3155 Claims Processing Jobs - Page 16

We are looking for a highly skilled E/M Coder with 1-6 years of experience to join our team. The ideal candidate will have expertise in coding and analyzing medical data, ensuring accurate and efficient processing. Roles and Responsibility Analyze medical records to assign accurate codes for diagnoses and procedures. Review and interpret medical information to identify relevant details for coding purposes. Assign appropriate codes using knowledge of coding systems and regulations. Collaborate with healthcare professionals to clarify coding discrepancies or issues. Maintain confidentiality and adhere to HIPAA guidelines when handling sensitive patient information. Stay updated with changes in...

Role & responsibility District medical officer - Field auditing and investigation Preferred candidate profile BHMS,BAMS,BDS & MBBS

Responsibilities: * Process claims from intake to payment * Collaborate with stakeholders on claim resolution * Ensure accurate adjudication & payment processing * Meet service level agreements (SLAs) for turnaround time

Manage dental billing during US business hours to resolve outstanding accounts receivable issues. Process claims, post payments, verify insurance coverage, and handle denials in accordance with industry standards. Strong English Communication skills.

Job description JD for Assistant Manager - Operations (RCM) Key Responsibilities and Duties: The Assistant Manager is responsible for several areas that are key to success, an outsourced billing service in the U.S. healthcare industry. In this role you are essentially play a vital role in the growth of the company. You are responsible for identifying issues in all process and altering the concern department. Duties include overall responsibility for smooth running of all process simultaneously alerting management of concerns and red flags. In addition, you are responsible for highlighting the requirements to the Manager for leading India Operation and implementing the requirement with the gu...

Call Insurance companies on behalf of physicians and carry out a further examination on outstanding Accounts Receivables Prioritize unpaid claims for calling according to the length of time it has been outstanding Call insurance companies directly and convince them to pay the outstanding claims Check the relevance of insurance info offered by the patient Evaluate unpaid insurance claims Call insurance companies and check on the status of claims Transfer the outstanding balance to the patient if he/she doesn't have adequate insurance coverage If the claim has already been paid, ask the insurance company for an Explanation of the Benefits Make corrections to the claim based on inputs from the ...

1. Automate Claims Processes- Design anddevelop automated workflows and business rules to streamline claims processing. 2. Integrate with Existing Systems- Integrateautomated claims processing solutions with existing systems and technologies. 3. Testing and UAT - Test and validateautomated claims processing solutions to ensure accuracy and efficiency. 4. Daily production issue - Troubleshootissues and resolve problems related any day-to-day production issues across allclaim systems for death and health . Collaborate with IT stakeholders, claim team and other requiredstakeholders to understand requirements and implement solutions6. Strong technical skills while alsounderstanding the business ...

International insurance claims processing for Member claims. Job Description* Delivers basic technical, administrative, or operative Claims tasks. Examines and processes paper claims and/or electronic claims. Completes data entry, maintains files, and provides support. Understands simple instructions and procedures. Performs Claims duties under direct instruction and close supervision. Work is allocated on a day-to-day or task-by-task basis with clear instructions. Entry point into professional roles. Responsibilities: - Adjudicate international pharmacy claims in accordance with policy terms and conditions to meet personal and team productivity and quality goals. Monitor and highlight high-...

INSCOL Academy is looking for Student Advisor to join our dynamic team and embark on a rewarding career journey. As a Student Advisor, you will play a pivotal role in guiding and supporting students throughout their academic journey. Your primary responsibility is to provide comprehensive advising services to help students achieve their educational and career goals. This role requires a deep understanding of academic programs, university policies, and resources available to students. You will collaborate with faculty, staff, and other stakeholders to ensure students receive the necessary support and guidance to succeed. Responsibilities : Provide academic advising to students regarding cours...

About Plum Plum is an employee insurance and health benefits platform focused on making health insurance simple, accessible and inclusive for modern organizations. Healthcare in India is seeing a phenomenal shift with inflation in healthcare costs 3x that of general inflation. A majority of Indians are unable to afford health insurance on their own; and so as many as 600mn Indians will likely have to depend on employer-sponsored insurance. Plum is on a mission to provide the highest quality insurance and healthcare to 10 million lives by FY2030, through companies that care. Plum is backed by Tiger Global and Peak XV Partners. About the Role The Strategic Accounts Servicing Team is responsibl...

Roles & Responsibilities: Strategize and execute all Hyperlocal digital media activities with agency and regional offices (SEM | Programmatic | SNS media | Display ads) Benchmark the planning cost and KPI s (Internal and external) Measure and report performance of all hyperlocal campaigns, and assess against goals (KPIs) Identify trends and insights, optimize spend and performance with agencies accordingly Work with teams across regional offices and dealerships for flawless execution of campaigns Manage the dealer claim process along with agencies and Kia finance team Evaluate emerging trends in Hyperlocal and provide perspective adoption where appropriate Required Qualification : Graduate/P...

