3165 Claims Processing Jobs - Page 35

Roles and Responsibility 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. Proficient in using various software applications and tools. Excellent analytical and problem-solving skills. Ability to work effectively in a fast-paced environment. Strong communication and interpersonal skills. F...

About Client Hiring for One of the Top most Prestigious Multinational Corporations!!! Job Title : Senior Process Analyst / US Healthcare Insurance Qualification : Any Graduate and Above Relevant Experience : 3 to 7 Years Must Have Skills : 1.Medical Billing. 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 Responsibiliti...

Roles and Responsibility Develop high-quality medical documents, including clinical trial protocols, informed consent forms, and case study reports. Review and edit medical documents for accuracy, clarity, and compliance with regulatory requirements. Collaborate with cross-functional teams, including physicians, researchers, and other stakeholders, to develop and review medical documents. Conduct thorough reviews of medical documents to identify areas for improvement and implement changes as needed. Stay up-to-date with industry trends and developments in medical research and technology. Participate in the development of new medical document templates and tools. Job Requirements Minimum 3 ye...

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. Prepare and review safety reports, such as adverse event reports and periodic safety update reports. Stay up-to-date with changing regulations and guidelines related to clinical safety. Provide training and guidance to internal stakeholders on clinical safety best practices. Job Requirements Strong understanding of clinical trials, safety protocols, and regulatory req...

Claims Associate Medical Company : GoDigit General Insurance Department : Health Claims – Medical Position Overview Looking to leverage your medical expertise in a dynamic insurance environment? As a Claims Associate – Medical, you will play a key role in ensuring the accuracy, quality, and integrity of health claims decisions by applying clinical knowledge, regulatory awareness, and strong attention to detail. This role demands a balance of technical understanding and operational execution. Key Responsibilities Claims Processing: Review, analyze, and process health claims accurately and within turnaround time (TAT) as per internal SOPs and regulatory norms. Medical Review: Assess the clinic...

Great Britain - Claims Role Great Britain Claims Designation Advisor Business Unit Great Britain Shift Timings Day Rotational Location Thane – iTHINK Reporting to Business Support Supervisor/ Assistant Manager About Willis Towers Watson Willis Towers Watson (NASDAQ: WLTW) is a leading global advisory, broking and solutions company that helps clients around the world turn risk into a path for growth. With roots dating to 1828, Willis Towers Watson has 45,000 employees serving more than 140 countries and markets. We design and deliver solutions that manage risk, optimize benefits, cultivate talent, and expand the power of capital to protect and strengthen institutions and individuals. Our uniq...

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

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...

Job Title: AR Analyst US Healthcare Location: Hyderabad Shift Timings: 6:30 PM – 3:30 AM (IST) Transport: One-way cab provided Job Description: We are hiring AR Callers with 6 months–3 years of experience in US Healthcare. The role involves working on Physician Billing, Medical Billing, and Denial Management , ensuring timely follow-ups and claim resolution. Responsibilities: Follow up with insurance companies on claims status. Handle denials, rejections, and appeals effectively. Work on Physician & Medical Billing processes. Maintain compliance and quality standards. Requirements: 6 months to 3 years of experience in AR Calling / Medical Billing / Denial Management . Good knowledge of US He...

As a Claims Specialist at Quantanite, you will play a crucial role in managing the end-to-end claims process to ensure timely and accurate reimbursement. Your responsibilities will include reviewing, submitting, and following up on insurance claims, collaborating with internal teams, insurance companies, healthcare providers, and patients to resolve billing discrepancies, and maintaining compliance with regulations. Key Responsibilities: - Review claims for assigned offices and ensure timely submission. - Perform quality control checks on patient accounts to guarantee accurate billing. - Analyze denial queues to identify outstanding claims and unpaid balances. - Follow up with insurance comp...

Role & responsibilities Short Paid Claim Contesting Executive-Drive timely and accurate contesting of short-paid claims across hospital-insurer interfaces, ensuring recovery yield and SOP compliance. Analyze short-paid claims and categorize by deduction type, insurer, and RCA triggers. Draft and submit contest letters with supporting documentation via IHX and insurer portals. Track contesting outcomes and escalate unresolved cases per SLA timelines. Collaborate with unit credit cells and central recovery team for RCA discipline and documentation hygiene. Maintain dashboards for contesting status, win-loss ratios, and financial impact. Ensure adherence to SOPs and flag deviation trends for go...

Role & responsibilities Maximize recovery of outstanding claims from TPAs and insurers through disciplined follow-up, documentation, and stakeholder coordination. Monitor aging reports and follow up on pending claims across TPAs and insurers. Coordinate with internal billing, credit cell, and finance teams for claim documentation and query resolution. Engage with insurer/TPA representatives to expedite settlements and resolve disputes. Maintain tracker for recovery status, escalations, and financial realization. Support RCA documentation and contesting for short-paid or denied claims. Prepare weekly MIS and recovery dashboards for leadership review. Preferred candidate profile Familiarity wi...

Greetings from The Job Factory !! Job Summary: We are seeking highly motivated and enthusiastic undergraduate or graduate freshers/ experience to join our team as International Process Associates. The successful candidates will work on international processes, providing exceptional service to our global clients. **Only immediate joiners with Graduates and Undergraduates can apply** **Only candidates who have excellent communication can apply** For More Details Call : HR Arfath @ 9008816263(Call or Whatsapp) Email id : Arfath@thejobfactory.co.in Role & Responsibilities: 1. Handle customer inquiries and resolve issues via phone, email, or chat 2. Provide product information and support to cust...

