3165 Claims Processing Jobs - Page 26

Greeting from Medi assist TPA Pvt ltd. Hiring Medical officer for Insurance Claim processing Profile Location- Mumbai -Andheri East. Role - Medical officer Exp : 0-3 years WORK FROM OFFICE ONLY. Job description : 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 ...

Job Title: AR Caller Location: Bangalore / Hyderabad / Coimbatore Job Type: Full-Time Shift: Day / Night / US Shift Experience Level: 0 to 8 years Job Summary: The AR Caller is responsible for calling insurance companies in the US to follow up on pending or denied medical claims. The role requires strong communication skills, attention to detail, and the ability to analyze and resolve billing issues to ensure timely payments. Key Responsibilities: Call insurance companies (in the US) to follow up on outstanding accounts receivables. Understand the denials and take necessary action. Analyze claims and determine the reasons for rejections or delays. Initiate appeals or corrections as needed. D...

Quantuspro Solutions is seeking a candidate with good analytical skills with understanding of US Health care/ Revenue Cycle Management/Accounts Receivables/ Claims processing. **EXCELLENT COMMUNICATION SKILLS IN ENGLISH IS VERY IMPORTANT** ** FRESHERS ARE WELCOME ** Job Description: - US Healthcare / Dental Billing Process - Accounts Receivables Calls - Denials and Appeals Management - End to End Billing Cycle Management - Posting Payments - Knowledge of Provider Credentialing - Knowledge of Insurance Eligibility verification - Knowledge in Dental Billing is a Plus - Excellent Communication Skills - Must be flexible to work in Day / Night Shifts - Good Typing Speed - Must be willing to work ...

We are looking for Duty Medical Officer who has experince in Insurance Sector. Experience : Minimum of 1 year in Insurance Qualification : MBBS Interested kindly contact 7358189600

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

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

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

Role & responsibilities This role will need to partner with others inter-departmental teams in order to realize some of the outcomes About you: • The successful candidate should have excellent computer (PowerPoint, Excel and Word) skills, strong financial and analytic research skills, problem solving, and organizational skills as well as a commitment to quality, customer satisfaction and meeting of deadlines. • Previous experience in claims processing preferably in the Consumer Directed Health market with knowledge of HSA, FSA, HRA, DCA, and other Transit products. • Ability to work independently and collaboratively in a fast-paced environment. EDUCATION/EXPERIENCE • Bachelors/ master’s degr...

Aster DM HealthCare Global Centre is looking for Executive - Revenue Cycle Management to join our dynamic team and embark on a rewarding career journey. Responsible for overseeing revenue cycle operations, which includes managing billing, coding, collections, and cash flow. Develops and implements revenue cycle strategies that align with the organization's goals and objectives. Should have a strong background in revenue cycle management. Excellent communication and leadership skills. Should also have a thorough understanding of revenue cycle operations. Disclaimer : This job description has been sourced from a public domain and may have been modified by Naukri. com to improve clarity for our...

Allianz is looking for Claims Analyst to join our dynamic team and embark on a rewarding career journey. Oversee the claims processing department and ensure timely settlements. Verify and validate claims documentation and eligibility. Handle complex or disputed claims and resolve issues efficiently. Coordinate with other departments for claim investigations. Train and guide claim processors to maintain accuracy and efficiency. Disclaimer : This job description has been sourced from a public domain and may have been modified by Naukri. com to improve clarity for our users. We encourage job seekers to verify all details directly with the employer via their official channels before applying.

About Client Hiring for One of the Topmost Prestigious Multinational Corporations!!! Job Title : Senior Process Analyst / US Healthcare Insurance Qualification : Any Graduate and Above Relevant Experience : 3 to 8 Years Must Have Skills: 1. US Health insurance 2. Excellent Verbal and Written Communication Skills (Internal & External stakeholders). 3. Active Listening and Comprehension Skills Consulting Skills Communication, questioning, report writing, and presentation. 4. Proficiency in Microsoft Office Suite. 5. Time Management & Organizational Skills. 6. Attention to Detail High accuracy in documentation. 7. Healthcare Processes. Good Have Skills : US Healthcare Insurance Roles and Respon...

Role & responsibilities Handle end-to-end payment processing including Authorization, Clearing, and Settlement for US clients. Perform transaction processing, reconciliation, and exception management within SLA. Manage chargebacks, disputes, and fraud investigation for card transactions. Provide operational support for payment gateways & merchant acquiring services. Ensure compliance with US banking regulations, PCI DSS, EMV, ISO8583 standards . Collaborate with internal teams (Risk, Technology, Client Services) for issue resolution. Monitor daily transaction flows, settlement reports, and reconciliations . Maintain accuracy, timeliness, and adherence to US time-zone processes . Preferred ca...

SUMMARY Retail Staff Opportunity for Freshers ===================================== Summary ----------- We are seeking a dynamic and enthusiastic Retail Staff member to join our team in Rajasthan. As a key member of our retail team, you will be responsible for providing an exceptional customer experience, maintaining a well-organized store environment, and contributing to the overall success of our retail operations. Responsibilities - - - - - - - - - - - - - - - - - - - Folding and stacking merchandise at the basic table Timely displaying received stocks to ensure a visually appealing store environment Maintaining the upkeep of the store section, including ensuring a carton-free floor Ensur...

