2028 Claims Processing Jobs - Page 22

We are hiring for an MNC into FMCG Sector. Job Title: Commercial Officer FMCG Location: Ghaziabad Experience Required: 5 Years+ Qualification: Graduate / Postgraduate (Commerce / Finance preferred) Key Responsibilities: Manage GT scheme claims and damage claim procedures with complete accuracy. Ensure timely submission of claims with proper documentation by following up with the Sales team. Handle prompt resolution of distributor claims in line with SOPs. Prepare and maintain MIS reports on spend analysis, budget vs. actual spent analysis. Develop and update claim trackers (submission, approvals, deductions, etc.). Respond effectively to audit queries and distributor queries regarding GT claims. Oversee timely settlement of distributors’ secondary, external & damage claims as per SOP. Create and track sales promotion budgets head-wise. Verify targets and reward calculations for RD, SD, SS, OIs and process pay-outs. Manage MIS reports and reconciliation for schemes and sales promotions through Botree external claim module. Prepare monthly provisions for schemes and RDSM. Maintain trackers for RDSM, claims, special budgets, RD/SD/SS rewards, channel program outlet payments, etc. Critical Skills: Strong knowledge of claim reimbursement processes and commercial functions. Proficiency in MS Excel (advanced level) and SAP. Ability to efficiently address and resolve queries from sales/export teams and distributors. Strong analytical, reporting, and problem-solving skills. Excellent communication and interpersonal abilities. Self-motivated and detail-oriented with a structured approach to work. Preferred Candidate Profile: Experience in FMCG industry with hands-on knowledge of claim reimbursement and commercial operations. Proficient in SAP and advanced MS Office applications. Prior experience in handling audit requirements, sales promotion budgets, and distributor claim management.

Designation : AR caller RCM, US healthcare Department : Operations Location : Hyderabad Report to : Team Leader, Operations. Work Set-up: Work from Office WORK BRIEF: To perform the job successfully, an individual must be able to perform each essential duty satisfactorily. The goal of the Sr. Revenue Cycle Billing Specialist is to successfully collect on aging medical insurance claims. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. CORE RESPONSIBILITIES File claims using all appropriate forms and attachments. Research account denials and file written appeals, when necessary. Evaluate the information received from the client to determine which insurance to bill and attain necessary attachments or supporting documentation to send with each claim. Research account information to determine the necessary attachments or supporting documentation to send with each claim. Document in detail all efforts in CUBS system and any other computer system necessary. Verify patient information and benefits. Essential Knowledge: Basic knowledge of using MS office basic applications like Word, PowerPoint, Excel, Notes, etc. Essential Skills: Min 2 Years of experience in accounts receivable follow-up / denial management for US healthcare customers Fluent verbal communication abilities Knowledge on Denials management and A/R fundamentals will be preferred Willingness to work in night shifts from office Prior experience of working in a medical billing company and use of medical billing software will be considered an advantage Knowledge of Healthcare terminology and ICD/CPT codes will be considered a plus MINIMUM QUALIFICATION: Graduate with minimum 2 Years of AR calling experience in US Healthcare market Pursuing Candidates – NOT Accepted for this role Note : Kindly mention HR- Nawaz khan on top of CV at the time of Walk-in. Disclaimer: Firstsource follows a fair, transparent, and merit-based hiring process. We never ask for money at any stage. Beware of fraudulent offers and always verify through our official channels or priyanka.narayanamoorthy@firstsource.com

Key Responsibilities 1. Insurance Billing 1. Prepare and submit accurate and timely insurance claims to various payers. 2. Ensure compliance with insurance company guidelines and regulations. 3. Maintain up-to-date knowledge of insurance policies, procedures, and coding requirements. 2. Claims Management 1. Monitor and resolve billing-related issues, including denied claims and appeals. 2. Communicate with insurance companies, patients, and healthcare providers to resolve billing issues. 3. Ensure accurate and timely follow-up on outstanding claims. 3. Data Entry and Record-Keeping 1. Accurately enter patient and billing information into the practice management system. 2. Maintain organized and up-to-date records of billing transactions and correspondence. 4. Customer Service 1. Provide excellent customer service to patients, healthcare providers, and insurance companies. 2. Respond to patient inquiries and resolve billing-related concerns.

