3155 Claims Processing Jobs - Page 19

Job Purpose To collect, check and compile data pertaining to all Property Insurance policies for all Units for enabling timely renewal, accurate insurance coverage, policy compliances and premium refund. To check and maintain the policy documentation and data (physical and soft) for quick retrieval. To effectively handle all claims below Rs.1 Cr. Maintenance and accounting for Cash deposit accounts with Insurance companies. Job Context & Major Challenges -Follow up with Units and Surveyors for Claims (which are less than Rs. 1 Cr.) related requirements and documentation. Entails dealing with too many people on regular basis. -Regular (in fact daily) Follow up is required with Insurance Compa...

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 claims 5. Collaborate with IT stakeholders, claim team and other requiredstakeholders to understand requirements and implement solutions6. Strong technical skills while alsounderstanding the b...

Adjudicate international pharmacy claims in accordance with policy terms and conditions to meet personal and team productivity and quality goals. Monitor and highlight high-cost claims and ensure relevant parties are aware. Monitor turnaround times to ensure your claims are settled within required time scales, highlighting to your Supervisor when this is not achievable. Respond within the time commitment given to enquiries regarding plan design, eligibility, claims status and perform necessary action as required, with first issue/call resolution where possible. Interface effectively with internal and external customers to resolve customer issues. Identify potential process improvements and m...

How will you make an impact in this role -Fraud Disputes is a blend set-up for India market in an extremely professional, responsive, and competent manner -Handle incoming and outgoing calls related to claims processing, providing excellent customer service and support -Review and analyze claims to ensure accuracy and compliance with company policies and regulations -Process claims efficiently and accurately within the designated time frames -Resolve claim issues and discrepancies by conducting thorough investigations -Analyze and decide on accepting or rejecting a fraud claim -Claim Processing -Prior experience in phone/ email servicing required -Handle complaints from Card members and Busi...

Mysore Shift: US Shift / Night Shift-Work from Office CTC: Up to 4 LPA Notice Period: 0–15 Days Min. 1 year in US Healthcare Claims B.Sc. (Science) background preferred Based in or willing to relocate to *Mysore* sravani.asarla@liveconnections.in

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. L&A Business Consultant Working as part of the Consulting team, you will take part in engagements related to a wide range of topics. Some examples of domains in which you will support our clients include the following Proficient inIndividual and Group Life Insurance concepts,different type of Annuity products etc. Proficient in different insura...

Your key responsibilities Guidewire Billing Center Support and Maintenance (Staff 3-6 years) Must be flexible to work in shifts (Rotational Shift India Shift, UK Shift) and On Call Support on a roster-ed rotational basis. Contribute in various technical streams of Guidewire implementation project. Manages the integration of Guidewire software with other external systems. Design, modifies and implements Guidewire product suite. Skills and attributes for success Deep understanding of Guidewire framework, implementation, architecture and components. Must have experience in GuideWire Billing Center 9.0 version+ Well versed in development streams - Configuration/Integration/Both Strong knowledge ...

Follow up with insurance companies for claim status. Handle denials, underpayments, and initiate appeals. Document call details and claim outcomes. Meet daily/weekly productivity targets. Candidates with prior experience are preferred.

Job description Healthcell is hiring for Payment Posting & Denial Management in the day shift. Excellent computer skills required. Candidates with prior Payment Posting into US Medical billing experience required. Anyone with 1+ years of Payment Posting or Denial Management experience required Salary will be Exceptionally Best In the Industry Candidates staying in Western Suburbs only apply If Interested call on 8369857886 / 9819446869

MEGA WALKIN INTERVIEW DRIVE OCTOBER INTERNATIONAL VOICE PROCESS Walk-in Interview Date and Time- Monday-Saturday (10:00 AM-3:00 PM) . Who we are looking for? Only graduates freshers can apply Under graduate with 6 month experience Voice Inbound process Preferably customer service experience Excellent Spoken English/Hindi Computer Skills ability/experience using computer applications Call Handling Etiquette What would be the roles and responsibilities . Handle customer inquiries and resolve issues efficiently. Provide accurate information to customer Process transactions and maintain customer records. Deliver excellent customer service and enhance customer satisfaction. What you will be signi...

Position Summary The incumbent will be required to be a part of Operations function responsible for MetLife Global Capability Center and will be required to report to the Manager Operations of the MetLife Global Capability Center Job Responsibilities Essential Functions The key deliverables of the role will include but will not be restricted to the details below: Type of activities Work allocation Processing Reporting Meeting SLA including Performance guarantees Staffing Management Maintain regulatory compliance Customer interactions Basic Function Update & maintain day to day Workforce Management while ensuring decisional timeliness standards are met within the regulations Preparing, Report...

Hiring a detail-oriented EDI Rejection Specialist for US Healthcare billing to analyze and resolve claim rejections for timely reimbursement. Must have strong communication skills to work with teams, clients, and payers. Required Candidate profile 5-7 yrs US Healthcare RCM experience in EDI claim management. Strong knowledge of transactions, claim processing, payer guidelines. Excellent communication, analytical, and multitasking skills.

1.Collection Management Follow up with clients/customers via phone, email, and visits to ensure timely payment of outstanding invoices. Monitor aging reports and prioritize collections based on risk and value. Negotiate payment plans and resolve disputes related to billing or services. 2. Account Reconciliation Reconcile customer accounts and ensure accuracy of payment records. Investigate and resolve discrepancies in payments, invoices, and credit notes. 3. Reporting & Documentation Maintain detailed records of collection activities, communication logs, and payment commitments. Prepare daily, weekly, and monthly collection reports for management review. Track KPIs such as DSO (Days Sales Ou...

