2028 Claims Processing Jobs - Page 25

We’re Hiring – Customer Service Associate (Night Shift) Location: Mumbai (Airoli) | WFO US Healthcare – International Voice Process 20K in-hand + incentives + night allowance Call HR Khushi – 9389460353 |

We’re Hiring – Customer Service Associate (Night Shift) Location: Mumbai (Airoli) | WFO US Healthcare – International Voice Process 20K in-hand + incentives + night allowance Call HR Khushi – 9389460353 |

Deputy Manager - UK Operations (Motor Insurance Claims) - Bengaluru Location - Bangalore An excellent opportunity for a seasoned operation professional to lead and manage high-performing teams in motor insurance claims. This role offers exposure to end-to-end claims operations, client interactions, and team leadership in a process excellence-driven environment. Your Future Employer - A leading global business process management company serving clients across industries like Insurance, Banking, Travel, Healthcare, and more. With a strong focus on innovation, analytics, and digital transformation, the organization enables businesses to achieve superior operational outcomes and efficiency. Responsibilities - Managing day-to-day operations and driving performance improvements across functions. Overseeing the motor bodily injury claims process with a focus on compliance and timely resolution. Leading and mentoring a team to foster engagement and accountability. Collaborating with legal and external stakeholders on complex claims. Monitoring KPIs, identifying process gaps, and driving continuous improvement initiatives. Ensuring compliance with industry regulations and internal controls. Driving automation initiatives and contributing to digital transformation efforts. Requirements - Graduate degree in Business Administration, Insurance, or a related field. Strong experience in operations management, especially in the insurance sector. Proven track record in managing motor insurance claims and leading large teams. Excellent communication, analytical, and stakeholder management skills. Familiarity with claims systems, risk assessment methodologies, and process optimization tools. What is in it for you - Opportunity to drive operational excellence and team performance. Exposure to global best practices in insurance operations. Be a key contributor to digital transformation and strategic projects. Reach us: If you think this role aligns with your career goals, please email your updated resume to vasu.joshi@crescendogroup.in for a confidential discussion. Disclaimer: Crescendo Global specializes in Senior to C-level niche recruitment. We are committed to enabling job seekers and employers with an engaging and professional recruitment experience. Crescendo Global does not discriminate on the basis of race, religion, gender, sexual orientation, age, disability, or any other protected status. Note: Due to the volume of applications we receive, we may only respond to shortlisted candidates. Thank you for your understanding. Scam Alert: Beware of fraudulent job offers in the name of Crescendo Global. We do not charge fees or request purchases. All valid opportunities are listed at www.crescendo-global.com. Profile Keywords - Deputy Manager Jobs, Operations Jobs, Insurance Claims Jobs, Motor Insurance, Claims Management, SLA Management, Team Leadership, Client Management, Operations Excellence, BPM Jobs, Insurance Operations, Claims Processing.

Hiring for US Health care claims Need 1 year experince in US Healthcare calims US shifts and offs Work from office Work location Bangalore Need immediate joiners Salary max 3.5 LPA Graduation mandate Freshers cannot apply. Need only experience in US Healthcare Claims Intersted candidates can walk in to the below address Brigade Tech Gardens, Kundalahalli, Brookefields Green Avenue, Kundalahalli, ITPL Main Rd, Phase 2, Brookefield, Bengaluru, Karnataka 560037 Contact person HR Bhanumathi 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 @firstsource.com email addresses.

Overview The Coding Denial Specialist responsibilities include working assigned claim edits and rejection work ques, Responsible for the timely investigation and resolution of health plan denials to determine appropriate action and provide resolution. Responsibilities Processes accounts that meet coding denial management criteria which includes rejections, down codes, bundling issues, modifiers, level of service and other assigned ques. Resolve work queues according to the prescribed priority and/or per the direction of management in accordance with policies, procedures, and other job aides. Validate denial reasons and ensures coding is accurate. Generate an appeal based on the dispute reason and contract terms specific to the payor. This includes online reconsiderations. Follow specific payer guidelines for appeals submission. Escalate exhausted appeal efforts for resolution. Adhere to departmental production and quality standards. Complete special projects as assigned by management. Maintain working knowledge of workflow, systems, and tools used in the department. Qualifications High school diploma or equivalent. One to three years’ experience in physician medical billing with emphasis on research and claim denials.

