3165 Claims Processing Jobs - Page 39

Please share your resume @ shikha.nillay@provana.com or text me @ 7678565526 L ocation: CHENNAI Role: Charge Entry Specialist Responsibilities: Charge Entry: Accurately input and post charges into the billing system for a variety of healthcare services provided to patients. Data Verification: Review and verify the accuracy of charge data from clinical documentation and coding to ensure compliance with payer requirements. Reconciliation: Reconcile posted charges with corresponding insurance claims and payments to identify discrepancies and resolve issues promptly. Reporting: Generate and maintain reports on charge postings, identifying trends and issues that may impact revenue cycle performan...

Hiring For Claims Analyst Good communication with experience in managing customer claims in the retail industry Degree in Commerce, Accounting with good analytical skills and high level of accuracy and attention to detail Analyze customer claims and deductions by reviewing supporting documentation such as purchase orders, invoices, and proof of delivery to determine their validity. Should be able to analyse, validate customer claims and deductions Work closely with various internal teams, including sales, accounting, and customer service, to gather information and achieve resolution Research and resolve various types of deductions, including those for shortages, pricing, and other terms of s...

Job Title: Billing Head Location: Shalby Hospitals Department: Billing & Recovery Key Responsibilities Oversee and manage all corporate recovery processes. Ensure timely follow-ups with government and corporate bodies for recovery. Receive and review outstanding payment reports; coordinate with concerned departments and stakeholders for closure. Maintain effective coordination with corporate representatives to ensure smooth billing and settlements. Ensure settlement of all advises in a timely manner. Address and resolve patient grievances related to billing promptly and effectively. Handle and resolve all queries related to NMI (Need More Information) cases. Maintain accurate data and report...

Job Title: Bodyshop Advisor Department: Claims Employment Type: Full-Time We are seeking a detail-oriented and customer-focused Bodyshop Advisor to join our team. The role involves managing customer accidental claims, coordinating with insurance companies, and ensuring a smooth claims process. The ideal candidate should possess excellent communication skills, a customer-first mindset, and the ability to handle claim documentation efficiently. Key Responsibilities: Act as the primary point of contact for customers regarding accidental claims. Assist customers in filing and documenting insurance claims for vehicle accidents. Coordinate with insurance companies to intimate, process, and follow ...

Role: Assistant Manager Company: MediAssist TPA Location: IBC Knowledge Park, Bannerghatta Road, Bengaluru, India (On-site) Employment Type: Full-time Onrole Experience: 5 to 10 years (Minimum 5 years in TPA mandatory ) CTC: 6 LPA TO 7 LPA (based on experience) Role Summary: Lead policy configurations and health insurance claims operations, including internal IR handling, CRM/account management tickets, and policy document rechecks ensuring accuracy, compliance, and timely closures. Key Responsibilities: Policy configuration as per insurer/client guidelines Handle Internal IR and CRM/Account Management tickets within TAT Recheck and validate policy documents; ensure accurate setup Support en...

Claims Adjudicator US Healthcare (NSA Project) | 1+ Years | Mangalore | 3.5 LPA | Immediate Joiners Job Description Claims Adjudicator (US Healthcare NSA Project) We are seeking a detail-oriented and experienced Claims Adjudicator to join our No Surprises Act (NSA) project team . The ideal candidate will have a strong background in US healthcare claims adjudication with proven expertise in claims adjustments . Prior experience working on NSA-related initiatives will be a strong advantage. Key Responsibilities: Review, analyze, and adjudicate healthcare claims in line with US healthcare regulations and payer policies . Manage complex claim adjustments , ensuring accuracy and compliance with r...

Job Summary We are looking for a detail-oriented and proactive Accounts Receivable (O2C) professional with hands-on experience in Cash Application or Billing. The role involves ensuring accurate posting of customer payments/invoices, timely resolution of operational issues, and adherence to AR policies and procedures to support smooth month-end closing. Job Location: Bangalore Experience Required: 1 to 2 years Shift: Willingness to work in any shift (including night shifts) Key Responsibilities Perform day-to-day Accounts Receivable (O2C) activities including cash application or billing. Monitor and follow up on open sales orders and unposted cash to ensure timely resolution. Research, Analy...

