3155 Claims Processing Jobs - Page 4

Key Responsibilities: Enter and validate patient, insurance & charge details. Verify or validate CPT, HCPCS & ICD-10 codes. Review superbills and ensure payer-specific compliance. Coordinate with Coding & AR teams for issue resolution. Maintain HIPAA compliance and billing accuracy.

TPA, HEALTH CLAIMS, CLAIM PROCESS, KNOWLEDGE OF COMPUTER AND HOSPITAL ,DOCUMENTATION, KNOWLEDGE OF ADMINISTRATION Required Candidate profile EXPERIENCE CERTIFICATE AND PROOF OF SALARY Perks and benefits PF, ESI AND OTHER HR POLICIES

Responsibilities: Manage claim denials by communicating with providers and insurers. Ensure timely US healthcare claims processing. Follow up on pending claims, verify insurance details, and maintain accurate records. Shift allowance House rent allowance Maternity policy Referral bonus Provident fund Maternity leaves Paternity leaves

Greetings from Vidal Health Insurance TPA Pvt Ltd.,Openings For District Medical Officer!!! - Non Clinical Role, Immediate Joiners Preferred Qualification -MBBS( MCI) Location - Ahmedabad Roles and Responsibilities Involved in analyzing medical reports and do medical Audit at the Hospitals. Should have medical knowledge. Providing quality services. Updating the new medical terms and conditions as per the policy. Should be good knowledge in Academics. Resolving Claims related queries and discrepancies, Following up and responding to queries of customers. Approving and Rejection of Payments to the Customers with all verification. Updating the Status of the Customers about the respective Claim/...

Review and evaluate cashless and reimbursement medical claims submitted by hospitals and insured members. Approve or recommend modifications/rejections based on clinical justification Please call or WhatsApp on 9451802744, 9415408154

Patient management: Assist with patient admissions and discharges related to the Swasthya Sathi scheme and help patients with the necessary forms.

Responsible for calling insurance companies to resolve claims, verify patient eligibility, follow up on pending payments, and ensure timely AR closure. Requires good communication, analytical, and denial management skills. ONLY AR CALLERS CAN APPLY Provident fund

Key Responsibilities: Quickly and efficiently respond to incoming calls and faxes, identify how best to assist. Conduct outbound calls of insurance verifications to understand if patients prescribed therapy is eligible for coverage. Document results in appropriate tracking system. Document calls in appropriate tracking systems, and handle/escalate calls per established procedures. Process patient applications and follow the program's specifications to determine their eligibility. Document results in appropriate tracking system and manage follow-ups as appropriate. Place follow-up calls and respond to enquiries from patients and/or healthcare providers as necessary. Maintain a professional, c...

Role & responsibilities Should have medical knowledge. Providing quality services. Updating the new medical terms and conditions as per the policy. Should be good knowledge in Academics. Resolving Claims related queries and discrepancies, Following up and responding to queries of customers. Approving and Rejection of Payments to the Customers with all verification. Updating the Status of the Customers about the respective Claim/Preauth.. Preparing the Weekly consolidated reports of the team and updating to the Management. Approving and Rejecting of Claim/Preauth after all necessary checks I nterested Candidates can Whatsapp your resume to Akshay - 8088428808/ or Apply in Naukri Itself.

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...

Responsibilities: Motor vehicle Insurance quote Generation, claim settlement, MIS, and insurance operations. Strong portal handling and communication skills required. Annual bonus

TATA AIG General Insurance Company Limited is looking for Deputy Manager - Health Claims to join our dynamic team and embark on a rewarding career journey Assist the Manager in the day-to-day operations of the business, including setting goals, developing strategies, and overseeing the work of team members Take on leadership responsibilities as needed, including managing team members and making decisions in the absence of the Manager Identify and address problems or challenges within the business, and develop and implement solutions Collaborate with other departments and teams to ensure smooth and efficient operations Maintain accurate records and documentation Contribute to the development ...

TATA AIG General Insurance Company Limited is looking for Manager - Health Claims to join our dynamic team and embark on a rewarding career journey Delegating responsibilities and supervising business operations Hiring, training, motivating and coaching employees as they provide attentive, efficient service to customers, assessing employee performance and providing helpful feedback and training opportunities. Resolving conflicts or complaints from customers and employees. Monitoring store activity and ensuring it is properly provisioned and staffed. Analyzing information and processes and developing more effective or efficient processes and strategies. Establishing and achieving business and...

Aster Medcity 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. Compliance : They help ens...

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...

Firstsource Solutions Ltd is looking for Senior Analyst - Underwriting to join our dynamic team and embark on a rewarding career journey Analyze and assess insurance applications and risks Develop and implement underwriting policies and guidelines Monitor and analyze underwriting performance and make improvements Collaborate with sales and claims teams to ensure underwriting alignment Prepare and present underwriting reports to management Provide training and support to junior underwriters Ensure compliance with regulatory requirements and industry standards Disclaimer: This job description has been sourced from a public domain and may have been modified by Naukri.com to improve clarity for ...