Overview The Coding Denial Specialist responsibilities include working assigned claim edits and rejection work ques, Responsible for the timely investigation and resolution of health plan denials to determine appropriate action and provide resolution. Responsibilities Processes accounts that meet coding denial management criteria which includes rejections, down codes, bundling issues, modifiers, level of service and other assigned ques. Resolve work queues according to the prescribed priority and/or per the direction of management in accordance with policies, procedures, and other job aides. Validate denial reasons and ensures coding is accurate. Generate an appeal based on the dispute reason and contract terms specific to the payor. This includes online reconsiderations. Follow specific payer guidelines for appeals submission. Escalate exhausted appeal efforts for resolution. Adhere to departmental production and quality standards. Complete special projects as assigned by management. Maintain working knowledge of workflow, systems, and tools used in the department. Qualifications High school diploma or equivalent. One to three years’ experience in physician medical billing with emphasis on research and claim denials.

Responsible for accurate payment posting, reconciliation, denial support, reporting, and communication with insurers/patients. Ensure compliance, maintain confidentiality, and drive process improvements in payment posting workflows. Required Candidate profile Graduate preferred with 1-2 years in healthcare payment posting/RCM. Skilled in data entry, reconciliation, communication; familiar with billing, insurance, HIPAA, and coding.

Female Candidates can apply. Must have Min 1+yrs exp as a Team Leader from International Healthcare or Insurance Process BPO. Must know KPI's and Team Leading Skills. US Shifts Fluent English Call 8447780697 send CV monu@creativeindians.com

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Specialist Qualifications: Any Graduation Years of Experience: 7 to 11 years Language - Ability: English(Domestic) - Advanced About Accenture 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. Visit us at www.accenture.com What would you do We help insurers redefine their customer experience while accelerating their innovation agenda to drive sustainable growth by transforming to an intelligent operating model. Intelligent Insurance Operations combines our advisory, technology, and operations expertise, global scale, and robust ecosystem with our insurance transformation capabilities. It is structured to address the scope and complexity of the ever-changing insurance environment and offers a flexible operating model that can meet the unique needs of each market segment.Claim processing team collects end-end data dataDevelop and deliver business solutions that support the claims process across its lifecycle, including first notice of loss, claims investigation, payment administration or adjudication, provider reimbursement (health care), subrogation and recovery. What are we looking for Claims ProcessingClaims AnalysisClaims AdministrationPayer Claims ProcessingStrong analytical skillsHands-on experience with trouble-shootingResults orientationAbility to perform under pressureWritten and verbal communication Roles and Responsibilities: In this role you are required to do analysis and solving of moderately complex problems May create new solutions, leveraging and, where needed, adapting existing methods and procedures The person would require understanding of the strategic direction set by senior management as it relates to team goals Primary upward interaction is with direct supervisor May interact with peers and/or management levels at a client and/or within Accenture Guidance would be provided when determining methods and procedures on new assignments Decisions made by you will often impact the team in which they reside Individual would manage small teams and/or work efforts (if in an individual contributor role) at a client or within Accenture Please note that this role may require you to work in rotational shifts Qualification Any Graduation

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Senior Analyst Qualifications: Any Graduation Years of Experience: 5 to 8 years Language - Ability: English(Domestic) - Advanced About Accenture 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. Visit us at www.accenture.com What would you do We help insurers redefine their customer experience while accelerating their innovation agenda to drive sustainable growth by transforming to an intelligent operating model. Intelligent Insurance Operations combines our advisory, technology, and operations expertise, global scale, and robust ecosystem with our insurance transformation capabilities. It is structured to address the scope and complexity of the ever-changing insurance environment and offers a flexible operating model that can meet the unique needs of each market segment.Claim processing team collects end-end data dataDevelop and deliver business solutions that support the claims process across its lifecycle, including first notice of loss, claims investigation, payment administration or adjudication, provider reimbursement (health care), subrogation and recovery. What are we looking for Claims ProcessingClaims AnalysisClaims AdministrationPayer Claims ProcessingStrong analytical skillsWritten and verbal communicationResults orientationDetail orientationAbility to perform under pressure Roles and Responsibilities: In this role you are required to do analysis and solving of increasingly complex problems Your day to day interactions are with peers within Accenture You are likely to have some interaction with clients and/or Accenture management You will be given minimal instruction on daily work/tasks and a moderate level of instruction on new assignments Decisions that are made by you impact your own work and may impact the work of others In this role you would be an individual contributor and/or oversee a small work effort and/or team Please note that this role may require you to work in rotational shifts Qualification Any Graduation

