3165 Claims Processing Jobs - Page 25

Job Title: CLAIMS HANDLER Location: Bangalore Job Type: Full-time Experience Required: 0 to 3 Years/ fresher can also apply Education: Any grad Process 1st round HR Round 2nd round SHL Test 3rd round SD(OPS Round) Qualification/Experience grad Location Sutherland Global services. Unit no 202, 2nd floor, campus D, Centennial Business park Kundan Halli main road, EPIP Area, Bangalore, Karnataka 560066. Transport 2-way cab Salary 4.5 lpa Note Work from office WANT A GOOD WORK LIFE BALANCE Fixed shifts and fixed weekend off Collection Voice Process Sutherland is seeking highly proficient * Claims associate in Bangalore. If you have the right experience and expertise, this could be an excellent c...

JOB DESCRIPTION Designation/ Role: Trainee Department : Accounts Receivable Work Timing: Night Shift Qualifications: Minimum HSC/10+2 Equivalent (Any Graduate Preferred) Skills: Good verbal and written communication Skills. Able to build rapport over the phone. Strong analytical and problem-solving skills. Be a team player with positive approach. Good keyboard skills and well versed with MS-Office. Able to work under pressure and deliver expected daily productivity targets. Ability to work with speed and accuracy. Medical billing AR or Claims adjudication experience will be an added advantage. Experience 01-year experience US calling process will be an added advantage. Job Description The jo...

Hiring for Claims Process Associate !!! Skills Required: Candidate should be excellent in verbal communication skills Freshers and Experienced candidates can apply for this position Experienced candidates must have atleast 6 months to 1 year of experience into claims processing Graduation mandatory Education: Non-Technical education background required(eg.BA,B.com,BBA) Additional Information: *Should be flexible to work from office and rotational shifts *Candidate should be in 20 kms of radius from work location * 5 days working, 2 days week offs Interview Location BLOCK-D, CENTENNIAL. 201 Kundalahalli Main Road EPIP Zone, Brookefield,Bengaluru- 560066 POC - HR Sharon Note : Sutherland never...

Responsibilities AreaGreet and welcome all walk-in customers, directing them to the clinic to promote free eye check-ups. Participate in stocktakes, maintain sales floor standards, and handle daily tasks to ensure an exceptional shopping experience for customers.Familiarize with the POS system to ensure smooth and accurate transaction processing.Commit to customer satisfaction by addressing and resolving any customer concerns.Focus on customer needs, driving overall satisfaction. Personal Attributes & Competencies:Minimum qualification: Diploma or Bachelor's degree in Optometry Freshers are welcome to apply no prior work experience required Strong ability to build rapport and foster trusting...

Conduct eye examinations using specialized equipment. Evaluate patients for the presence of vision problems and other eye disorders. Prescribe eyeglasses, contact lenses, and other visual aids. Provide advice to patients on eye care and recommend treatment options. Degree in Optometry or related field. Valid license to practice as an Optometrist. Strong knowledge of optometry practices and procedures. Excellent communication and interpersonal skills. Are you a passionate Optometrist looking for an opportunity to showcase your skills in West Bengal? We at xxxxx are seeking a skilled professional to join our team. As an Optometrist, your responsibilities will include conducting eye examination...

SUMMARY P&C Insurance Team Lead ========================== Summary ----------- We are seeking an experienced P&C Insurance Team Lead to manage a team and oversee all relevant technical/operational processing activities. The successful candidate will provide direct assistance to underwriting teams as needed, while also handling people management, performance appraisals, and client interaction. Responsibilities - - - - - - - - - - - - - - - - - - - Monitor the performance of a team of Claims adjusters and provide timely feedback Conduct employee performance reviews and assist with professional development Set objectives and manage the team's progression Coordinate with internal customers and m...

Positions General Duties and Tasks: Process Insurance Claims timely and qualitatively Meet & Exceed Production, Productivity and Quality goals Review medical documents, policy documents, policy history, Claims history, system notes and apply the trained client level business rules to make appropriate Claims decisions, call out claims trends and flag fraud activities Stay up to date on new policies, processes, and procedures impacting the outcome of Claims processing Be a team player and work seamlessly with other team members on meeting customer goals Requirements for this role include: Both Under Graduates and Post Graduates can apply. Excellent communication (verbal and written) and custom...

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...

The Billing Manager responsible for overseeing the hospital’s billing operations, ensuring accurate and timely submission of claims, payment posting, and revenue collection. The Manager leads the billing team, coordinates with clinical departments.

We have vacancy for the post of TPA manager. Qualification - BAMS/BHMS Experience - 2 to 10 yrs. as TPA Manager Job description - Act as the primary liaison between the hospital and various TPAs, insurance companies, and corporate clients. Handle empanelment and renewal of contracts with TPAs and insurance companies. Ensure smooth coordination for pre-authorization, approval, and discharge processes. Resolve disputes or issues related to pending approvals, denials, or short payments. Supervise TPA executives/coordinators in the billing or insurance desk. Train staff on TPA procedures, documentation standards, and claim follow-up. Conduct regular performance reviews and ensure efficient team ...