Firstsource Solutions Ltd is looking for Senior Analyst - Underwriting to join our dynamic team and embark on a rewarding career journey Analyze and assess insurance applications and risks Develop and implement underwriting policies and guidelines Monitor and analyze underwriting performance and make improvements Collaborate with sales and claims teams to ensure underwriting alignment Prepare and present underwriting reports to management Provide training and support to junior underwriters Ensure compliance with regulatory requirements and industry standards Disclaimer: This job description has been sourced from a public domain and may have been modified by Naukri.com to improve clarity for ...

Firstsource Solutions Ltd is looking for Senior Analyst - Underwriting to join our dynamic team and embark on a rewarding career journey Analyze and assess insurance applications and risks Develop and implement underwriting policies and guidelines Monitor and analyze underwriting performance and make improvements Collaborate with sales and claims teams to ensure underwriting alignment Prepare and present underwriting reports to management Provide training and support to junior underwriters Ensure compliance with regulatory requirements and industry standards Disclaimer: This job description has been sourced from a public domain and may have been modified by Naukri.com to improve clarity for ...

Firstsource Solutions Ltd is looking for Senior Analyst - Underwriting to join our dynamic team and embark on a rewarding career journey Analyze and assess insurance applications and risks Develop and implement underwriting policies and guidelines Monitor and analyze underwriting performance and make improvements Collaborate with sales and claims teams to ensure underwriting alignment Prepare and present underwriting reports to management Provide training and support to junior underwriters Ensure compliance with regulatory requirements and industry standards Disclaimer: This job description has been sourced from a public domain and may have been modified by Naukri.com to improve clarity for ...

Job Title: Charge Entry, Demo Entry & Payment Posting Experience: 1-3 Years (Relevant experience in Medical Billing / US Healthcare) Role: Processor / Senior Processor Company: Vee Healthtek Pvt Ltd Locations: Chennai Job Type: Full-time Salary: Competitive (based on experience) Benefits: 1200 Allowances, 1200 Food Card & Two-way Cab Responsibilities: 1-3 years of relevant experience in US Healthcare / Medical Billing (Non-Voice) Strong knowledge of Charge Entry / Demo Entry / Payment Posting Perform accurate entry of patient demographics, charges, and payments into billing systems Review and verify insurance information and coding details Ensure 100% accuracy and compliance with client guid...

Key Responsibilities Operations Management: Oversee end-to-end policy servicing, issuance, endorsements, renewals, and claims processing. Ensure timely and accurate onboarding of group clients and retail customers. Manage operational SLAs and TATs across channels. Process Optimization & Automation: Identify gaps and drive process improvements to enhance efficiency and customer experience. Collaborate with technology teams to automate workflows and reduce manual interventions. Compliance & Risk Management: Ensure adherence to IRDAI guidelines and internal audit requirements. Maintain robust documentation and audit trails for all operational activities. Stakeholder Coordination: Liaise with Sa...

Guidewire CLaim Center data mapper 3 - 8 Yrs Seeking a skilled Data Mapper to support migration of claims data from legacy systems to Guidewire Claim Center. The ideal candidate will have strong P&C insurance domain knowledge, expertise in SQL, and hands-on experience mapping data between legacy tables and Guidewire Claim Center. A solid understanding of the Guidewire Claim Center data model is essential. Key Responsibilities: Analyze and map legacy system tables to Guidewire Claim Center structures Develop and validate SQL queries for data extraction and transformation Collaborate with business and technical teams to ensure accurate data mapping Document mapping rules and resolve data discr...

Role: Claims Executive Industry Type: Insurance Department: BFSI, Investments & Trading Employment Type: Full Time, Permanent Role Category: General Insurance Education: B. Tech/B.E. in Mechanical Key Skills: Insurance claims Job Responsibilities: Financial Contribute to renewal portfolio expansion through relationship building with the insurance companies and surveyors to ensure optimum claim settlement in the minimum time. During the processing of the claim analyze the following and communicate to underwriters: adequacy of coverage wrt. location specifications e.g.. Earthquake /flood etc. adequacy of the sum insured anomalies in the policy scope of additional policies other related informa...

Role & responsibilities Analyzing and summarizing medical records for pre and postsettlement projects. Interpreting clinical data in terms of medical terminology and diagnosis. Adhering to company policies/ principles and hence taking good care of Archer culture. Adhere to Health Insurance Portability and Accountability Act (HIPPA) all the time. Daily reporting to Medical team lead for productivity & quality Preferred candidate profile Knowledge of basic level of health care data analysis and clinical review. Sound knowledge of medical terminology, assessments, patient evaluation, and clinical medicine. Ability to work proficiently with Microsoft Word, Adobe, and Excel. Perks and benefits

Role & responsibilities: Data Entry/Onboarding of claimants in Salesforce. Reviewing claimants bankruptcy (legal) documents, maintaining account documents/files, sending LOI, sending and responding to emails, etc. Coordinating with members of onshore team and departments entwined with service line. Additionally, handling communication with Trustee, Assistant US Trustee, and Bankruptcy Attorney, and firm representatives via emails/callsto resolve the lien in timely manner without any escalation. Responding to all emails received personally or in mailbox within given TAT as per the SOP or 24 hours Maintaining service line tracker, account documents and files with precision. Keen eye forlittle ...