Skill required: Supply Chain - Automotive Supply Chain Designation: Business Advisory Associate Qualifications: BE/Diploma in Automobile Years of Experience: 1 to 3 years About Accenture 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. Visit us at www.accenture.com What would you do To maintain quality and service standards of the Warranty Claims processing team in support of the contracted Service Level AgreementInvestigate and Verify warranty claims based on available external support resources (Parts catalog, Dealer Assist & Standard labor time) & take appropriate decisionImplement practices to improve operational efficienciesBE Automobile Graduate/Diploma with or without Automotive experienceBE Mechanical Graduate/Diploma with Automotive experienceExperience in WarrantyExperience with Auto componentsInterpersonal skills to deal with dealers, warranty engineers, etcData processing accuracy, detail oriented, and ability to evaluate/research a warranty claimExpert level capability in use of desktop software (MS Office Suite, with focus on Excel)Organized, timely, pro-active and highly productiveStrong written communication in EnglishAttention to detail and ability to multi-taskExperience in Warranty /Auto Dealership What are we looking for BE Automobile Graduate/Diploma with or without Automotive experienceBE Mechanical Graduate/Diploma with Automotive experienceExperience in WarrantyExperience with Auto componentsInterpersonal skills to deal with dealers, warranty engineers, etcData processing accuracy, detail oriented, and ability to evaluate/research a warranty claimExpert level capability in use of desktop software (MS Office Suite, with focus on Excel)Organized, timely, pro-active and highly productiveStrong written communication in EnglishAttention to detail and ability to multi-taskExperience in Warranty /Auto Dealership Roles and Responsibilities: Investigate and Verify warranty claims based on available external support resources (Parts catalog, Dealer Assist & Standard labor time) & take appropriate decision Qualification BE,Diploma in Automobile

Skill required: Supply Chain - Automotive Supply Chain Designation: Business Advisory Associate Qualifications: BE/Diploma in Automobile Years of Experience: 1 to 3 years About Accenture 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. Visit us at www.accenture.com What would you do To maintain quality and service standards of the Warranty Claims processing team in support of the contracted Service Level AgreementInvestigate and Verify warranty claims based on available external support resources (Parts catalog, Dealer Assist & Standard labor time) & take appropriate decisionImplement practices to improve operational efficiencies What are we looking for BE Automobile Graduate/Diploma with or without Automotive experienceBE Mechanical Graduate/Diploma with Automotive experienceExperience in WarrantyExperience with Auto componentsInterpersonal skills to deal with dealers, warranty engineers, etcData processing accuracy, detail oriented, and ability to evaluate/research a warranty claimExpert level capability in use of desktop software (MS Office Suite, with focus on Excel)Organized, timely, pro-active and highly productiveStrong written communication in EnglishAttention to detail and ability to multi-taskExperience in Warranty /Auto Dealership Roles and Responsibilities: Investigate and Verify warranty claims based on available external support resources (Parts catalog, Dealer Assist & Standard labor time) & take appropriate decision Qualification BE,Diploma in Automobile