We are Hiring AR Caller / Sr. AR Caller | 5.5 LPA | 2 way cab Roles We are Hiring For: AR Caller / Sr. AR Caller Physician Billing (RCM / Denial Management) Prior Authorization Executive US Healthcare Locations: Hyderabad | Bangalore | Mumbai | Chennai Eligibility: Experience: Minimum 1 Year in AR Calling (Physician Billing / RCM / Prior Auth) Qualification: Intermediate / Graduate (Any stream) Relieving Letter: Required for some processes (Not mandatory for all) Notice Period: Immediate Joiners Preferred Salary & Perks: Up to 41,000 Take-Home Shift Allowance: Up to 2,200 Joining Bonus: 20,000 (Mumbai only) Performance Incentives + Monthly Allowances Cab Facility: 1-Way / 2-Way (Depends on project & location) How to Apply: Share your updated resume on WhatsApp: HR Ramya 7680003242 Timings: 9:30 AM 6:30 PM

Role Overview The Team Lead will be responsible for overseeing day-to-day operations, guiding team members toward performance excellence, and ensuring seamless delivery of client and internal objectives. This role demands strong leadership, communication, and problem-solving skills to foster a high-performing, collaborative environment. Key Responsibilities: Lead, mentor, and motivate a team to achieve operational and strategic goals Monitor team performance and provide regular feedback and coaching Coordinate task allocation, day-to-day resource planning, and workflow optimization Act as the primary point of contact for escalations and issue resolution from the team. Ensure compliance with client expectations, SLAs, and internal standards Facilitate onboarding and training for new team members Collaborate cross-functionally to drive process improvements and innovation Prepare and present performance reports to the management Required Skills & Qualifications Proven experience in team leadership or supervisory roles Strong interpersonal and communication skills Ability to manage multiple priorities in a fast-paced environment Proficiency in us healthcare domain (preferable in claims management) Analytical mindset with a proactive approach to problem-solving Bachelor's degree in or equivalent experience Preferred Attributes Experience in client-facing environments Familiarity with quality standards and project methodologies Having good documentation and reporting skills Commitment to fostering a positive and inclusive team culture Candidate should be ready to work night shift (US Shift).

Hello Candidate, Greetings from Starworth Global Solutions !!!! Position-AR Caller/Sr AR Caller Job Location: Chennai, Bangalore, Trichy Exp: 1year to 6 yrs Salary: 40k Max (Based on exp. and Skill) Skills: Any billing, Denial Management exp is must (Strictly no fresher, relevant exp in AR Calling (voice), in us healthcare, can apply) JOB REQUIREMENTS : To be considered for this position, applicants need to meet the following qualification criteria: * 1year - 5 Years of experience in accounts receivable follow-up / denial management for US healthcare customers. * Fluent verbal communication abilities / call center expertise. * Knowledge on Denials management and A/R fundamentals will be preferred. * Willingness to work continuously in night shifts. * Basic working knowledge of computers. IF INTERESTED CALL/WATSAPP: 6369491535 or priyadharshini.chandrasekar22@gmail.com REGARDS; Priya SGS.

Urgent requirement for BHMS,BAMS,BDS -Badodara(Gujrat )candidate with TPA experience. Interested candidates can call on 9371762436 or share their updated resumes to career@mdindia.com Job Description: Scrutiny of medical documents and adjudication. Assess the eligibility of medical claims and determine financial outcomes. Identification of trigger factors of insurance related frauds and inform the concerned department. Determine accuracy of medical documents. Need to Visit the Hospitals Should have own Bike Required Candidate profile: BHMS,BAMS,BDS graduate. Male candidate prefer. Good Medical & basic computer knowledge Should have completed internship (Permanent Registration number is mandatory) Experience in of 1 year in TPA required Work from office. Only Male Candidates Required

Bpo Hiring For Health Care Domain Voice Process 6.5 LPA Location Gurugram Only Graduates. No B.E./Btech/UG''s Minimum 1 Year of Voice Experience With International BpO MUST Pls Cal Dipankar @ 9650094552 Email CV @ jobsatsmartsource@gmail.com