Retail Claims - Automation & ProjectsKey Responsibilities1 Automate Claims Processes- Design anddevelop automated workflows and business rules to streamline claims processing Integrate with Existing Systems- Integrateautomated claims processing solutions with existing systems and technologies Testing and UAT - Test and validateautomated claims processing solutions to ensure accuracy and efficiency 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 Strong techn...

Initiate calls requesting status of claims in queue. Contact insurance companies for further explanation of denials and underpayments Take appropriate action on claims to guarantee resolution. Ensure accurate and timely follow-up where required. Document actions taken in claims billing summary notes To prioritize the pending claims for calling from the aging basket To make a physical call by following the international norms and applicable rules for confidentiality and HIPAA compliance. Responsible for working on Denials, Rejections, LOAs to accounts, making required corrections to claims. Shall understand and abide by the organizations information security policy and protect the confidentia...

Initiate calls requesting status of claims in queue. Contact insurance companies for further explanation of denials and underpayments Take appropriate action on claims to guarantee resolution. Ensure accurate and timely follow-up where required. Document actions taken in claims billing summary notes To prioritize the pending claims for calling from the aging basket To make a physical call by following the international norms and applicable rules for confidentiality and HIPAA compliance. Responsible for working on Denials, Rejections, LOAs to accounts, making required corrections to claims. What you will need: Good voice and demonstrate professional demeanor via phone. Must be a Graduate Must...

Minimum of 5+ years of experience Data file analysis and problem resolution of inbound files. Data analysis using Excel, SQL, or other ODBC toolsets with Oracle RDBMS. Document preparation (Functional Requirements FRD). SDLC lifecycle adherence and management of change control process and approvals QA support of requirements and testing Maintain team documentation of data inventory, mapping document and flow diagrams Assists in managing large scale projects, leads appropriate resources, and determines project requirements and deliverables, to ensure successful implementations to meet customer stakeholder user needs. Assists in ensuring successful project conclusions and large-scale projects ...

Role Responsibilities : In-depth knowledge and experience in the US healthcare (Non Voice) Provider Data Validation and Provider Data management. Candidate should have 3 years and above experience in US healthcare and into provider enrollment and credentialling. Ensures day-day transactions are processed per standard operating procedures. Follows Work process flow to ensure pends are completed and maintain Quality and timeliness standards. Knowledge in Amisys and Cenprov application are preferred. Product knowledge in checking affiliation for Medicaid, Medicare and Exchange. Everyday checked Contract information in Payment Index such as, Pay class, override key, accepts code and etc. Ability...

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...

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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 ...

Roles and Responsibilities : Review and process claims in accordance with established guidelines, regulations, and company policies. Conduct thorough reviews of medical records, diagnoses, treatments, and procedures to determine coverage eligibility. Identify potential denials and take proactive steps to resolve issues before submitting claims to payers. Collaborate with internal stakeholders to ensure accurate coding, billing, and reimbursement processes. Job Requirements : 4-8 years of experience in claims adjudication or related field (e.g., HCPCS). Strong understanding of ICD-10-CM/PCS, CPT, HCPCS codes; ability to apply knowledge effectively. Proficiency in claims processing software ap...

Description The Assistant Manager/Deputy Manager Claims will be responsible for overseeing the claims process, ensuring efficient and effective handling of claims, and managing a team of claims professionals. This role requires strong analytical skills and the ability to communicate effectively with various stakeholders. Responsibilities Manage and oversee the claims process from initiation to resolution. Ensure compliance with company policies and regulatory requirements. Evaluate claims for completeness and accuracy, and make determinations on claims settlement. Communicate effectively with clients, insurance agents, and other stakeholders regarding claims status and resolution. Assist in ...

Job Summary: The Business Analyst will play a key role in supporting finance and management information (MI) systems for an insurance company. The individual will bridge the gap between business operations, finance, and IT, ensuring the successful implementation and optimization of finance-related systems and management reporting tools. The role involves gathering business requirements, facilitating communication between stakeholders, and analyzing data to improve decision-making processes within the insurance domain. Key Responsibilities: Requirements Gathering : Collaborate with stakeholders (finance teams, insurance operations, and IT) to gather, document, and translate business requireme...

Job Descriptions: 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 nonavailability of tariff. Approve or deny the cla...

You would be responsible for managing the end-to-end claims process for clients, ensuring seamless handling from claim intimation to settlement follow-ups. You will be the key point of contact for clients and AMCs regarding claim processes. You should be strategic and detail-oriented, ensuring timely documentation, filing, and resolution of claims while also contributing to business growth through lead generation and upselling. Job Duties and Deliverables include, but are not limited to Constantly upgrading yourself on industry trends and claim procedures. Managing claim intimations and ensuring accurate registration of claims. Coordinating with AMCs for smooth claim processes and timely res...

Billing & Claims Processing: Generate and verify patient bills for ECHS beneficiaries as per CGHS/ECHS rate lists. Ensure proper documentation (OPD/IPD case papers, prescriptions, lab/radiology reports, etc.) is attached with each bill. Required Candidate profile Bachelor’s degree in Commerce, Business Administration, or a related field. Knowledge of ECHS/CGHS billing procedures is preferred. Prior experience in hospital billing.

4+ Years of Experience in US Healthcare Claims Adjudication Open Positions : Team Leader Operations Quality Specialist Subject Matter Expert (SME) Process Trainer Hari - 7618776218 Shiny -7022976218