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Specialist Qualifications: Any Graduation Years of Experience: 7 to 11 years About Accenture 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. Visit us at www.accenture.com What would you do We help insurers redefine their customer experience while accelerating their innovation agenda to drive sustainable growth by transforming to an intelligent operating model. Intelligent Insurance Operations combines our advisory, technology, and operations expertise, global scale, and robust ecosystem with our insurance transformation capabilities. It is structured to address the scope and complexity of the ever-changing insurance environment and offers a flexible operating model that can meet the unique needs of each market segment.Claim processing team collects end-end data dataYou will be responsible for developing and delivering business solutions that support the claims process across its lifecycle, including first notice of loss, claims investigation, payment administration or adjudication, provider reimbursement (health care), subrogation and recovery. What are we looking for Commercial InsuranceProperty and Casualty InsuranceProblem-solving skillsAbility to perform under pressureAbility to establish strong client relationshipAbility to work well in a teamHands-on experience with trouble-shootingInsurance ClaimsProperty and Casualty Claims Certifications: Insurance Industry Generalist Certification - Accenture Roles and Responsibilities: In this role you are required to do analysis and solving of moderately complex problems May create new solutions, leveraging and, where needed, adapting existing methods and procedures The person would require understanding of the strategic direction set by senior management as it relates to team goals Primary upward interaction is with direct supervisor May interact with peers and/or management levels at a client and/or within Accenture Guidance would be provided when determining methods and procedures on new assignments Decisions made by you will often impact the team in which they reside Individual would manage small teams and/or work efforts (if in an individual contributor role) at a client or within Accenture Please note that this role may require you to work in rotational shifts Qualification Any Graduation

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 varsha.kumari@mediassist.in

Ready to shape the future of work? At Genpact, we don't just adapt to change we drive it. AI and digital innovation are redefining industries and were leading the charge. Genpact's AI Gigafactory, our industry-first accelerator, is an example of how were scaling advanced technology solutions to help global enterprises work smarter, grow faster, and transform at scale. From large-scale models to agentic AI, our breakthrough solutions tackle companies most complex challenges. If you thrive in a fast-moving, tech-driven environment, love solving real-world problems, and want to be part of a team that's shaping the future, this is your moment. Genpact (NYSE: G) is an advanced technology services and solutions company that delivers lasting value for leading enterprises globally. Through our deep business knowledge, operational excellence, and cutting-edge solutions we help companies across industries get ahead and stay ahead. Powered by curiosity, courage, and innovation , our teams implement data, technology, and AI to create tomorrow, today. Get to know us at genpact.com and on LinkedIn, X, YouTube, and Facebook Inviting applications for the role of Insurance - Underwriting - Hyderabad Job Location - Hyderabad Shift timing - US shifts Work module - Work from office In this role, you will be responsible for Provide expert advice on commercial insurance products, risk management strategies, and regulatory requirements. Your expertise will be required to ensure that team members receive the best possible advice and solutions tailored to their specific needs. You will be required to interact and work with the client partners for all process/business knowledge related documents are updated periodically and team is made aware of the same in a timely manner. Should be open to work in any shift as per the business requirement Responsibilities Transaction processing for Underwriting Support Teams Communicating with the Onsite Team Responsible for Risk Clearance, Bind & Issue, Endorsement Processing, Renewal Processing Responsible to comprehend, good customer service attitude to clearly articulate the resolution Responsible to handle varied volumes of workloads and to reach targets and deadlines on a timely basis Qualifications we seek in you! Minimum qualifications Non Tech Graduates Good understanding of P&C products Should have wing to wing knowledge of the Underwriting lifecycle Must demonstrate and foster customer focus, teamwork, accountability, initiative, and innovation. Fluent in English language- both written and oral Preferred Qualification and Experience Insurance domain awareness. Good knowledge of MS Office. Preferred with certification on one of the streams i.e., IIA, or Cert CII or equivalent or AINS, CPCU certification etc. Knowledge of P&C insurance Good understanding of US Underwriting, Policy binding and Issuance Knowledge of Premium bearing & non premium bearing endorsement Knowledge of Renewal & Non-Renewal Why join Genpact? Be a transformation leader Work at the cutting edge of AI, automation, and digital innovation Make an impact Drive change for global enterprises and solve business challenges that matter Accelerate your career Get hands-on experience, mentorship, and continuous learning opportunities Work with the best Join 140,000+ bold thinkers and problem-solvers who push boundaries every day Thrive in a values-driven culture Our courage, curiosity, and incisiveness - built on a foundation of integrity and inclusion - allow your ideas to fuel progress Come join the tech shapers and growth makers at Genpact and take your career in the only direction that matters: Up. Lets build tomorrow together. Genpact is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, religion or belief, sex, age, national origin, citizenship status, marital status, military/veteran status, genetic information, sexual orientation, gender identity, physical or mental disability or any other characteristic protected by applicable laws. Genpact is committed to creating a dynamic work environment that values respect and integrity, customer focus, and innovation. Furthermore, please do note that Genpact does not charge fees to process job applications and applicants are not required to pay to participate in our hiring process in any other way. Examples of such scams include purchasing a 'starter kit,' paying to apply, or purchasing equipment or training.