Department: Billing Reports To: Head Billing Job Summary: The Billing Executive is responsible for preparing, verifying, and processing patient bills accurately and promptly. The role involves coordinating with various hospital departments to ensure correct charge entries, insurance details, and payment collections while maintaining transparency and compliance with hospital billing policies. Key Responsibilities: Patient Billing & Invoicing: Generate inpatient, outpatient, and emergency bills accurately using the Hospital Information System (HIS). Verify all procedures, investigations, pharmacy, and consumable charges are correctly posted. Insurance & Corporate Billing: Coordinate with the i...

Responsibilities: Register insurance claims with complete, accurate details Update claims tracker regularly Collect and follow up on required documents Prepare monthly & quarterly MIS reports Coordinate with teams for data accuracy & issue resolution

Role Mandates: Candidate must have minimum 3 year of experience on paper as a Senior Analyst or equivalent working in US Insurance claims domain Experience in working in claims related processes in lines of business like Property, General Liability and Auto claims. Experience with mailbox management/triaging claims Should have experience in handling Outbound calls to get claim related information from different internal and external parties including Insurance carriers, clients, brokers Graduation is MANDATORY (Except Pharma/LLB/BDS) Responsibilities: Evaluate claims to ensure sufficient information is available for loss reporting. Submit claims to carriers and confirm receipt along with adj...

As an experienced Insurance Operations Specialist, you will be responsible for handling claims, coordinating policies, and ensuring compliance with insurance regulations. Your role will require a sound understanding of insurance products, liabilities, and assets. Your excellent communication and interpersonal skills will be essential for effectively coordinating with clients and stakeholders. Key Responsibilities: - Manage claims handling process efficiently - Coordinate insurance policies and endorsements - Ensure accurate renewals of policies - Process claims with attention to detail and compliance Qualifications Required: - Minimum 1 year of experience in liabilities - Minimum 2 years of ...

Job Description: About Us At Bank of America, we are guided by a common purpose to help make financial lives better through the power of every connection. Responsible Growth is how we run our company and how we deliver for our clients, teammates, communities and shareholders every day. One of the keys to driving Responsible Growth is being a great place to work for our teammates around the world. We're devoted to being a diverse and inclusive workplace for everyone. We hire individuals with a broad range of backgrounds and experiences and invest heavily in our teammates and their families by offering competitive benefits to support their physical, emotional, and financial well-being. Bank of...

As a Sr. Blaze Developer based in Bangalore & Hyderabad, your role involves engaging in application design, development, testing, release, and support. You are expected to produce fully functional application code based on industry best practices. Additionally, you will gather specific requirements, ask questions, and suggest solutions, troubleshoot, and debug to optimize performance. Furthermore, you will liaise with the Product development team to plan new features in an agile model. Key Responsibilities: - Engage in application design, development, testing, release, and support - Produce fully functional application code following industry best practices - Gather specific requirements, as...

Job Summary: We are seeking a qualified and experienced medical professional with a strong background in health insurance claim settlement and customer service . The ideal candidate will leverage their clinical knowledge to evaluate and process health insurance claims efficiently while ensuring a high level of customer satisfaction. This hybrid role bridges the gap between medical accuracy , regulatory compliance , and empathetic customer support . Key Responsibilities: Medical Review & Claims Adjudication: Assess and validate medical claims based on clinical documentation and policy coverage. Interpret diagnostic reports, treatment plans, and prescriptions to determine claim eligibility. Co...

We are hiring for International Healthcare Customer Support. Role & responsibilities : Handle outbound calls related to healthcare services within the US healthcare system. Proactively reach out to members to provide support, resolve issues, and ensure a positive experience. Identify and address varying levels of member complexity and communicate effectively. Ensure strict compliance with HIPAA regulations and other healthcare-related guidelines. Resolve member inquiries efficiently and professionally, escalating complex cases as required. Preferred candidate profile Proven experience in outbound voice processes, preferably in the US healthcare sector. Strong verbal and written communication...

Retail Claims - Automation ProjectsKey Responsibilities1. 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 claims5. Collaborate with IT stakeholders, claim team and other requiredstakeholders to understand requirements and implement solutions6....

Must have US Healthcare domain knowledge and basic understanding of healthcare claims processing Must have HIPAA, 837 experience Elicits, analyzes, specifies, and validates the business needs of stakeholders, be they customers or end users. Collaborates with project sponsors to determine project scope and vision. Clearly identifies project stakeholders and establish customer classes, as well as their characteristics. Conducts interviews to gather customer requirements via workshops, questionnaires, surveys, site visits, workflow storyboards, use cases, scenarios, and other methods. Identifies and establishes scope and parameters of requirements analysis on a project-by-project basis to defin...

Role & responsibilities Handle claim submission, follow-up, and settlement with TPAs and government panels. Track outstanding payments and prepare periodic reconciliation reports. Coordinate with TPAs, insurance companies, and internal departments for claim clarifications. Maintain records of claims, payments, and rejections in both Excel and Tally. Post settlement entries, adjustments, and payment receipts in Tally. Prepare monthly outstanding and collection status reports for management review. Ensure timely submission of required documents for pending claims. Follow up on delayed or short payments and resolve discrepancies. Maintain communication logs and documentation for all settlement ...

The staff has to perform the work of chief Contract expert and needs to monitor the EPC-Contracts Qualifications Graduate in discipline. 20+ years in railway or railway related industry, out of which minimum 10 years in Metro/MRTS. Shall have worked in atleast one metro project.