6244 Claims Jobs - Page 4

Title: IT Systems Analyst II Level: P3-II Quick role description: This person will be a critical member of Lumen s software asset management (SAM) team, focusing on support of software licensing for desktop and personal productivity tools. The person will also support Lumen s Lead SAMs in the proactive assessment of Lumen s software licensing compliance and the execution of supplier-initiative license audits. JD: Skills required: Software asset manager (SAM) Foundational knowledge of IT software licensing and compliance. Understanding of a variety of personal productivity and desktop software products, including Microsoft, Adobe, Quest, and other suppliers. Understanding of software licensin...

ROLES & RESPONSIBILITY: Process health insurance claims efficiently and accurately. Handle interactions with both corporate and retail clients. Ensure compliance with company and regulatory guidelines during claim processing. Coordinate with internal teams and external stakeholders for claim resolution. Maintain proper documentation and records of claims processed. Draft professional emails and prepare reports using MS Office tools. CANDIDATE BACKGROUND: 6 months to 5 years of experience, preferably with a TPA, insurance broker, or insurance company. Prior experience in health claim processing is essential. Familiarity with PSU insurance broker companies will be an added advantage. Basic pro...

Overall Purpose of the Role Ensuring timely and quality fulfilment of customer s service requests. Areas of Responsibility Interact/Coordinate with Repair partners to fulfil service requests in defined TAT. Provide superior customer service Validation of job sheets/estimates/invoices/other documents required for claims approvals & fulfillment. Ensuring regular updates in system Qualification & Experience Required Graduate / Diploma in Electronics /telecommunication. Upto 5 years of experience Experience as a Service Coordinator/Executive in electronics repair industry desirable. Skills Required Customer orientation Team working skills Quick Learnability skills and adaptability Highly organiz...

Company description Ferrero is a family-owned company with a truly progressive and global outlook and iconic brands such as Nutella , Tic Tac , Ferrero Rocher , Raffaello , Kinder Bueno and Kinder Surprise . As the love for our brands continues to grow, so too does our global reach. Represented in more than 50 countries, with products sold in more than 170, the Ferrero Group is loved by generations around the world. The secret to our global success40,000 dedicated employees who celebrate care and quality to craft a business, careers and brands we are proud of. Join us, and you could be one of them. Diversity Statement Ferrero is committed to building a diverse and inclusive culture in which ...

ROLES & RESPONSIBILITY: Knowledge Non EB insurance like Property/Liability insurance is a must, having at least 4+ years of experience in handling Property/Liability insurance quotes, preferably from the broker environment experience. Quote submission TAT adherence within 2-3 working days. A routine coordination with the sales team for the closure and conversion of the submitted quotes End to end processing of endorsement and claim requests for Property/Marine/Liability business. Maintaining various MIS of daily processed cases for various business reports. Should be well versed with excel and be able to work with the online tools for quote preparation that are provided by insurers Coordinat...

Assist in the revenue cycle process by performing administrative tasks such as data entry, claim preparation, and basic follow-up on claims. Ensure accurate patient information is recorded in the system, including insurance details, patient demographics, and procedures. Assist with tracking claim statuses and identifying missing or incorrect information for resubmission. Monitor claim rejection reasons and assist in making necessary corrections to resubmit claims for processing. Provide support to senior team members by managing smaller or routine tasks, such as processing payments or preparing documentation. Help maintain and update patient and insurance records in the system. Collaborate w...

Manage more complex tasks related to revenue cycle processes, including reviewing claim rejections, resolving billing discrepancies, and following up on denied claims. Provide leadership and mentoring to junior process associates, ensuring they understand procedures and provide quality work. Assist with the coordination of processes between coding, billing, and collections departments to improve overall workflow efficiency. Work with payers to investigate and resolve claim denials, ensuring that all necessary documentation and evidence are provided for reconsideration. Perform quality checks and audits on claims and billing to ensure compliance with healthcare regulations. Contribute to proc...

Review clinical documents, medical records, and physician notes to assign appropriate codes for diagnoses, procedures, and treatments based on established coding standards (ICD-10, CPT, HCPCS). Ensure codes used for billing are accurate and comply with insurance and government payer requirements. Collaborate with healthcare providers and other departments to clarify diagnoses and procedures, ensuring proper code assignment. Stay updated on coding guidelines, regulations, and changes in healthcare billing practices. Submit coded claims to the billing department or insurance companies for reimbursement. Conduct audits to ensure accurate coding and prevent compliance issues. Requirements and sk...