H.Sc / Graduate freshers with good communication. US healthcare Exp will be an advantage. Knowledge of basic computer operations. Willingness to work in the late evening and night shifts. Courteous with strong customer service orientation. Good listening and speaking skills. Typing speed 30/90% Work from office only Mandatory Skills: Claims_Processing.

About The Role Skill required: Supply Chain - Mechanical Engineering Designation: Business Advisory Associate Qualifications: BE Years of Experience: 1 to 3 years What would you do? Process warranty claims for a US based agricultural and construction and forestry equipment to maintain quality and service standards of the Warranty Claims processing team in support of the contracted Service Level Agreement What are we looking for? BE Mechanical/Automobile Graduate (Fresher/Experienced)Experience in WarrantyExperience with Auto componentsInterpersonal skills to deal with dealers, warranty engineers, etcData processing accuracy, detail oriented, and ability to evaluate/research a warranty claimBasic level capability in use of desktop software (MS Office Suite, with focus on Excel)Organized, timely, pro-active and highly productiveStrong written communication in EnglishAttention to detail and ability to multi-taskInvestigate and Verify warranty claims based on available external support resources (Parts catalog, Dealer Assist & Standard labor time) & take appropriate decisionImplement practices to improve operational efficienciesCoach and Train team members Roles and Responsibilities: In this role you are required to solve routine problems, largely through precedent and referral to general guidelines Your primary interaction is within your own team and your direct supervisor In this role you will be given detailed instructions on all tasks The decisions that you make impact your own work and are closely supervised You will be an individual contributor as a part of a team with a predetermined, narrow scope of work Please note that this role may require you to work in rotational shiftsVerification and analysis of warranty claims based on available external resources (e.g. DTAC, parts catalogs, sales information)Running queriesDocumenting and adding comments (e.g. to slow pay list or to the claim) Qualification BE

1-5 years of experience in AR calling or revenue cycle management (RCM). Strong understanding of US healthcare Excellent communication skills Send resumes to people-culture@worldsourceteam.co.in Contact : Rajan 99400 65113.

To manage the insurance portfolio of all types of insurance policies & ensure adequate risk coverage at optimum costs and claims management. To procure various insurance policies with adequate coverage at optimum cost, ensure timely renewal of the insurance policies, and to ensure internal customer expectations for deliverables in terms of time, cost and service quality are met in line with business objectives. Proficient in managing insurance claims, especially PDBI claims Good technical knowledge about insurance products, coverage features, and claims process Coordination with cross-functional teams within the Company, Subsidiaries, insurers, surveyors etc. Implement best practices as per the companys guidelines. Ensure compliance of various processes and demonstrate through the conduct of internal as well as external audits. Obtaining and compiling relevant information from various departments on insurance requirements. Understand various risks, suggest appropriate clauses/wordings in the insurance policies to mitigate the risks, and get the desired insurance coverage. Review the performance of Insurers and TPAs and ensure prompt settlement of insurance claims within a stipulated time frame. Promptly address queries & concerns on Insurance matters. Conduct knowledge-sharing sessions with colleagues from other departments on the coverage under important insurance policies & the claims process.