About The Role 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 existing workflows (required for Bill...

About The Role 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 existing workflows (required for Bill...

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...

About The Role Project Role Application Lead Project Role Description Lead the effort to design, build and configure applications, acting as the primary point of contact. Must have skills Business Requirements Analysis Good to have skills Insurance Claims, Guidewire BillingCenter BA Minimum 5 year(s) of experience is required Educational Qualification 15 years full time education Summary As an Application Lead, you will lead the effort to design, build, and configure applications, acting as the primary point of contact. Your typical day will involve collaborating with various stakeholders to gather and analyze business requirements, ensuring that the applications meet the needs of the organi...

About The Role Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years Language - Ability: English(Domestic) - Intermediate 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 worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and hum...

About The Role Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 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 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 ...

Role Objective: To bill out medical accounts with accuracy within defined timelines and reduce rejections for payers. Essential Duties and Responsibilities: Process Accounts accurately basis US medical billing within defined TAT Able to process payer rejection with accuracy within defined TAT. 24*7 Environment, Open for night shifts Good analytical skills and proficiency with MS Word, Excel, and PowerPoint Qualifications: Graduate in any discipline from a recognized educational institute. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Good communication Skills (both written & verbal) Skill Set: Candidate should have good healthcare knowledge. Candidate should hav...

About The Role Skill required: Claims Services - Payer Claims Processing Designation: Health Operations New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 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 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. W...

About The Role Skill required: Claims Services - Payer Claims Processing Designation: Health Operations New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 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 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. W...

We are seeking an experienced and detail-oriented Billing & Insurance Manager to oversee hospital billing operations, ensure accurate claims processing, coordinate with insurance providers, and streamline revenue cycle management. The ideal candidate will have a strong understanding of medical billing procedures, TPA coordination, and hospital insurance practices. Key Responsibilities Oversee end-to-end billing operations for IP, OP, and corporate clients. Manage claim submission, follow-up, and settlement with TPAs and insurance companies. Verify insurance eligibility, pre-authorizations, and final bill approvals. Review and audit billing reports to ensure accuracy and compliance. Coordinat...

Greetings from Edelweiss Life Insurance !! We are hiring operations experienced candidate for the post of Branch Operation Execitive for Kozhikode branch. Role & responsibilities 1. Handling branch operations. 2. Customer servicing, Policy servicing & issuance 3. Upselling LI products. Preferred candidate profile 1. Any graduate with minimum 1 year of experience in operations/Customer service/ Back end/ in BFSI/Insurance/NBFC/Financial services industry. CTC max up to 3 LPA + Incentives Job Location : Mavoor Road junction, Kozhikode Interested candidates can share the CV to suprabha.p@edelweisslife.in (or) 9995803702 Thanks, Suprabha TA Partner Human Resource

Job Title: Assistant Manager Insurance Location: Bangalore Employment Type: Full-time About Agrizy: Agri-food tech startup Agrizy, founded in 2021 by Saket Chirania and Vicky Dodani, is dedicated to transforming the agrifood processing sector. By leveraging cutting-edge technologies, Agrizy addresses the common challenges encountered by FPOs and MSME agrifood processors. Through Agrizy, the underutilized capacities of MSME agrifood processors are linked with the customized processing needs of major buyers in both domestic and global markets. Additionally, Agrizy assists these processors in sourcing raw materials from farm-gate aggregators and FPOs, standardizing their operations and processi...

At EY, youll have the chance to build a career as unique as you are, with the global scale, support, inclusive culture and technology to become the best version of you And were counting on your unique voice and perspective to help EY become even better, too Join us and build an exceptional experience for yourself, and a better working world for all, Software Engineer / Sr Software Engineer in the Technology Consulting team to work on various Guidewire engagements for our customers across the globe, Your client responsibilities: Need to work as a team member to contribute in various technical streams of Guidewire engagements, Interface and communicate with the onsite coordinators Completion o...

In this Role you will be Responsible For : Read and understand the process documents provided by the customer. Entry-level administrative operations support performing various basic tasks (mail, file services, reporting, project support, and general account support activities). Analyze the insurance request received from the customer and process as per standard operating procedures. Familiarize, navigate multiple client applications and capture the necessary information to process customer request. Provides basic-level of support on programs, projects, reporting, filing (electronic and hard-copy), confidential materials handling, and issue resolution. Scope of work is routine and decision ma...