4512 Claims Jobs - Page 47

How will you make an impact in this role Perform Manual review on accounts claimed as Fraud by card members/Third parties/POAs and Victims. Ensure accurate analysis of Fraud Application Claims and make sound decisions to approve or decline the same through systematic analysis Meet and endeavor to exceed metrics on quality, compliance regulations and productivity/efficiency as per goals sheet Highlight issues through feedback and recommend changes in workflows, procedures, service levels, based on customer demands to meet their needs and ensure quality service is given at all times Balance customer interests with the interests of American Express Quality focused with strong attention to detai...

Responsibilities: Investigate and resolve complex denial issues. Analyze denial trends to identify opportunities for process improvement. Initiate and lead payer calls for escalated denial inquiries, follow-ups, and disputes. Develop and implement strategies to reduce denial rates and enhance reimbursement. Collaborate with internal stakeholders to address root causes of denials. Prepare and submit appeals for denied claims as needed. Maintain comprehensive documentation of denial activities and outcomes. Requirements: Associate degree in healthcare administration or a related field (preferred). Minimum of 1-2 years of experience in AR/Denial management or revenue cycle management.

About Syfe Syfe is a digital investment platform with a mission to empower people to grow their wealth for a better future. Built on the pillars of advice, access and innovation, we cater to the full spectrum of an individuals wealth needs across diversified proprietary portfolios, cash management solutions and a state-of-the-art brokerage. The Syfe team combines world-class financial expertise with best in-class technology talent. Excellence in execution is in our DNA and we offer equity ownership to all employees regardless of seniority and designation. We are regulated by the financial authorities across Singapore, Hong Kong and Australia. In Singapore alone, where we are headquartered, o...

Job Summary: The Health Care Billing Executive is responsible for managing and overseeing the billing process within a healthcare facility. This role involves preparing and submitting medical claimsverifying insurance informationfollowing up on unpaid claimsand ensuring compliance with healthcare regulations and policies. The executive plays a key role in optimizing revenue cycle management and maintaining clear communication between patientshealthcare providers etc., Job Responsibilities: Medical Billing: Prepare and submit accurate medical claims to insurance companies and government health programs (Schemes). Insurance Verification: Verify patient insurance coverage and eligibility before...

We are seeking a detail-oriented Associate to join our team for a real estate lending client. This position involves handling various tasks related to Updating financial statements of borrowers, analysis of P&L, Incorporating data from loan documents, underwriting documents, and appraisal documents for sizing the deal and supporting underwriting decisions Validating claims Weekly/ Monthly reporting The ideal candidate will have experience working with income statements, balance sheet and should have strong analytical skills and should be comfortable working on excel. Core Competencies: Service Orientation Should be aware of both - the internal as well as external customers and their needs; a...

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 TAGIC Product...

Job Title: Global Fabric Cleaning Powders Ecodesign R&D Associate Business Group: Home Care (R&D) Location: Bengaluru BUSINESS CONTEXT Fabric Cleaning Powders is the largest format by volume and turnover in the Home Care portfolio globally. As per the new Share that Matters strategy in Home Care, the focus in Powders is to grow share in selective Power Growth Cells in our key markets. This is achieved through Unmissable Brand Superiority by delivering Product Superiority against local and global competitors. Further, the business needs Fuel for Growth from scale formats like Powders. This is needed to drive disproportionate growth in new formats of the future. Globally, Powders have been con...

Skill required: Retirement Solutions - Customer Service Designation: Customer Service Analyst Qualifications: Any Graduation Years of Experience: 3 to 5 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 We are dealing with individual retirement of variable annuity and here...

Job Summary: This role is about managing one of our independent franchise bottlers Superior Group, with volume for the Company. These markets come with their unique characteristics and challenges, so the role will require crafting both a long-term vision as well as working on tactics, collaborating with Bottler teams and BU functional leads to deploy the strategy. Bring to life the networked organization- as there are related resources sitting in different functions across the OU. This role must be able to articulate business strategy clearly and align multiple stakeholders who come from different functional backgrounds. Internal interface will include other departments, bottlers, Next gen, ...

Job Summary: This role is about managing one of our independent franchise bottlers Superior Group, with volume for the Company. These markets come with their unique characteristics and challenges, so the role will require crafting both a long-term vision as well as working on tactics, collaborating with Bottler teams and BU functional leads to deploy the strategy. Bring to life the networked organization- as there are related resources sitting in different functions across the OU. This role must be able to articulate business strategy clearly and align multiple stakeholders who come from different functional backgrounds. Internal interface will include other departments, bottlers, Next gen, ...

Skill required: Retirement Solutions - Customer Service Designation: Customer Service Analyst Qualifications: Any Graduation Years of Experience: 3 to 5 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 We are dealing with individual retirement of variable annuity and here...

Skill required: Retirement Solutions - Customer Service Designation: Customer Service Analyst Qualifications: Any Graduation Years of Experience: 3 to 5 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 We are dealing with individual retirement of variable annuity and here...

Job Description Role Assistant Area Sales Manager Location Lucknow RO Function Customer Development Responsibilities: Customer Infrastructure & satisfaction: The AASCM is responsible for ensuring a robust Customer Infrastructure is in place in the territory. Distributors are appointed by the AASCM wherever necessary, and it is his responsibility to track their overall performance on key metrices. AASCM is supposed to optimize the quantity & quality of customers in his area such that there are no service gaps while ensuring adequate service levels for trade and financial viability for customers. He monitors the financial health and profitability of all Customers. The AASCM also needs to step ...