Educational Requirements MBA,MCA,MTech,Bachelor of Engineering,BCA,BTech Service Line Application Development and Maintenance Responsibilities As a Senior Product Manager you will be pivotal to creating roadmap, owning release plan for multiple capabilities that is futuristic and meets industry and client needs. You will be responsible for continuous backlog management, prioritizing the backlog considering the needs and objectives of every stakeholder. As a thought leader in your business domain, bring in industry best practices, learnings from client demos and interactions into designing. You will anchor business pursuit initiatives, sales demo. You will have the opportunity to shape the Infosys platform that enables payers and providers to deliver better care. Additional Responsibilities: Experience in market leading healthcare products (key emphasis). Proven track record of at least 8 years in software product management roles. Capability/Feature planning and design, manage the specifications of their development, and monitor their on-going operation to better understand customer experiences. Clearly communicating progress towards delivery, technical challenges that may occur. Act as a thought leader and subject matter expert in the assigned product area, develop essential product documentation including business case, business requirements and use cases. Own product backlog and collaborate closely with the platform engineering team. Create Journey Maps that re-imagine/re-define the healthcare problematic process areas. Understanding of trends affecting customer adoption. Experience of working with enterprise customers, both technical and business, and at all levels. Influence leaders in diverse functional areas Strong business acumen including experience in estimation and pricing, market research. Demonstrated ability to navigate ambiguity and adapt quickly to modern technology and processes. Strong analytical ability with exposure to data science and automation Teaming/Collaboration - Demonstrates exceptional leadership and team management skills, with a collaborative and empowering approach to achieve results through influence. Excellent communication, presentation, and interpersonal skills to develop lasting relationships with senior business or technical leaders with the highest levels of business acumen and technical expertise. Technical and Professional Requirements: Payer/ Provider/ PBM organizations Product Management/Product Engineering /Healthcare Operations Experience working with industry leading Enrollment, Claims, Billing or EHR systems. Managing product lifecycle in whole from ideation, exploration, approval, development, implementation, measurement, and ongoing development. Expertise in US Government Program Line of Business - Medicare, Medicaid, Duals, Marketplace Plan Sponsor & Product, Enrollment & Billing, Provider Data Management, Provider Network Management, Claims, Encounters, Medicare, and Marketplace Risk Adjustment. Developing results-oriented strategies to solve complex and open-ended business problems. Market Analysis and Product fitment Communicating and facilitating architecture design discussions/decisions and impacts to key stakeholders. Customer success on managing customer engagements and requirements. Leading business pursuits and product demonstrations. Agile Product Development Methodology Preferred Skills: Domain->Healthcare->Healthcare - ALL

Role & responsibilities Outbound calls to insurances for claim status and eligibility verification Denial documentation and further action Calling the insurance carriers based on the appointment received by the clients. Working on the outstanding claims reports/account receivable reports received from the client or generated from the specific client software. Calling insurance companies to get the status of the unpaid claims. Willing to work in any process pertaining to voice based on the requirement (Insurance Follow UP, Patient calling, Provider outreach program etc. Maintain the individual daily logs. Performs assigned tasks/ completes targets with speed and accuracy as per client SLAs Work cohesively in a team setting. Assist team members to achieve shared goals. Compliance with Medusinds Information Security Policy, client/project guidelines, business rules and training provided, companys quality system and policies Communication / Issue escalation to seniors if there is any in a timely manner Punctuality is expected all the time Preferred candidate profile 0-3 months in any international call center. Minimum typing speed of 35 WPM Basic knowledge of MS Office Preparing spreadsheets and documents Good Communication skills must be able to fluently converse in English. Must have a neutral accent • No stammering and lisp Interested candidates can forward their resume on neha.prajapati@medusind.com

Role & responsibilities Review and process prior authorization requests in a timely and accurate manner. Communicate with healthcare providers, insurance companies, and patients to obtain necessary information and documentation. Ensure compliance with all regulatory and company policies and procedures. Maintain accurate records of all prior authorization activities and decisions. Provide support and guidance to healthcare providers and patients regarding prior authorization requirements and processes. Collaborate with other team members to improve workflow and efficiency. Stay updated on industry trends, regulations, and best practices related to prior authorization and healthcare operations. Preferred candidate profile B.Pharma/M.Pharma qualified candidates with 1 year of health care operations experience can apply. Perks and Benefits # Salary up to 5.8lpa # Both way cabs. # Rotational Shifts. # Top most brand name. # Good career growth. # and many more benefits. If interested then whats app your resume or call @ Gautam- 8800499244 OR Itisha- 99900 52966