Opening for Us HealthCare Process 24/7 RO 2 RO Wkoff Location- Thane, Navi Mumbai, Mumbai HSC-Graduate fresher and Exp both will do Salary :- Upto 38k Interested Candidates Contact via (sakshi@careerguideline.com) or WhatsApp ( 8976570074 )

Responsibilities: * Manage US healthcare accounts receivable calls * Execute denial management strategies * Oversee revenue cycle processes * Handle medical billing tasks * Process payments accurately Health insurance Office cab/shuttle Provident fund

Veradigm Welcome to Veradigm! Our Mission is to be the most trusted provider of innovative solutions that empower all stakeholders across the healthcare continuum to deliver world-class outcomes. Our Vision is a Connected Community of Health that spans continents and borders. With the largest community of clients in healthcare, Veradigm is able to deliver an integrated platform of clinical, financial, connectivity and information solutions to facilitate enhanced collaboration and exchange of critical patient information. We are an Equal Opportunity Employer. No job applicant or employee shall receive less favorable treatment or be disadvantaged because of their gender, marital or family status, color, race, ethnic origin, religion, disability or age; nor be subject to less favorable treatment or be disadvantaged on any other basis prohibited by applicable law. For more information, please explore Veradigm.com. What will your job look like: Responsible for charge entry through the careful review of source data provided by clients with accurate recording demographics and charges associated with patient information and insurance. Supports the RCMS BU's overall Operations and Client Services by efficiently and effectively driving the accounts receivable process and achieving KPI results. No budget responsibilities, but must meet established RCM KPI's. Main Duties: Strong customer service skills; answering client calls; • prompt return and follow up to all interactions; prompt response to requests for information, both internally and externally • Timely input of demographic charges and time of service payment information • Expert ability to add specific data such as modifiers, payer specific information, including authorization criteria, CPT and ICD codes and date of injury (DOI) • Knowledgeable to append modifiers based on payer specifics, insurance and authorization requirements and referring physicians unique attributes • Understand and interpret the Correct Coding Initiative (CCI) as it applies to charge entry work • Reduce denials by correct use of modifiers, mapping, and linking codes with services • Responsible for the processing and discrepancy reconciliation and closing of charge batches across all systems • Successfully and effectively track and follow up on information requests to and from the clients. • Work with clients and others to facilitate information and resolve charge questions • Achieve goal of a 48-hour turnaround batch time • Responsible for Claim Edit Reports and Unassigned Money Reports • Complies and enforces all policies and procedures • Achieve goals set forth by RCM Management regarding error-free work, transactions, processes, productivity and compliance requirements • Other duties as assigned Academic Qualifications: High School Diploma or GED (Required) An Ideal Candidate will have: 1+ year relevant work experience (Preferred) • Extensive knowledge with email, search engines, Internet; ability to effectively use payer websites and Laserfiche; basic competence in use of Microsoft products. Preferred experience with MS Access and PowerPoint, Crystal reports and various billing systems, such as Next Gen, Pro, Epic and others. Work Arrangements: Work from Pune Office all 5 days. Shift Timing: 7:30 PM IST to 4:30 AM IST (US Shift) Benefits Veradigm believes in empowering our associates with the tools and flexibility to bring the best version of themselves to work. Through our generous benefits package with an emphasis on work/life balance, we give our employees the opportunity to allow their careers to flourish. Quarterly Company-Wide Recharge Days Peer-based incentive Cheer awards “All in to Win” bonus Program Tuition Reimbursement Program To know more about the benefits and culture at Veradigm, please visit the links mentioned below: - https://veradigm.com/about-veradigm/careers/benefits/ https://veradigm.com/about-veradigm/careers/culture/

PLEASE READ CAREFULLY BEFORE APPLYING: APPLY ONLY IF YOU MEET ALL THE CRITERIA MENTIONED BELOW : We are hiring freshers for the role of AR Caller (US Healthcare Process) . Responsibilities: Make outbound calls to US insurance companies regarding pending or denied claims. Follow up with payers to ensure timely resolution of claims. Review rejections and take appropriate action for resolution. Accurately update internal systems with call details and claim status. Work towards daily and weekly performance goals. Candidate Requirements: Excellent English communication skills (spoken and written). Willing to work night shifts (US timings). Must reside within 25 KM of Manikonda, Hyderabad. Any graduate (from any stream). Immediate joiners only. Salary & Benefits: CTC: 3,00,000 per annum Take Home: Approx. 16,000 per month Night Shift Allowance: 2,200 per month Cab Facility: 2-way cab service available within 20 KM radius Week Offs: Fixed Saturday & Sunday off Career Growth: Structured training, professional work environment, and internal promotion opportunities If you meet all the criteria mentioned above, do not just apply here to connect faster, send a WhatsApp message to HR Krishnaveni at 9154184125 or Email your resume to Krishnaveni.vs@axisservice.co.in