Job Description: 5+ Years -11 Years of overall IT experience including 4+ years of Guidewire experience. Extensive experience working on ClaimCenter versions 10 and Cloud versions. Guidewire cloud certified. Should have worked on implementation projects. Insurance domain knowledge with Property & Casualty background. Strong knowledge of Guidewire platform (Gosu scripting/ UI / Data Model). Hands-on experience on ClaimCenter configuration. Experience on Integration with External Systems using Guidewire Platform supported integration techniques. Knowledge on GX Model, Entity Populator and XML. Experience on any database Oracle / SQL Server and well versed in SQL. Experience working on Agile me...

Roles and Responsibilities Manage insurance claims from receipt to settlement, ensuring timely and accurate processing. Conduct thorough analysis of claim documents, including medical records, police reports, and other relevant documentation. Identify potential fraud risks and take necessary actions to mitigate them. Collaborate with internal stakeholders, such as adjusters, attorneys, and medical providers to resolve claims disputes.

Immediate Joiner need BUDGET-30 LPA exp-5+ YRS Claim Centre,Gosu DEVOPS GIT GUNIT GOSU/JAVA M-7731036846/shantha@yeslandmark.com

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 d...

Role & responsibilities Coordinate with patients, TPAs, and insurance companies for pre-authorization, approval, and final claim settlements. Prepare and submit claim documents and bills to TPAs/insurance companies in the prescribed format. Follow up regularly with TPAs for claim status, pending queries, and settlement updates. Verify patient insurance details, coverage, and eligibility before admission and discharge. Maintain accurate and up-to-date records of all claims submitted and settled. Handle rejections, discrepancies, and short settlements by coordinating with relevant departments and TPAs. Ensure compliance with hospital policies and TPA/insurance requirements. Generate periodic r...

Role & responsibilities Asst. Billing Manager works under supervision of Head of Accounts & Finance Guide and mentor team Maintains billing controls by preparing and recommending policies and procedures. Maintains financial security by following internal controls. Prepares refunds by verifying documentation, and requesting refunds. Maintains customer confidence and protects operations by keeping financial information confidential. Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies. Accomplishes the result by performing the duty. Supervise, guide, train,...

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

As a Senior Relationship Manager at BimaKavach, you will play a crucial role in owning and growing relationships with B2B clients, providing them with tailored insurance solutions to protect what matters most. Your responsibilities will include: - Building and nurturing deep, long-term relationships with leadership teams of allocated clients. - Understanding each client's unique risk landscape and offering tailored insurance solutions across Employee Benefits (EB) and Non-EB lines. - Leading end-to-end account servicing including onboarding, policy renewals, cross-sells, upsells, claims support, and ongoing consultation. - Owning your portfolio by making regular client visits, delivering exc...

Job Title: Team Leader-Claims Adjudication (US Healthcare)-Coimbatore Experience: 5-8 years Qualification: Bachelors degree Shift: Night shift Transportation: Pick up and drop would be provided Job Summary: Team Leader - Claims Adjudication will oversee a team of healthcare professionals responsible for processing member enrollments and adjudicating claims in compliance with US healthcare regulations, client-specific guidelines, and quality standards. The role ensures efficient workflow, team performance, process improvement, and client satisfaction. Key Responsibilities: Team Management & Leadership: Lead, mentor, and manage a team handling enrollment, Provider configuration- Coimbatore and...

Greetings!! Openings for " Immediate Openings-Claims Adjudication-Quality Analyst " -Coimbatore Required Skills: Subject matter expert in Claims process. Able to perform Quality Audits. Exceptional interpersonal, customer service, problem-solving, verbal and written communication, and conflict resolution skills. Proficiency with the necessary technology, including computers, software applications, phone systems, etc. Ability to improve and/or transform teams processes across functions within the organization. Ability to understand basic data and take appropriate action. Ability to drive individual and team efficiency and productivity through effective and efficient metric management. Ability...

- Bangalore Were hiring experienced professionals in US Healthcare! : •4+ yrs. US Healthcare claims experience for Non Voice (Claims adjudication/claim processing) • 4+ yrs. of experience in International contact Centre (Inbound Voice) Claims adjudication in US Healthcare or Internation contact center experience is mandatory. Should have good communication skills Speak , read and written . Open : • Operations -Team Leader / AM/DM/M/SM •Quality Specialist & TL Quality •Subject Matter Expert (SME) •Process Trainers. •WFM- RTA/ Cap Planning/ Forecasting & Scheduling (Specialist, AMs and DMS ) ? •Leading US Healthcare brand •Fast-track growth & leadership opportunities •Attractive benefits & rew...

Medcare Hospitals Medical Centres is looking for Associate - Insurance to join our dynamic team and embark on a rewarding career journey. 1. Customer service : Associates in Insurance serve as the primary point of contact for customers, providing them with information about policies, handling claims and addressing any concerns or issues they may have. 2. Risk assessment and analysis : They help assess risks associated with insuring different clients, analyze data and make recommendations to senior-level professionals. 3. Claims processing : Associates in Insurance handle claims processing, by gathering information, reviewing policies, assessing damage and negotiating settlements. 4. Complian...