Eurofins Assurance India Pvt Ltd is a leading certification body providing Audit & Certification , Inspections , and other services covering the broad spectrum of sustainable supply chain. Eurofins will help the customers to mitigate risks in their supply chain and to ensure the benchmarking performance with operations, processes, systems, people or capabilities. Whether you are in Food, Cosmetics, Consumer products or Health care sector, our global auditor and technical expert network will help to mitigate/eliminate your risks against supply chain and distribution flows: Regulatory and Industrial standards . We have accreditations for a number of different industry standards/memberships to ...

Eurofins Assurance India Pvt Ltd is a leading certification body providing Audit & Certification , Inspections , and other services covering the broad spectrum of sustainable supply chain. Eurofins will help the customers to mitigate risks in their supply chain and to ensure the benchmarking performance with operations, processes, systems, people or capabilities. Whether you are in Food, Cosmetics, Consumer products or Health care sector, our global auditor and technical expert network will help to mitigate/eliminate your risks against supply chain and distribution flows: Regulatory and Industrial standards . We have accreditations for a number of different industry standards/memberships to ...

Role Objective: To bill out medical accounts with accuracy within defined timelines and reduce rejections for payers. Essential Duties and Responsibilities: Process Accounts accurately basis US medical billing within defined TAT Able to process payer rejection with accuracy within defined TAT. 24*7 Environment, Open for night shifts Good analytical skills and proficiency with MS Word, Excel, and PowerPoint Qualifications: Graduate in any discipline from a recognized educational institute. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Good communication Skills (both written & verbal)Skill Set: Candidate should have good healthcare knowledge. Candidate should have...

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 admissibil...

About The Role Project Role : Business Analyst Project Role Description : Analyze an organization and design its processes and systems, assessing the business model and its integration with technology. Assess current state, identify customer requirements, and define the future state and/or business solution. Research, gather and synthesize information. Must have skills : Microsoft Dynamics CRM Functional Good to have skills : NAMinimum 3 year(s) of experience is required Educational Qualification : 15 years full time education Summary :As a Business Analyst, you will engage in a variety of tasks that involve analyzing organizational processes and systems. Your typical day will include assess...

About The Role Skill required: Operations Support - Pharmacy Benefits Management (PBM) Designation: Health Operations Specialist Qualifications: Any Graduation Years of Experience: 7 to 11 years What would you do? Embedding digital transformation in healthcare operations end-to-end, driving superior outcomes and value realization today, and enabling streamlined operations to serve the emerging health care market of tomorrowYou will be a part of the Healthcare Claims team which is responsible for the administration of health claims. This team is involved in core claim processing such as registering claims, editing & verification, claims evaluation, and examination & litigation.The business pr...

Analyst Claims- Review and process property insurance claims, including analyzing policies, assessing damage, and determining coverage and settlements. Work with insurance adjusters, clients, and third-Frty vendors to gather necessary information and documentation for claims processing. Collation of data and information of claims for reporting purposes Investigate and evaluate claims to ensure accuracy and completeness. Prepare and present reports and recommendations to management regarding claims status, trends, and outcomes. Involvement in subrogation requests and required follow-ups. Communicate with clients and stakeholders regarding claims status and resolution. Provide support to other...

SUMMARY Retail Staff Job Description Our client, a UAE-based multinational conglomerate headquartered in Dubai, is seeking freshers to join their retail staff team. The group is involved in the retailing of various products such as apparel, footwear, consumer electronics, cosmetics & beauty products, home improvement, and baby products. Additionally, the group focuses on hospitality & leisure, healthcare, and mall management. Responsibilities: Folding and stacking at a 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 displa...

Mercer is seeking candidates to join our Claims Service team based in the Pune/Mumbai office. This is a hybrid role that requires working in the office at least three days a week. Specialist Claims Service (Grade C1) What can you expect: Excellent exposure to complex & diverse claims handling. Opportunity to enhance Claims knowledge and understanding & build on client management skills. As a new colleague, you will be provided with Business Overview/Insights, in-depth process training, roles & responsibilities overview, expectations of various stakeholders to make you successful in this role. Within the first 30 days, we expect you to gain good understanding of the role and requirement that ...

Role & responsibilities Strong knowledge of Health Insurance and products Must have a minimum of 10 years experience in health claims management with over 5 years managerial experience. The candidate can be from health insurance, general insurance, reinsurance, or life insurance industries. Extensive experience in health claims processing and administration. Proficient in health claim fraud prevention & loss mitigation framework. Should have experience in managing large teams Understanding of Health Claims and claim related processes Lead a team handling claims, customer queries & complaints, risk & Loss mitigation team , Implement & monitor framework designed. Drive health claims policy for...

Primary Responsibilities: Claims adjudication/Adjustments/Rework by reviewing the policies, researching, investigating, negotiating, processing, and adjusting claims Consistently meet established productivity, schedule adherence and quality standards Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regard to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company ma...

Claims Handling: Manage end-to-end claims processes for home insurance policies, covering both structure and/or contents. Ensure accurate and thorough evaluation of claims documentation for compliance with policy terms and conditions. Manage end-to-end claims processes for home insurance policies, covering both structure and/or contents. Assess and validate claims arising from any of the following insured events: Fire Explosion or Implosion Lightning Earthquake, volcanic eruption, or other convulsions of nature Storm, Cyclone, Typhoon, Tempest, Hurricane, Tornado, Tsunami, Flood, and Inundation Subsidence of land, Landslides, or Rockslides Bush fire, Forest fire, Jungle fire Impact damage ca...