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

Role & responsibilities Job Description: (FAC) 1. Acts as an interface between the TPA, Insurance Company and the hospital. 2. Responsible for investigation of suspicious claims. 3. Effective usage of Fraud control measures. 4. Act as a backend support to the TPA. 5. Responsible for data mining and analytics related to Fraud and Investigation (IFD) 6. MIS reporting related to fraud control and all stakeholders. 7. Should should be completely fine with doing field work (for Investigations) .

Scrutiny of medical documents and adjudication. Assess the eligibility of medical claims and determine financial outcomes. Identification of trigger factors of insurance related frauds and inform the concerned department. Determine accuracy of medical documents. Required Candidate profile: MBBS graduate. Male candidate prefer. Good Medical & basic computer knowledge Should have completed internship (Permanent Registration number is mandatory) Freshers can also apply. Work from office.

MDINDIA HEALTH INSURANCE TPA PVT LTD is looking for Medical Claims Processors-BAMS/BHMS to join our dynamic team and embark on a rewarding career journeyVerify medical claims for accuracy and completeness. Ensure compliance with insurance policies and regulatory guidelines. Coordinate with healthcare providers for necessary documentation. Approve or deny claims based on eligibility criteria.

Hiring B Pharma Freshers ( Male Candidates ) 1. Scrutiny of medical documents and adjudication 2. Assess the eligibility of medical claims and determine financial outcomes 3. Identification of trigger factors of insurance related frauds and inform the concerned department 4. Determine accuracy of medical documents Desired Candidate Profile : BPharma/ MPharma - Freshers

Scrutiny of medical documents and adjudication. Assess the eligibility of medical claims and determine financial outcomes. Identification of trigger factors of insurance related frauds and inform the concerned department. Determine accuracy of medical documents. Required Candidate profile: MBBS graduate. Male candidate prefer. Good Medical & basic computer knowledge Should have completed internship (Permanent Registration number is mandatory) Freshers can also apply. Work from office.

Description: Scrutiny of medical documents and adjudication. Assess the eligibility of medical claims and determine financial outcomes. Identification of trigger factors of insurance related frauds and inform the concerned department. Determine accuracy of medical documents. Required Candidate profile: BAMS / BHMS / BDS graduate. Male candidate prefer. Good Medical & basic computer knowledge Should have completed internship (Permanent Registration number is mandatory) Freshers can also apply. Work from office.

Job Description (IFD) Communicating with clients and understanding the investigation requirements. Meeting with clients to discuss the nature of the investigation. Conducting field investigations on appointed cases, insurance claims, or client requests. Conducting in-depth research on various appointed cases. Decide the extent and validity of a claim, and in so doing, prevent fraudulent claims by determining the claim's authenticity. Gathering and analyzing evidence reports. Conducting photographic and audio surveillance to gather evidence Reviewing and solving cases by authenticating insurance claims. Coordinating with agents to understand insurance claims matters. Answering to specific tri...

Description: Scrutiny of medical documents and adjudication. Assess the eligibility of medical claims and determine financial outcomes. Identification of trigger factors of insurance related frauds and inform the concerned department. Determine accuracy of medical documents. Required Candidate profile: BAMS / BHMS / BDS graduate. Male candidate prefer. Good Medical & basic computer knowledge Should have completed internship (Permanent Registration number is mandatory) Freshers can also apply. Work from office.

Job Description (IFD) Communicating with clients and understanding the investigation requirements. Meeting with clients to discuss the nature of the investigation. Conducting field investigations on appointed cases, insurance claims, or client requests. Conducting in-depth research on various appointed cases. Decide the extent and validity of a claim, and in so doing, prevent fraudulent claims by determining the claim's authenticity. Gathering and analyzing evidence reports. Conducting photographic and audio surveillance to gather evidence Reviewing and solving cases by authenticating insurance claims. Coordinating with agents to understand insurance claims matters. Answering to specific tri...

