3743 Claims Processing Jobs

Hiring for leading insurance company for US Claims process Graduate with min 3 years End to end Claims experience is mandate US shift SAT-SUN OFF Package upto 8 LPA Viman Nagar, Pune CALL US 93254 29799 / 87669 05361

Minimum of 2 years of experience in physician revenue cycle management and AR calling. Basic knowledge of claim form 1500 and other healthcare billing forms. Proficiency in medical coding tools such as CCI and McKesson. Familiarity with payer websites and their processes. Expertise in specialties including cardiology, radiology, gastroenterology, pediatrics, orthopedics, emergency medicine, and surgery. Understanding of Clearing House systems like Waystar and e-commerce platforms. Excellent communication skills. Should be a Graduate. Comfortable to Work in Night Shifts. Ready to join immediately or 15Days NP. other benefits: Night shift Allowance (100 Per Working Day) Saturday and Sunday Fix...

Responsibilities: The Claim Adjustment Specialist is responsible for end-to-end validation, reviewing and responding to all requests and questions with respect to Risk Management-related issues which include workers compensation claims. Provide direct assistance on all claim-related questions or requests. Take ownership of the question or request and ensure the question or request is properly handled or documented. Coordinate with TPA on claim issues and concerns while providing claim oversight. Accurately document claim activities and maintain up to date records in claim management system. Review claim forms, supporting documents and customer information. Validate claim eligibility based on...

About The Role This job involved leading a team whose primary role involved in supporting the data entry updates/ gathering required information / documents to support claim finalization. As part of the role the teams review images and documentation received with regards on the claims and as per guidelines update the information into the system and perform follow ups with vendor for the required information. Managing tasks and workflows in accordance to set standards and ensuring necessary claims processing guidelines are being adhered to through the process. Handling new hire training and transitions for the scope of services. Will need to have a high interest in driving domain certificatio...

We are hiring for Claims Adjudication!! HR SPOC: Abhilash Job Title: CSA and Senior CSA Grade: H1/H2 Job Category: Associate Function/Department: Operations Reporting to: Team Lead Roles & Responsibilities (Indicative not exhaustive): A claims examiner needs to analyze multiple documents / contracts and decide to pay / deny the claim submitted by member or providers with respect to client specifications. The claims examiner should also route the claim to different department or provider / member for any missing information that required for claims adjudication. The claims needs to be completed adhering to required TAT and quality SLA. Minimum Eligibility: Graduation is Mandatory Minimum 1 ye...

Retail Claims - Automation & Projects Key Responsibilities 1. Automate Claims Processes- Design and develop automated workflows and business rules to streamline claims processing. 2. Integrate with Existing Systems- Integrate automated claims processing solutions with existing systems and technologies. 3. Testing and UAT - Test and validate automated claims processing solutions to ensure accuracy and efficiency. 4. Daily production issue - Troubleshoot issues and resolve problems related any day-to-day production issues across all claim systems for death and health claims 5. Collaborate with IT stakeholders, claim team and other required stakeholders to understand requirements and implement ...

Responsibilities: * Manage back office operations using Zoho Books & MS Office * Prepare invoices, reconcile accounts, process claims & credit notes * Generate stock reports, manage expenses & communicate with clients

Job Description: 1. Should have strong Development experience in Guidewire Policy Center, Billing Center and Claim Center applications (min Any 2 Centers exp). 2. Should have working experience in Java as well as Gosu 4. aptitude to work in development and support project which requires deep Technical knowledge in GW and functional or insurance PC 5. Should have working experience in Commercial, Personal Lines LOB Mandatory Skills: Guidewire Billing Center / Policy Center / Claim Center

About The Role Skill required: Retirement Solutions - New Business Processing Designation: Insurance Operations Associate Qualifications: Any Graduation Years of Experience: 1 to 3 years Accenture is a global professional services company with leading capabilities in digital, cloud and security.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 world’s 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 countr...

About The Role Skill required: Retirement Solutions - New Business Processing Designation: Insurance Operations Analyst Qualifications: Any Graduation Years of Experience: 3 to 5 years Accenture is a global professional services company with leading capabilities in digital, cloud and security.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 world’s 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 countrie...

About The Role Skill required: Retirement Solutions - New Business Processing Designation: Insurance Operations Senior Analyst Qualifications: Any Graduation Years of Experience: 5 to 8 years Accenture is a global professional services company with leading capabilities in digital, cloud and security.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 world’s 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 c...

About The Role Skill required: Retirement Solutions - New Business Processing Designation: Insurance Operations Senior Analyst Qualifications: Any Graduation Years of Experience: 5 to 8 years Accenture is a global professional services company with leading capabilities in digital, cloud and security.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 world’s 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 c...

About The Role Skill required: Retirement Solutions - New Business Processing Designation: Delivery Operations Team Lead Qualifications: Any Graduation Years of Experience: 7 to 11 years Accenture is a global professional services company with leading capabilities in digital, cloud and security.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 world’s 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 countr...

