Associate Fraud & Claims Operations Representative Wells Fargo

1.0 - 4.0 years

7 - 17 Lacs

Hyderabad

Work from Office

About this role: Wells Fargo is seeking an Associate Fraud & Claims Operations Representative In this role, you will: Support and capture all pertinent information from customers about their claims Conduct research and provide updates on status of new and existing claims Identify opportunities to improve customer experience after thorough research of complex account activity, and take appropriate actions to handle the claim Perform routine customer support tasks by maintaining balance between exceptional customer service and solid investigative research while answering incoming calls in a call center environment Receive direction from team lead and escalate questions and issues to more exper...

Posted 3 months ago

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Medical Claims Review Advisor Cigna

3.0 - 5.0 years

5 - 7 Lacs

Bengaluru

Work from Office

Provides clinical review expertise for high dollar and complex claims, including facility and professional bills. Provides cost containment services by identifying coding and billing errors and insuring application of Medical and Reimbursement Policies. Additionally identifies cases for potential fraud and abuse and makes referrals. Major Job Responsibilities Evaluates medical information against criteria, benefit plan, coverage policies and determines necessity for procedure and refers to Medical Director if criteria are not met Evaluate itemized bills against reimbursement policies Adheres to quality assurance standards Serves as a resource to facilitate understanding of products Handles s...

Posted 3 months ago

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Executive - Claims Processing - MBBS / BAMS / BHMS Huquo Consulting

2.0 - 7.0 years

5 - 15 Lacs

Kolkata, Patna, Jamshedpur

Work from Office

Full Time Opportunity Location: Goa/Kolkata/Patna/Assam/Jharkhand/Jamshedpur Job Description: - As a claim processing executive you will be responsible for handling all claim related activities on day today basis. - Checking all documents submitted by customers. - Verification of all documents with doctors, hospitals to cross check them for further process. - Coordination with customer if any document is missing or fake. Mentioning remark on every documents. - Coordination with head office to submit claim reports. - Coordination with branch head and other managers for smooth work process. - Maintaining MIS report on daily basis Qualification : MBBS, BAMS, BHMS Experience : 2 to 10 years in h...

Posted 3 months ago

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Executive - Claim Processing - Insurance Huquo Consulting

2.0 - 7.0 years

3 - 5 Lacs

kolkata

Work from Office

- As a claim processing executive you will be responsible for handling all claim related activities on day today basis. - Checking all documents submitted by customers. - Verification of all documents with doctors, hospitals to cross check them for further process. - Coordination with customer if any document is missing or fake. Mentioning remark on every documents. - Coordination with head office to submit claim reports. - Coordination with branch head and other managers for smooth work process. - Maintaining MIS report on daily basis Qualification : MBBS, BAMS, BHMS Experience : 2 to 10 years in health insurance claim processing

Posted Date not available

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