About Us: Medi Assist is India's leading Health Tech and Insure Tech company focused on administering health benefits across employers, retail members, and public health schemes. We consistently strive to drive innovation and participate in such initiatives, to lower health care costs. Our Health Benefits: Administration model is designed to deliver the tools necessary for a health plan to succeed, whether its our modular claims management system, our technology that unveils data to make important decisions, or our service solutions built around the voice of the customer. In short, our goal is to link our success to that of our members Roles and Responsibilities: 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, differentiation of 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 per the terms and conditions within the TAT. Handle escalations and responding to mails accordingly. Work from Office only 4th floor, AARPEE Chambers, Off Andheri-Kurla Road Industrail Estate Marol, Andheri East, , Marol Cooperative Next To Times Square, Shagbaug, Gamdevi, Marol, Mumbai, Maharashtra 400059 Interested candidates can share their resumes to abhilasha.dutta@mediassist.in CV on 8050700698

Firstsource Solutions Ltd is looking for Senior Analyst - Underwriting to join our dynamic team and embark on a rewarding career journey Analyze and assess insurance applications and risks. Develop and implement underwriting policies and guidelines. Monitor and analyze underwriting performance and make improvements. Collaborate with sales and claims teams to ensure underwriting alignment. Prepare and present underwriting reports to management. Provide training and support to junior underwriters. Ensure compliance with regulatory requirements and industry standards.

Aster Medcity is looking for Deputy Manager.Internal Audit.Aster DM Healthcare Limited - India Corporate to join our dynamic team and embark on a rewarding career journey Assist the Manager in the day-to-day operations of the business, including setting goals, developing strategies, and overseeing the work of team members Take on leadership responsibilities as needed, including managing team members and making decisions in the absence of the Manager Identify and address problems or challenges within the business, and develop and implement solutions Collaborate with other departments and teams to ensure smooth and efficient operations Maintain accurate records and documentation Contribute to the development and implementation of business plans and goals

Arzion RCM is looking for Arzion Business Solutions - Patient Caller in Chennai to join our dynamic team and embark on a rewarding career journey Tellecaller is responsible for various tasks including planning, execution, and management of related duties They should possess relevant skills and experience to excel in this role Duties include teamwork, problem-solving, and achieving organizational goals Candidates must have strong communication and technical abilities Responsibilities include project management, strategy execution, and performance optimization (More details as per role requirements )

Account receivable Caller or credential specialist worked in US health care medical billing.Good knowledge of RCM 6239443426 Meena Only candidate from Mohali , Himachal , Chandigarh apply Candidate from other location please donot apply

The Performance Management Analyst will be responsible for collecting, creating, utilizing reporting, data and analytics to assess solutions that will achieve optimal RCM performance and financial objectives of our clients Raj 8377993148

Urgent Hiring For Health Insurance EXP:-Min 6 Months to 1 Year in Health Insurance Sales/Agency sales CTC:-Upto 5 LPA+Incentives Contact Person:HR Snehal:8788255050

Role & responsibilities Verify the accuracy and completeness of claim documents, including medical records and billing information Handle customer inquiries related to claims status and provide resolution. Maintain and update claim records in the system. Identify discrepancies, fraudulent claims, and escalate cases as necessary.

Role & responsibilities: Outline the day-to-day responsibilities for this role. Preferred candidate profile: Specify required role expertise, previous job experience, or relevant certifications. Perks and benefits: Mention available facilities and benefits the company is offering with this job.