Responsibilities: *Freshers Preferred * Manage claims from intake to payment. * Investigate health claims accurately. * Ensure timely claim settlements. * Collaborate with stakeholders on claims management. * Process insurance claims efficiently. Office cab/shuttle Food allowance Health insurance Annual bonus Provident fund

About The Role Skill required: Retirement Solutions - New Business Processing Designation: Delivery Operations Associate Manager Qualifications: Any Graduation Years of Experience: 10 to 14 years Accenture is a global professional services company with leading capabilities in digital, cloud and security.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 world’s 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 1...

Job description Check the medical admissibility of a claim by confirming the diagnosis and treatment details. Scrutinize the claims as per the terms and conditions of the insurance policy Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiate open billing and package, etc. Understand the process difference between PA and an RI claim and verify the necessary details accordingly. Verify the required documents for processing claims and raise an IR in case of an insufficiency. Coordinate with the LCM team in case of higher billing and with the provider team in case of non-availability of tariff. Approve or deny the claims as ...

To contact the insured for Underwriting referred proposals to procure the complete medical history using Audio and/or Video tools. To Follow up with customer for past medical records and/or relevant health documents Maintain end to end TAT / SLAs. Required Candidate profile Location – Bangalore Candidate must know to speak excellent English. CTC – Upto 3.5 LPA

Responsibilities: Manage health claims from start to finish Input data accurately into system Collaborate with insurers & providers Ensure compliance with regulatory standards Process mediclaim & TPA requests

We are looking for a skilled professional to join our team as an Executive in Revenue Cycle Management at Aster RV Hospital, located in the Healthcare/Medicine industry. The ideal candidate will have a strong background in revenue cycle management and excellent leadership skills. Roles and Responsibility Manage and oversee the revenue cycle process to ensure accurate and timely payments. Develop and implement strategies to improve revenue cycle efficiency and reduce costs. Collaborate with cross-functional teams to resolve billing and payment issues. Analyze and report on revenue cycle performance metrics to identify areas for improvement. Ensure compliance with regulatory requirements and i...

Job Summary: We are looking for a detail-oriented and analytical Claims Associate to join our non-medical insurance team. The ideal candidate will be responsible for reviewing, assessing, and processing insurance claims with accuracy and integrity, ensuring adherence to company policies and compliance standards. Key Responsibilities:- Evaluate and process insurance claims to determine validity and payment eligibility. - Review documentation including claim forms, bills, and related records for accuracy and completeness. - Interpret policy terms to determine coverage and liability. - Detect and investigate potential fraudulent or suspicious claims. - Coordinate with internal teams and externa...

Immeadiate joiners preferred AR caller Experience - 1- 4years location - Chennai, Trichy salary - 20000 - 40000 per month contact - 7904990032 *4- 8 months of gaps accepted

Position - AR Callers Experience - Min 1 year of experience in AR Calling A previous company's relieving letter is not mandatory Salary Slab max- 40K Immediate joiners or 15 days max Hospital Billing needed Suvetha: 9043426511

Job Title - Claims Supervisor Location - Taratala , Kolkata Roles and Responsibilities Manage claims processing from receipt to settlement, ensuring timely and accurate resolution. Oversee claims adjudication, including investigation, assessment, and payment processing. Ensure compliance with insurance policies, regulations, and industry standards. Analyze data to identify trends and areas for improvement in the claims process. Coordinate with TPAs (Third Party Administrators) for smooth claim settlement. Desired Candidate Profile 3-5 years of experience in claims management or related field. Strong knowledge of claims processing, adjudication, and settlement procedures. Proficiency in handl...

Key Responsibilities: Respond to incoming faxes promptly and document them in tracking systems; escalate as needed. Process patient applications, verify eligibility, and manage follow-ups. Handle patient and provider inquiries professionally with clear communication. Coordinate prescription orders and transfers to specialty pharmacies based on urgency. Educate patients on insurance options and available programs. Ensure strict adherence to SOPs and HIPAA guidelines. Perform insurance verification, patient enrollment, reverification, and accurate data entry. Minimum Requirements Experience : 2+ years in customer service or US healthcare; strong problem-solving skills; experience handling sens...

Qualifications: Bachelor of Arts Must Have India Benefits Administration National Pension Scheme (NPS) Management Workday ServiceNow Position Overview We are seeking a highly skilled and experienced candidate with 49 years of relevant experience in India benefits administration. The ideal candidate will be responsible for managing end-to-end employee benefits processes, including National Pension Scheme (NPS) enrollments, advances, reimbursements, health and insurance enrollments and claims, vendor invoicing, and managing meal and fuel card programs. The role requires a strong personality with excellent communication skills in English (native-level proficiency) to lead onboarding sessions, c...