7662 Claims Jobs - Page 41

SUMMARY Retail Staff Opportunity for Freshers ===================================== Summary ----------- We are seeking a dynamic and enthusiastic Retail Staff member to join our team in Rajasthan. As a key member of our retail team, you will be responsible for providing an exceptional customer experience, maintaining a well-organized store environment, and contributing to the overall success of our retail operations. Responsibilities - - - - - - - - - - - - - - - - - - - Folding and stacking merchandise at the basic table Timely displaying received stocks to ensure a visually appealing store environment Maintaining the upkeep of the store section, including ensuring a carton-free floor Ensur...

1 . We Are Hiring AR Callers || Up to 45 K take home Salary || Cab Facility || Incentives || Immediate Joiners || Job Title - Senior AR Caller Eligibility :- Min 8 + Months of experience into AR Calling Package :- Up to 45 K + Incentives + 2 way Cab Facility For Physician Billing ( PB ) - 40 K Take Home salary For Hospital Billing ( HB ) - 45 K Take Home salary Location :- Hyderabad , Bangalore, Chennai, Navi Mumbai Immediate Joiners Preferred Relieving letter is not Mandate WFO Perks and Benefits : incentives allowances 2 way cab If Interested, Kindly share your updated resume to HR. Swetha- 9059181703 References are Welcome 2 . Urgent Requirement Medical Billing Role: Medical Billing & Cha...

Job Summary We are seeking a Sr. Developer with 6 to 8 years of experience in Facets and Claims systems to join our team. The ideal candidate will have expertise in medical coding and charge entry and will work in a hybrid model with day shifts. This role involves developing and optimizing claims processes to enhance efficiency and accuracy contributing to the companys mission of providing top-notch healthcare solutions. Responsibilities Develop and maintain Facets-based applications to ensure seamless claims processing and management. Optimize existing claims systems to improve accuracy and efficiency in processing healthcare claims. Collaborate with cross-functional teams to integrate Clai...

Job Summary We are seeking a Sr. Developer with 6 to 8 years of experience in Facets and Claims systems to join our team. The ideal candidate will have expertise in medical coding and charge entry and will work in a hybrid model with day shifts. This role involves developing and optimizing claims processes to enhance efficiency and accuracy contributing to the companys mission of providing top-notch healthcare solutions. Responsibilities Develop and maintain Facets-based applications to ensure seamless claims processing and management. Optimize existing claims systems to improve accuracy and efficiency in processing healthcare claims. Collaborate with cross-functional teams to integrate Clai...

Roles and Responsibilities Manage a team of Adjudicators to ensure efficient claims processing and resolution. Oversee daily operations, ensuring timely completion of tasks and meeting productivity targets. Develop and implement process improvements to enhance efficiency, quality, and customer satisfaction. Collaborate with cross-functional teams to resolve complex issues related to health insurance claims. Ensure compliance with regulatory requirements, industry standards, and company policies. Desired Candidate Profile 5-10 years of experience in US Healthcare Adjudication (Claims) or equivalent experience in Insurance Claims handling. Strong understanding of health claims processing, incl...

Hiring Guidewire QA (5+ Years) | Insurance Domain Skills Required: • Guidewire Claim Center • Claims Domain • SQL • qTest • CI/CD • API Testing – Postman, SoapUI, Rest Assured • Automation – Selenium, TestNG, Maven • Basic Java/Python Location: Bangalore / Chennai Shift: 2 PM – 11 PM IST Send Resume: thulasi.d@tekskills.in

Hiring for Claims Adjudication Associate Need immediate joiners only Job Summary: We are looking for candidates with hands-on experience in healthcare claims adjudication. The ideal candidate should have a strong background in reviewing, analyzing, and processing medical and hospital claims with accuracy and compliance to organizational guidelines. Key Responsibilities: Review, verify, and adjudicate healthcare claims (professional and facility). Ensure claims are processed accurately as per policy guidelines and benefit coverage. Analyze medical documentation, invoices, and coding to validate claim submissions. Identify discrepancies, incomplete information, or potential fraud indicators. M...

Role & responsibilities Enrolls providers (individually or in groups) with Medicare, Medicaid, and all major private insurance payers. Should have exposure in handling PECOS and NPPES systems - Strong knowledge in CAQH application and Facilitate provider re-attestations of CAQH data as required by CAQH. Verifies completeness and accuracy of application documents, coordinates with onshore team and payer support to obtain all necessary information. Promptly submits applications to ensure maximum reimbursement for all providers. Performs electronic funds transfer (EFT) and electronic remittance advice (ERA) enrollment for all providers, for all applicable payers. Compiles and maintains a list o...