Bpo Hiring For Health Care Domain Voice Process 6.5 LPA Location Gurugram Only Graduates. No B.E./Btech/UG''s Minimum 1 Year of Voice Experience With International BpO MUST Pls Cal Dipankar @ 9650094552 Email CV @ jobsatsmartsource@gmail.com

Key Responsibilities: Insurance Policy Management : Provide expert advice on property and casualty insurance products, helping clients choose the best coverage based on their needs. Client Consultation : Assess clients risk profiles, evaluate their property and liability coverage requirements, and recommend appropriate policies. Sales & Business Development : Generate new business by identifying prospects, creating proposals, and converting leads into customers. Claims Assistance : Assist clients with claims processing and work with the insurance company to ensure timely claims resolution. Underwriting Support : Collaborate with underwriters to evaluate the risk involved in insuring the client's property and assets. Policy Renewals : Follow up with clients to discuss policy renewals, offering additional coverage or policy adjustments as needed. Market Research : Stay up-to-date on changes in insurance regulations, industry trends, and new product offerings. Customer Service : Provide ongoing support to existing clients, addressing any inquiries or concerns regarding their insurance policies. Documentation : Maintain accurate records of client interactions, policies sold, claims processed, and renewals completed.

This is a full-time on-site role for an AR Calling Specialist. The AR Calling Specialist will be responsible for managing accounts receivable, following up on unpaid claims, resolving denials, and ensuring timely collections. This role requires attention to detail, strong communication skills, and the ability to work effectively within a team to optimize revenue recovery. Qualifications AR Calling and Accounts Receivable Management skills Understanding of medical billing processes and insurance policies Strong communication and negotiation skills Ability to prioritize tasks and meet deadlines Knowledge of medical coding and experience in using different billing software Knowledge of healthcare regulations and compliance Previous experience in revenue cycle management or healthcare billing

Hello All, Greetings for the day! We have an job opportunity with our client Neovance (Earlier Called as Fortrea). Work Experience: 2-4 Years of Experience (1+ Years exp in US health experience or Recent experience in US Health care) Work Location: Bangalore (Preferred). Education: bachelors degree or a master’s Degree with all Documents from a regular College/University. Project: 6 months (Extension based on Performance) Shift: 6:00 PM - 03:00 AM (2 Ways Cab facility) Work model: Work From Home for initial Few Months, then Work From Office as per company’s requirement. Interview Round: 3 Rounds (Mettle Assessment - Online Screening Round - In Person Interview at Allegis Group) Experience: The Program Specialist ideally should have two or more years of prior customer service, volunteering, or other customer-facing experience. Prior experience in the US healthcare industry is a must , and the Program Specialist must be a proven problem solver with the ability, drive, and initiative to learn the required healthcare, reimbursement, and customer service skills necessary to support the assigned program(s). Experience in handling sensitive data in US healthcare with high degree of proficiency. Must be familiar with HIPAA guidelines. Candidates should be flexible in working from home or in an office setting per business needs Key Responsibilities: Quickly and efficiently respond to incoming calls and faxes, identify how best to assist. Conduct outbound calls of insurance verifications to understand if patient’s prescribed therapy is eligible for coverage. Document results in appropriate tracking system. Document calls in appropriate tracking systems, and handle/escalate calls per established procedures. Process patient applications and follow the program's specifications to determine their eligibility. Document results in appropriate tracking system and manage follow-ups as appropriate. Place follow-up calls and respond to enquiries from patients and/or healthcare providers as necessary. Maintain a professional, calm and friendly demeanor. Express thoughts and instructions clearly in both verbal and written communication; i.e. uses grammatically correct and concise language. Coordinate the order and transfer of prescriptions based on their degrees of urgency to specialty pharmacies as appropriate. Be familiar with the market place and the insurance options available for patients. Educate patients on the available options as appropriate. Strict adherence to follow the process SOPs Important Note: US or international Voice experience US Health Care and Customer solving experience Good Communication Good Typing speed Immediate to serving notice period AR Calling/ Voice process Out bound and Inbound calling experience HIPAA compliance Experience in interacting with Insurance people or stakeholders We have more then 30 roles open and the offer candidates will be onboarded in the month. We are accepting the applicants with 30 days Notice period (Serving Notice period) and Immediate joiners. We are mainly focusing Bangalore Applicants, they can visit office for interview. Interested Applicants can Apply to this Opportunity Regards Nithin N. 8660251618 nnithin@astoncarter.com