3165 Claims Processing Jobs - Page 34

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 stat...

SUMMARY Job Opening: Retail Staff Location: Jaipur Our client, a UAE-based multinational conglomerate headquartered in Dubai, is seeking freshers to join their retail staff team in Jaipur. This is an excellent opportunity for individuals looking to kickstart their career in the retail industry. Responsibilities: Folding and stacking at basic table. Timely display of received stocks. Upkeep of section. Ensuring a carton-free floor. Maintaining display standards, including signage. Merchandise clearance from the trial room. Ensuring the right product is displayed on the right browser. Providing customers with shopping bags. Requirements Requirements: Minimum qualification of 10th/12th/Graduate...

Seeking a Six Sigma Black Belt-certified Senior Process Improvement Engineer to lead insurance claims projects, drive process efficiency, coach teams, ensure compliance, and leverage automation. Strong analytics, leadership, insurance experience.

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...

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...

Secondary Skill : Serving with Integrity & CouragePosition Specific duties : Manage the ongoing medical, life and accident insurance for all geographies stay in connect with all stakeholders, ensure service levels and drive improvement Conduct analysis and study along with insurance broker for sourcing the right partner well before renewal time Create ongoing data-driven insights relating to insurance claims to drive speed, efficiency and cost improvement in claims and claims processing. Create dashboards and review with stakeholders periodically Drive cost reduction in claims through TPA, insurers and focusing on overall well-being of employees and families Ensure all systems and processes ...

Overview Managing Deduction claims and Invoice claims processing in SAP TPM Assist with promotional event enrolments / claim approvals. Ensure all customer contract legends are current to provide Trade Promotion Analyst guidance. Maintain a strong control environment with accurate trade accruals, contract approvals and verification. Manage exception through verbal and written interactions with Sales and Sales Finance. Responsibilities Managing Deduction claims and Invoice claims processing in SAP TPM Assist with promotional event enrolments / claim approvals. Ensure all customer contract legends are current to provide Trade Promotion Analyst guidance. Maintain a strong control environment wi...

Skills: MIS Reporting,Sales Make outbound calls to prospective clients to introduce and promote insurance products Explain policy coverage, benefits, terms, and conditions in a clear, customerfriendly manner Identify customer needs and recommend suitable insurance plans Handle queries, objections, and follow up to close enrollments Maintain accurate call logs and customer records in CRM Meet monthly sales targets and quality metrics Stay uptodate on product features and industry regulations

Conduct thorough analysis of clinical trial data to identify potential safety concerns. Develop and implement effective safety protocols to mitigate risks associated with medical devices. Collaborate with cross-functional teams to ensure compliance with regulatory requirements. Perform regular audits to ensure adherence to safety standards. Provide training and guidance on safety procedures to staff members. Review and approve safety documents, such as protocols and reports. Job Requirements Strong understanding of clinical trials, medical devices, and regulatory requirements. Excellent analytical and problem-solving skills. Ability to work effectively in a fast-paced environment. Good commu...

Manage and maintain accurate medical data records. Ensure compliance with regulatory requirements and industry standards. Collaborate with cross-functional teams to achieve project goals. Develop and implement effective data management processes. Analyze and interpret complex medical data to inform business decisions. Provide expert guidance on data-related matters to stakeholders. Job Requirements Strong understanding of medical terminology and concepts. Proficiency in data management software and tools. Excellent analytical and problem-solving skills. Ability to work effectively in a fast-paced environment. Strong communication and interpersonal skills. Experience working with IT Service &...

Conduct thorough analysis of clinical trial data to identify potential safety risks. Develop and implement effective safety protocols and procedures. Collaborate with cross-functional teams to ensure compliance with regulatory requirements. Perform regular audits to ensure adherence to safety standards. Provide training and guidance on safety procedures to staff members. Investigate adverse events and report findings to senior management. Job Requirements Strong knowledge of clinical safety principles and regulations. Experience working with medical devices is preferred. Excellent analytical and problem-solving skills. Ability to work effectively in a team environment. Strong communication a...

Manage and maintain accurate medical data records. Ensure compliance with regulatory requirements and industry standards. Collaborate with cross-functional teams to achieve project goals. Develop and implement effective data management processes. Analyze and interpret complex medical data sets. Provide expert guidance on data-related matters. Job Requirements Strong knowledge of medical terminology and concepts. Proficient in data management software and tools. Excellent analytical and problem-solving skills. Ability to work effectively in a fast-paced environment. Strong communication and interpersonal skills. Familiarity with IT Service & Consulting industry practices.

Manage and maintain accurate medical data records. Ensure compliance with regulatory requirements and industry standards. Collaborate with cross-functional teams to achieve project goals. Develop and implement effective data management processes. Analyze and interpret complex medical data to inform business decisions. Provide training and support to junior staff members. Job Requirements Strong knowledge of medical terminology and concepts. Experience with data management systems and software. Excellent analytical and problem-solving skills. Ability to work effectively in a team environment. Strong communication and interpersonal skills. Familiarity with IT Service & Consulting industry prac...

Cognizant Walk-in drive for US Healthcare - Senior Claims Auditor with Amisys experience in Hyderabad Interview Date : 27th Sep 2025 (Saturday) Interview Time : 10:00 AM 1:30 PM Venue : Building 12A , 1st floor Raheja Mindspace IT Park, Mindspace Madhapur Rd, HITEC City, Hyderabad, Telangana 500081 Contact Person : Vamsi Krishna Preferred candidates Profile: Must be a graduate. Minimum 1 to 6 Years of experience in US Healthcare Claims audit process. Must have worked on Claims Audit, including adjustments, pricing processes, and experience in high-dollar , COB , and PDR workflows. Strong knowledge of root cause analysis techniques . Proficiency in error categorization , documentation , and t...