Role Overview: As a Lead Corporate Insurance in the organization, you will be entrusted with managing the entire in-house insurance requirements. This includes overseeing various insurance types such as Fire, Burglary, Liability, Special Contingency, Sports-related policies, and Employee Benefit (GTL, GMC, and GPA). Your role will be pivotal in ensuring that insurance solutions align with the company's risk profile and specific needs. Key Responsibilities: - Establish and nurture trust with key personnel within the company for Client Relationship Management. - Conduct thorough assessments to identify specific insurance needs and provide tailored solutions within the allocated budget. - Act a...

Role & responsibilities Associate Certified in Guidewire ClaimCenter Configuration/Integration (Preferable to have ACE) Experience in implementing Guidewire ClaimCenter for a Tier 1 Insurer in US. A minimum of 2 full life cycle Guidewire ClaimCenter implementation Good Knowledge in Web Services, Plugins, XML, Messaging, Batch Should be aware of Designing and Modification of existing workflows, PCFs, GW Data Model. Experience in preparing Test Plans, Reviewing Test Results Hands on experience in either implementing a new ClaimCenter V10 in SaaS model or migrating an on-prem / self-managed Guidewire ClaimCenter implementation to SaaS model. Experience in writing the Business Rules for the OOTB...

Roles and Responsibilities Manage claim settlement process from intimation to finality, ensuring timely and accurate resolution. Ensure compliance with regulatory requirements and internal processes for claims processing and management. Coordinate with various stakeholders such as customers, agents, and third-party administrators to resolve complex claims issues. Analyze data to identify trends and areas for improvement in the claims department.

Job Description: You will be responsible for conducting internal quality checks on claims processed by the Claim Team on a daily basis. Additionally, you will attend external audits conducted by different Insurers at PHS Mumbai premises and visit Insurer offices to discuss recoveries/queries raised. It will be part of your role to sensitize the team about various errors made during processing. Key Responsibilities: - Conduct internal quality checks on claims processed by the Claim Team daily - Attend external audits conducted by different Insurers at PHS Mumbai premises - Visit Insurer offices to discuss recoveries/queries raised - Sensitize the team about various errors made during processi...

Vacancy Announcement GK Superspeciality Hospital is a 100-bedded multispeciality healthcare facility located in Narnaul, Haryana. We are dedicated to providing top-tier medical care, offering a wide range of specialized services to cater to the diverse needs of our community. Our hospital is equipped with state-of-the-art medical technology and is supported by a team of highly experienced doctors, specialists, and paramedics who work together to ensure the best possible care for our patients. Currently, we are expanding our team and are looking for dynamic and dedicated candidates for the position of Front Desk and TPA Executives to strengthen our administrative and patient service team. Pos...

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...

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 smitha @ 9880964847 (Call or Whatsapp) Email id : smitha@thejobfactory.co.in Role & Responsibilities: 1. Handle customer inquiries and resolve issues via phone, email, or chat 2. Provide product information and support to cus...

SUMMARY Job Title: Apprentice Apprentice Machine Operator / Computer Operator (Fresher) - Jammu We are inviting fresh ITI candidates to join as Apprentices under NAPS at our CFA in Karnal. This role offers hands-on learning in machine operations, computer operations, and warehouse processes , providing a strong foundation for future career growth. Work Location: Kikri Morh, Birpur Parmandal Road, Birpur, Jammu-181133, Jammu and Kashmir Experience: Fresher Only Qualification: ITI- Fitter/Electrician/Computer (COPA) Salary (Stipend): 12,000 Working Days: 6 Days a Week (1 Day Week Off) Shift: Rotational Shift Key Responsibilities Operate and monitor basic machinery or computer systems Support i...