Submit medical insurance claims to various insurance companies for services rendered, ensuring the claims are complete and accurate. Communicate with insurance companies to verify claim status, identify issues, and follow up on unpaid or denied claims. Review patient accounts for accuracy, including charges, insurance details, and co-payments. Prepare and send patient billing statements, explaining charges and payment due dates. Maintain and update billing records to ensure all charges are processed and payments are properly applied. Address patient inquiries regarding billing discrepancies, payment options, and insurance coverage. Requirements and skills: Knowledge of medical billing codes ...

Verify and validate patient insurance coverage and eligibility before services are provided, ensuring there are no billing surprises later. Coordinate with healthcare providers to ensure accurate submission of claims in line with insurance requirements. Work with insurance companies to resolve discrepancies or denials related to patient coverage and claims. Educate patients about their insurance benefits, co-pays, deductibles, and any potential out-of-pocket costs. Maintain detailed records of insurance communications, including coverage verification and claim submission details. Assist patients and the healthcare team in resolving insurance-related issues and ensuring smooth processing. Req...

Manage the entire billing process for patients, ensuring accuracy in charges and coding before submitting claims to insurance companies. Review and verify insurance information for accuracy and completeness. Follow up on denied or unpaid claims and work with insurance companies to resolve any discrepancies. Create and send patient invoices, ensuring transparency and clarity of all charges. Track payments and apply them correctly to patient accounts, ensuring timely and accurate payment collection. Assist with insurance audits, resolving any discrepancies found and ensuring proper billing practices. Maintain patient billing records and respond to patient inquiries regarding their bills. Requi...

Follow up on unpaid or overdue accounts, ensuring prompt collection and payment from insurance companies and patients. Communicate with insurance providers, patients, and healthcare facilities to resolve payment issues. Review unpaid claims, analyse discrepancies, and resolve billing issues with insurers or patients. Ensure accurate and timely posting of payments in patient accounts and update insurance records. Prepare aging reports, track outstanding accounts, and generate follow-up tasks for timely resolution. Work closely with the billing department to reconcile accounts and prevent payment delays. Maintain knowledge of payer contracts, reimbursement rates, and payer-specific requirement...

Overall Purpose of the Role Job purpose is to build & implement a strong Influencer Program that ensure channel partner alignment & operational synergy in achieving day to day objectives not just limited to sales but also focussed on sales pitch quality, training & data driven planning. Also to ensure optimal productivity of internal sales success resources and targeted level of performance on the agreed KPI : Training effectiveness, data driven decisions making , channel relationship & in market issue resolution Areas of Responsibility Work closely with client s regional leadership team and maintain good business relationship. Effectively lead the team of DSM/Promoters/Shop Owners and manag...

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 ACTIVITIES Assi...

About ProcDNA ProcDNA is a global consulting firm. Wefuse design thinking with cutting-edge technology to create game-changing Commercial Analytics and Technology solutions for our clients. Were a passionate team of 275+ across 6 offices, all growing and learning together since our launch during the pandemic. Here, you wont be stuck in a cubicle youll be out in the open water, shaping the future with brilliant minds. At ProcDNA, innovation isnt just encouraged;its ingrained in our DNA. Ready to join our epic growth journey. What are we looking for As a Data Scientist- I, you will play a key role in delivering end-to-end data science solutions across pharmaceutical and healthcare engagements....

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...

Digitalization & Transformation Partner with business functions to identify high-impact digital transformation opportunities. Work closely with functional heads and business users to understand challenges and translate them into digital use cases. Reimagine manual or repetitive processes using AI/ML and automation tools. Collaborate with IT and functional leaders to execute the identified projects end-to-end. Evaluate application of Agentic AI solutions across functions and drive its adoption AI/ML Solutioning & Implementation Conceptualize, prototype, and deploy AI-driven solutions to enhance process efficiency, accuracy, and customer experience. Evaluate use cases such as claims automation...

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

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...

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...

Consulting Skills, Client Knowledge, And Client Service Delivers on new/ adhoc tasks in order to meet client/ internal goals promptly Seeks and accepts feedback from coaches mentors to enhance knowledge and capabilities Prioritizes work as required Required Candidate profile Back End Experience: 2-4 yrs Shift Timing: 1.30 pm to 11 pm IST (UK Shift) Excellent communication skills Excellent understanding of the organization's goals and objectives. Perks and benefits PF 1-way drop Cab