Operating Procedures. Trains staff in established emergency procedures and implements accident and fire prevention procedures. Position focuses on ensuring guest and associate satisfaction while achieving the operating budget. CANDIDATE PROFILE Education and Experience High school diploma or GED; 4 years experience in the security/loss prevention or related professional area. OR 2-year degree from an accredited university in Criminal Justice or related major; 2 years experience in the secu...

Job Description: Key Responsibilities Design, develop, and maintain dashboards and reports to support RCMS operations, including work allocation, production efficiency, and performance tracking. Partner with the U.S. Director of Operations, RCMS, to align on departmental metrics, KPIs, and reporting standards. Collaborate with RCMS Revenue Optimization team to analyze RCM data (claims, denials, collections, AR) to identify operational trends, risks, and opportunities for improvement. Create scalable data models and visualizations to support customer and internal decision-making. Ensure data accuracy, integrity, and usability across all reporting and dashboarding tools. Support ad hoc reporti...

Job Title Sr Product Manager Job Description Sr Product Manager We are seeking Senior Product Manager who will drive the definition, development and introduction of winning propositions for the market of Image Guided Therapy Systems and other complementary modalities, enabling our customers to deliver the best possible patient care at optimal economical value while performing minimal invasive cardiovascular procedures. Your Role: Contribute to the definition of the integral proposition of the product based on market- and customer insights, including value proposition, supporting claims, pricing strategy, offer design, target customers and markets. Responsible for lifecycle management of our ...

1. JOB PURPOSE The Intake Care Supervisor directs the activities of staffs who are adjudicating and finalizing Pre-authorizations. As a subject matter expert to take an initiative in assisting team requirements pertaining to the operational software and tasks related to the policy coverage terms. 2. RESPONSIBILITIES AND DUTIES Perform job supervisory duties to assure proper training, instructions, and development of staff. Control cost by all permissible, equitable, fair means. Closely coordinate with the Reporting Manager on staff performance reviews and leave scheduling; Delegate and oversee activities performed by claims examiners. Daily monitoring of pipelines and queues. Identify traini...

Address inbound customer questions and concerns arriving via phone and email Own the entire interaction with that customer and provide total resolution for their needs Work with other associates, product managers, and partners to gather information, resolve customer needs, and improve processes Investigate and resolve customer inquiries related to their orders or shipments Update systems and document all interactions with customers, associates, and partners Provide order status, check inventory, schedule returns, file shipping claims, notate accounts, troubleshoot problems, handle complaints, and assist with billing inquiries Efficiently and professionally communicate with customers and assi...

The Senior Developer in the Technology Consulting team will work on various EIS implementation projects for our customers across the globe. Serve as a senior developer on Duckcreek implementation projects. Participate in and provide technical recommendations during technical and architectural discussions. Provide periodic updates to the Project Manager on deliverables. Mentor the project team in executing identified projects. Support the Project Manager in status reporting to leadership and onsite coordinators. Identify and escalate blockers and risks to the Project Manager/Scrum Master, ensuring appropriate mitigation and contingency plans are in place. Interface with customer representativ...

J.P. Morgans Commercial & Investment Bank is looking to hire a top performing Executive Assistant to support diverse teams. The Executive Assistant role requires support with a structured approach, attention to detail, and high energy in a fast-paced, deadline-driven environment. The candidate will interact with executive-level clients across various business lines, adapt procedures to meet department goals, and perform confidential administrative tasks for executives, managers, and stakeholders. They are expected to excel in a team setting, professionally represent the manager or group, and produce high-quality work. As an Executive Administrative Assistant, youll handle various confidentia...

Internal Title: Data Science Advisor External Title: Data Science Advisor Role Summary As a member of the Data Science Center of Expertise (DSCOE), the DS Advisor is responsible for leading and enabling Data Science within Cigna Group with demonstrable aptitude in Data Science (i) Technical Skills (ii) Leadership (iii) Scope & Impact (iv) Influence. Please see Qualifications section below for more details. The role will support the development and maintenance of proprietary advanced neural network ( AI ) foundation models in support of Cigna s business operations. Key Responsibilities: Write code using PyTorch and/or Tensorflow to implement, test, and operationalize deep learning models Coll...

Retail Claims - Automation & ProjectsKey Responsibilities1 Automate Claims Processes- Design anddevelop automated workflows and business rules to streamline claims processing Integrate with Existing Systems- Integrateautomated claims processing solutions with existing systems and technologies Testing and UAT - Test and validateautomated claims processing solutions to ensure accuracy and efficiency Daily production issue - Troubleshootissues and resolve problems related any day-to-day production issues across allclaim systems for death and health claims5 Collaborate with IT stakeholders, claim team and other requiredstakeholders to understand requirements and implement solutions6 Strong techn...

Downloads deposit files from lock box accounts2 Posts payments, denials, and adjustments from all payers3 Review all remittance advices for accuracy to identify errors or questionable data4 Researches and resolves unapplied/unidentified cash receipts5 Reviews postings to ensure payment is applied appropriately, corrects payment posting errors for the sites, and submits refund requests6 Assists with the follow up requests for medical records, continuing claim reports PRs, and other information related to claims that are on the no activity report7 Prepares and submits check requests to Accounting for payment of invoices