Contract Management: Draft, review, and negotiate commercial agreements: Container leasing agreements – Transport & haulage contracts – Vendor/Transporter agreements – Storage/yard agreements – Shipping line contracts – Customer service agreements (CSA/SLAs) • Maintain contract repository and ensure timely renewals. • Ensure all contracts follow company risk guidelines, liability clauses, and insurance requirements. Claims, Disputes & Litigation Manage container damage claims (P&I, cleaning, repair charges). • Handle demurrage/detention disputes with customers and shipping lines. • Coordinate with external lawyers on litigation, arbitration, and recovery matters. • Support operations teams d...

Overview Managing Deduction claims and Invoice claims processing in SAP TPM Assist with promotional event enrolments / claim approvals. Ensure all customer contract legends are current to provide Trade Promotion Analyst guidance. Maintain a strong control environment with accurate trade accruals, contract approvals and verification. Manage exception through verbal and written interactions with Sales and Sales Finance. Responsibilities Managing Deduction claims and Invoice claims processing in SAP TPM Assist with promotional event enrolments / claim approvals. Ensure all customer contract legends are current to provide Trade Promotion Analyst guidance. Maintain a strong control environment wi...

Review claims processed by the team for correctness and completeness. Serve as SPOC for stakeholders addressing inquiries and providing updates. Guide the team of processors and oversee their performance. Diligently attend to escalation

About The Role About The Role - Grade Specific Experience 3 to 15 years Skills Guidewire Developer experience with any of the detailed skill like (Policy / Billing / Claims / Integration / Configuration / Insurance Now / Portal / Rating) Insurance domain knowledge with Property & Casualty background Hands on experience in at least one of the Guidewire products (Claim/Policy/Billing) Should have knowledge on Admin data loading. Good knowledge in Web services, XML, GxModel, Messaging, Batch implementation, Integrating with 3rd Party Systems and Document composition tools like Xpressions, Thunderhead Experience on any database Oracle / SQL Server and well versed in SQL Designed & modified exist...

Designs, plans, develops and manages a product or portfolio of products throughout the solution portfolio lifecycle: from new product definition or enhancements to existing products; planning, design, forecasting, and production; to end of life. Management Level Definition: Contributions impact technical components of HPE products, solutions, or services regularly and sustainable. Applies advanced subject matter knowledge to solve complex business issues and is regarded as a subject matter expert. Provides expertise and partnership to functional and technical project teams and may participate in cross-functional initiatives. Exercises significant independent judgment to determine best method...

Designs, develops, troubleshoots and debugs software programs for software enhancements and new products. Develops software including operating systems, routers, networks, utilities, databases and Internet-related tools. Determines hardware compatibility and/or influences hardware design. What you ll do: Designs enhancements, updates, and programming changes for portions and subsystems of systems software, including operating systems, compliers, networking, utilities, databases, and Internet-related tools. Analyzes design and determines coding, programming, and integration activities required based on general objectives and knowledge of overall architecture of product or solution. Writes and...

Designs, develops, troubleshoots and debugs software programs for software enhancements and new products. Develops software including operating systems, routers, networks, utilities, databases and Internet-related tools. Determines hardware compatibility and/or influences hardware design. What you will do: Designs enhancements, updates, and programming changes for portions and subsystems of systems software, including operating systems, compliers, networking, utilities, databases, and Internet-related tools. Analyzes design and determines coding, programming, and integration activities required based on general objectives and knowledge of overall architecture of product or solution. Writes a...

Broad understanding of the category product, business management and sales challenges and strategies. Actively contributes to the definition of the category business plan. Establishes relationships and represents team with sales force and other partners at senior level. Product line and quota responsibility for a significant share of the product range, or a specific customer segment. Functional responsibility for the team in one or several areas (market analysis, marketing engagement, SF communication etc). May participate in engagement partnership with external IT vendor. What you need to bring: University or Bachelors degree in Marketing or Finance. Typically 5-8 years of professional expe...

Firstsource Solutions is a leading provider of customized Business Process Management (BPM) services. Firstsource specialises in helping customers stay ahead of the curve through transformational solutions to reimagine business processes and deliver increased efficiency, deeper insights, and superior outcomes. We are trusted brand custodians and long-term partners to 100+ leading brands with presence in the US, UK, Philippines, Mexico and India. Our 'rightshore' delivery model offers solutions covering complete customer lifecycle across Healthcare, Telecommunications & Media and Banking, Financial Services & Insurance verticals. Key Responsibilities Claims Processing Review and process medic...