Cognizant walk-in Drive for Senior claims adjudication in Coimbatore location. Interview Date : 27th Sep 2025 (Saturday) Interview Time : 9:30 AM - 12:30 PM Venue : Cognizant, CCC Campus, CHIL SEZ Campus, CHIL SEZ IT Park, Saravanampatti, Keernatham Village, Coimbatore-641035 Building Details : Food court - 2 nd floor, North End Contact Person : Govindaraj S / Gokul R Desired profile : Any graduates Minimum 1 to 4 Years of experience in US Healthcare Claims adjudication process (Payer side) Must have experience into End to End claims processing (US Healthcare) Must have strong knowledge in US Healthcare plans and claims forms like CMS 1500 & UB04 Must be willing to work in Night Shift (US Sh...

SUMMARY Job Title: P&C Insurance Team Lead Location: Noida Experience: 7+ years in claim processing Requirements Requirements: Graduate or Post graduate with 7+ years of experience Experience in dealing with international clients (Preferred) Must have Property and Casualty (P&C) Insurance experience Should have claims adjudication and adjusting experience Experience in end-to-end claims processing Minimum 2 years of experience in a team handling role Preferably CPCU or equivalent insurance designation Position Summary: The job holder will be responsible for managing a team and overseeing all relevant technical/operational processing activities. This role also involves providing direct assist...

Job Track Description: Requires relevant expertise through formal education in a professional, sales, or technical area. Performs technical-based activities. Contributes to and manages projects. Uses deductive reasoning to solve problems and make recommendations. Interfaces with and influences key stakeholders. Leverages previous knowledge and expertise to achieve results. Able to complete work self-guided. College or university degree required or equivalent work experience. General Profile Performs routine assignments. Exposure to fundamental theories and concepts. Develops skills by performing structured work assignments. Uses existing procedures to solve routine or standard problems. Rece...

JOB TITLE Technical Business Analysis Engineer II RESPONSIBILITIES May perform one or more of the following: Requirement/Analysis Ability to comprehend Business Requirement Documents (BRD) Maintain and Update Data/Vendor Interfaces BRD Interprets requirements to create systems specifications documents to build and execute system. Perform Data Analysis, Audit, and associated research and provide subsequent resolutions. Understanding of database/SQL Query Writing Work alongside with Sr. members or individually (as required) to assist in smooth integration/transition of processes and create/maintain documentations for the same. Responsible for solving the data and Vendor files related issues an...

Job Track Description: Requires experience in a professional, sales, or technical area through formal education. Performs technical-based activities. Contributes to and manages projects. Uses deductive reasoning to solve problems and make recommendations. Interfaces with and influences key stakeholders. Leverages previous knowledge and expertise to achieve results with teams and can complete work self-guided. A college or university degree required. General Profile Requires in-depth knowledge and experience. Uses best practices and understanding of business issues to improve products and services. Solves complex problems. Takes a new perspective using existing solutions. Works unaided and re...

TPAs, insurance companies, and corporate clients Pre-authorization and final approval process TPA desk operations Claims submission Discharge processes TPA tariff rates

Utilize advanced automation technologies to optimize operational processes, ensuring adherence to established procedures and quality standards. Analyze and interpret complex data sets to uncover patterns, providing insights that support operational initiatives and strategic decision-making. Contribute to the development of innovative solutions within the boundaries of established protocols, leveraging your understanding of business strategies and data analytics. Assist in the implementation of business strategies by developing and communicating technical requirements, ensuring alignment with overall business objectives. Provide quality service to customers through continuous communication. R...

KEY RESPONSIBILITIES: Handling of claim rejections/ claim related query over calls and emails. Floor support, Walk-in customers Satisfaction of customer Team satisfaction Learning and knowledge for team Required Candidate profile Must have BPT/Experienced claim adjudicator Medical Knowledge in depth. Must be comfortable for 6 day with rotational shift and customer servicing.

Job Description: Under direct supervision, the Associate is responsible for the timely and accurate posting and imaging of new claims. This includes accessing various systems, both internal and external, for eligibility. Other assignments can include managing incoming email inboxes, bulk uploading of claims and managing automated claims kick outs. The essential functions and responsibilities of this job position include, but are not limited to the following: Timely and accurately posts new claims in the Administrative System within established turnaround time Codes incomplete claims as appropriate Research claims eligibility to ensure the claim belongs to DRMS prior to posting. Reaches out t...

Roles and Responsibility Conduct thorough analysis of clinical trial data to identify potential safety risks and trends. Develop and implement effective safety protocols and procedures to mitigate identified risks. Collaborate with cross-functional teams, including regulatory affairs, quality assurance, and product development. Review and approve safety-related documentation, such as clinical study reports and investigational reports. Provide training and guidance on safety best practices to internal stakeholders. Stay up-to-date with changing regulations and industry standards related to clinical safety. Job Requirements Strong understanding of clinical trials, safety protocols, and regulat...

Roles and Responsibility Handle customer inquiries and resolve issues professionally and courteously. Provide excellent customer service through various communication channels. Resolve complex customer complaints and concerns efficiently. Collaborate with internal teams to improve overall customer satisfaction. Maintain accurate records of customer interactions and transactions. Continuously update knowledge of products and services to provide informed support. Job Requirements Minimum 3 years of experience in customer service, preferably in a voice-based role. Strong knowledge of US insurance products and services. Excellent communication and problem-solving skills. Ability to work in a fas...