Summary ofroleThe roleinvolves building robust fraud detection frameworks, managing investigationsthrough empanelled risk agencies, engaging with law enforcement and businessteams, and driving awareness across teams Key ResponsibilitiesDevelop and implement fraud risk frameworks across customer and distributors life cycle Monitor transactions, claims and sales practices to identify red flags and fraud patternsLead and manage investigations of suspected fraud cases through empanelled risk agencies, ensuring timely closure with quality reporting Evaluate and monitor performance of risk agencies to ensure adherence to defined SLAs and investigation quality standards Drive vendor staff training ...

Skill required: NA - Business Transformation Designation: Business Transformation Specialist Qualifications: Any Graduation Years of Experience: 7 to 11 years What would you do? In this role, you will be expected to develop transformation vision, assess vision feasibility and capability gaps, plan journey management. Also, translate economic trends into industry competitive advantage, transform a business to enable profitable & sustainable growth.Develop transformation vision, assess vision feasibility and capability gaps, plan journey management. Translate economic trends into industry competitive advantage, transform a business to enable profitable & sustainable growth. What are we looking...

About The Role Skill required: NA - Business Transformation Designation: Business Transformation Specialist Qualifications: Any Graduation Years of Experience: 7 to 11 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 In this role, you will be expected to develop transform...

Skill required: NA - Business Transformation Designation: Business Transformation Specialist Qualifications: Any Graduation Years of Experience: 7 to 11 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 In this role, you will be expected to develop transformation vision, a...

Skill required: NA - Business Transformation Designation: Business Transformation Specialist Qualifications: Any Graduation Years of Experience: 7 to 11 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 In this role, you will be expected to develop transformation vision, a...

Job Summary: The Senior Team Lead AR is responsible for overseeing the day-to-day operations of the Accounts Receivable team handling US healthcare clients. This role ensures timely billing, collections, denial management, and resolution of outstanding claims while mentoring team members and driving key performance indicators(KPI) Key Responsibilities: Lead and manage a team of AR executives and specialists. Monitor and ensure timely follow-up on unpaid claims. Analyze aging reports and implement strategies to reduce AR days. Handle escalations and resolve complex claim issues. Ensure compliance with HIPAA and payer-specific guidelines. Create, update, and implement SOPs for AR processes inc...

Job_Description":" Job Objective Overseeand monitor the overall safety, security, nautical and commercial operation(including commercial effectiveness and voyage efficiency) of the assignedships. Key Accountabilities Support Companystrategic goals Monitor updates and proposeimprovements in safety, security, commercial effectiveness, voyageefficiency and incident correctiveactions. Drive and provide recommendationsin improving automation and smart operation services for the Chartering andPerformance Modules. Review all necessary vesselinspection reports, quarterly financial reports, and documentation concerningvessel performance and operational issues and submit recommendations to Owners. Con...

Job Summary: The Senior Team Lead AR is responsible for overseeing the day-to-day operations of the Accounts Receivable team handling US healthcare clients. This role ensures timely billing, collections, denial management, and resolution of outstanding claims while mentoring team members and driving key performance indicators(KPI) Key Responsibilities: Lead and manage a team of AR executives and specialists. Monitor and ensure timely follow-up on unpaid claims. Analyze aging reports and implement strategies to reduce AR days. Handle escalations and resolve complex claim issues. Ensure compliance with HIPAA and payer-specific guidelines. Create, update, and implement SOPs for AR processes inc...

Summary: Technical expert with depth or breadth of knowledge within Quality Review and Audit. Applies standard techniques and procedures to routine instructions but requiring professional knowledge in specialist areas. Provides standard professional advice and creates initial reports/analyses for review. Develops and distributes audit reports. Assists with third party audits by completing questionnaires, validating selected claims, responding to errors, etc. Identifies and recommends changes to improvements in department processing and procedures and assists in the development of audit guidelines. May develop and/or recommend training programs to address error trends. Provides guidance, coac...

You will play a key role in designing, developing, and deploying AI solutions tailored to pharmaceutical clients. You will collaborate with cross-functional teams including data scientists, business consultants, and software developers to translate complex life sciences challenges into AI-driven innovations Well trust you to: Design and implement AI/ML pipelines that solve real-world problems in life sciences (e.g., territory alignment, rep scheduling, patient segmentation, incentive compensation optimization). Work closely with domain consultants to understand client requirements and develop tailored AI solutions. Lead efforts in data ingestion, feature engineering, and model development ac...

As a Market Access Consultant, you will collaborate with cross functional and cross geographic teams to deliver high impact market access, pricing, and contracting insights. You will partner with clients Value & Access, Brand, and Commercial teams to drive data driven decision making through advanced data wrangling, modeling, and real world evidence analyses. This position offers a solid foundation for career growth in Market Access leadership roles. Well trust you to: Design and execute market access projects, including payer landscape assessments, formulary access analyses, deep dives into access barriers, contracting scenario modeling, and contract operations. Extract, clean, and integrat...

Responsibilities & Key Deliverables Act as the single point of contact for corporate & fleet customers in the assigned zone for all service-related requirements. Ensure seamless after-sales support: preventive maintenance, breakdown support, parts availability, and warranty claims. Monitor and improve fleet uptime, service TAT (Turnaround Time), and customer satisfaction. Coordinate with dealers, workshops, and technical teams to deliver consistent service quality. Drive service revenue growth through AMC (Annual Maintenance Contracts), extended warranties, and value-added services. Track and report service KPIs (downtime reduction, complaint resolution). Handle escalations & critical issues...