ESSENTIAL RESPONSIBILITIES: Describe the essential responsibilities in order of importance: Begin each responsibility with an action verb. Claims Reporting Evaluate claims to ensure sufficient information is available for loss reporting. Submit claims to carriers and confirm receipt along with adjuster assignment. Manage claims intake queues, including new claims and exceptions. Ensure compliance with offshore reporting criteria for claims processing. Cross-verify reported claims and maintain accurate documentation. Claims Acknowledgment Send acknowledgment emails for claims information received via calls with insurance carriers. Follow special handling instructions for specific claims categ...

Job Title: * Broking Operations * Claims Assistant * Technical Accountant * Credit Control Work Mode : 5 days work from office Working Hours : Monday to Friday (9am to 6pm) Key Responsibilities: Manage reinsurance operations including treaty and facultative arrangements. Handle London Market processes , cover slips, and binding authority agreements . Perform pre-binding checks , risk logging, risk binding, and passing endorsements. Oversee technical accounting , reinsurance accounting , and treaty accounting . Manage credit control , cash allocations, and broker settlements. Support claims processing and assist in endorsements and underwriting tasks. Maintain strong knowledge of broker busin...

EPAM Anywhere is looking for Lead Business Analyst - Healthcare Payer Domain (SME) to join our dynamic team and embark on a rewarding career journey We are looking for a skilled Lead Business Analyst with expertise in the Healthcare Payer Domain to join our team at EPAM Anywhere. The ideal candidate will have a strong background in business analysis and experience working with healthcare payers. Roles and Responsibility Collaborate with cross-functional teams to identify business requirements and develop solutions. Conduct interviews with stakeholders to understand their needs and provide recommendations. Develop and maintain documentation of business processes and procedures. Analyze data t...

EPAM Anywhere is looking for Lead Business Analyst - Healthcare Payer Domain (SME) to join our dynamic team and embark on a rewarding career journey We are looking for a skilled Lead Business Analyst with expertise in the Healthcare Payer Domain to join our team at EPAM Anywhere. The ideal candidate will have a strong background in business analysis and experience working with healthcare payers. Roles and Responsibility Collaborate with cross-functional teams to identify business requirements and develop solutions. Conduct interviews with stakeholders to understand their needs and provide recommendations. Develop and maintain documentation of business processes and procedures. Analyze data t...

What are we looking for? We are looking for candidates to join us as a part of our Technology team as a Senior Business Analyst Total Experience Range: A minimum experience of 6-9 years Skill Set : • Strong knowledge of Life Insurance products. • Deep Knowledge of Life insurance process (quote, policy issuance, finance, claims).Expertise in any one of the processes is a must. • Hands-on experience with SQL and API Integration • In-depth Understanding of Java, microservices, and web services is an added advantage • Excellent communication/interpersonal skills Job Requirements : • Liaise with the internal business team (Sales, Underwriting, Actuary, Operations, Claims and Finance) and external...

Role: Manager Contracts Exp: 7-12 Years Location: Gurugram HR Domain/Industry: Real Estate Developments Job Role and Key Deliverables: Project Coordination: 1. Ensure coordination with Project Team, Architects, Contractors, vendors, consultant for smooth Tendering & Contract Management of the project 2. Ensure regular meeting with all internal & external stakeholders and ensure the tender drawings, specifications are updated as per consultant input , Assist CTO for all contract claim 3. Knowledge of applicable taxes in construction contracts. Cost Management, BOQ and Estimation 4. Ensure adoption of efficient methods/ measures of costing based on the various consumables used in the projects....

Role and Positions: GM/ Senior GM Contract Exp: 16-25 Years Location: Gurugram HR Industry: Real Estate Developments Academics: BE/ B Tech Civil Engineering, PGDM/ NICMAR/ MBA/ RICS will be plus Role Objective : This role mainly focuses on overseeing all aspects of contract management within construction projects Ensure smooth execution of contracts, manage daily correspondence, participate in meetings, and manage the contractual closing stage Key Job Responsibilities: 1. Lead end-to-end contract lifecycle management for projects from pre-contract to post-contract stages 2. Draft, review, negotiate, and finalize various types of contracts (e g, construction contracts, consultancy agreements,...

Responsibilities: * Pitch for renewals of insurance for commercial vehicles. *Make quotations and Policy of the same.