Educational Requirements MBA,MCA,MTech,Bachelor of Engineering,BCA,BTech Service Line Application Development and Maintenance Responsibilities A day in the life of an Infoscion As part of the Infosys delivery team, your primary role would be to interface with the client for quality assurance, issue resolution and ensuring high customer satisfaction. You will understand requirements, create and review designs, validate the architecture and ensure high levels of service offerings to clients in the technology domain. You will participate in project estimation, provide inputs for solution delivery, conduct technical risk planning, perform code reviews and unit test plan reviews. You will lead and guide your teams towards developing optimized high quality code deliverables, continual knowledge management and adherence to the organizational guidelines and processes. You would be a key contributor to building efficient programs/ systems and if you think you fit right in to help our clients navigate their next in their digital transformation journey, this is the place for you!If you think you fit right in to help our clients navigate their next in their digital transformation journey, this is the place for you! Technical and Professional Requirements: Domain experience: Payer core claims/Membership/provider mgmt. Domain experience: Provider clinical/RCM, Pharmacy benefit management Healthcare Business Analysts - with Agile/Safe-Agile Business analysis experience Medicaid, Medicaid experienced Business Analysts FHIR, HL7 data analyst and interoperability consulting Healthcare digital transformation consultants with skills/experience of cloud data solutions design, Data analysis/analytics, RPA solution design Keywords: Claims, Provider, utilization management experience, Pricing,Agile, BA Preferred Skills: Domain->Healthcare->Healthcare - ALL Technology->Analytics - Functional->Business Analyst

Roles & Responsibilities: Processing claims and refunds on daily basis. Compilation of claim paid along with NEFT details. Maintaining schedule of claims payable account monthly and identifying reasons for pendency s Passing necessary entries in SAP to clear open items in bank reconciliation. To ensure that all paid claims data in SAP is matching with core system report. Upgradation and automation in system for smooth functioning. Coordination with claims team and other departments.

Overview : We are seeking an experienced and detail-oriented Accounts Receivable Associate (AR Caller) to join our dynamic team. The successful candidate will be responsible for handling and resolving claims, managing account receivables, and ensuring prompt collections in line with US healthcare policies and regulations. Responsibilities : Claims Management: Follow up on outstanding claims to reduce the accounts receivable (AR) days and resolve claim issues in a timely manner. Denial Management: Handle denials by understanding the root cause, correcting errors, and re-submitting claims for processing. Communication: Effectively communicate with insurance companies, healthcare providers, and other stakeholders regarding claims status, denials, appeals, and payment discrepancies. Account Follow-up: Monitor and review AR aging reports to identify and prioritize unpaid claims for follow-up. Documentation: Maintain accurate records of communications, actions taken, and status updates on patient accounts using company software systems. Compliance: Ensure adherence to HIPAA guidelines and US healthcare regulations during all interactions and processes. Reporting: Prepare and submit daily/weekly/monthly reports to management on claims status, denials, and collections achieved. Requirements : - Proven experience (2-5 Years) working in accounts receivable within the US healthcare industry. - Calling experience on Denial Management - Physician Billing/Hospital Billing. - Knowledge of insurance claim submission and reimbursement processes (Medicare, Medicaid, commercial insurance). - Experience with electronic medical records (EMR) and billing systems (e.g., Epic, Cerner, Meditech). - Excellent analytical and problem-solving skills. - Ability to prioritize and manage multiple tasks in a fast-paced environment. - Proficient in Microsoft Office Suite (Excel, Word, Outlook). - Strong interpersonal and communication skills, both verbal and written. - Should be comfortable working from office and in Night shifts. Benefits : - 5 Days Working. - Both side Cab Facility. - PF & Health Insurance. - Performance Bonus. - Professional development and training opportunities. - Collaborative and supportive work environment. Note: Immediate joiners preferred. *Interested Candidates can reach-out to below mentioned details : Contact Person : Lalit Bisht Contact Number : 8375974434 Email ID : lalit.bisht@rsystems.com Office Address : R Systems International Limited, 1st & 2nd Floor, Malpani Agile, Baner Road, Pan Card Club Road, Pune- 411045 Maharashtra