3165 Claims Processing Jobs - Page 41

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...

Retail Claims - Automation ProjectsKey Responsibilities1. Automate Claims Processes- Design anddevelop automated workflows and business rules to streamline claims processing. 2. Integrate with Existing Systems- Integrateautomated claims processing solutions with existing systems and technologies. 3. Testing and UAT - Test and validateautomated claims processing solutions to ensure accuracy and efficiency. 4. 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....

Primary Responsibilities: Team Leadership & Management Manage and mentor a team of professional software engineers and/or supervisors Foster a collaborative and high-performance team culture Oversee resource allocation, project timelines, and delivery milestones Software Development & Lifecycle Management Lead end-to-end development activities including analysis, design, coding, testing, debugging, documentation, and maintenance Ensure adherence to engineering standards, tools, and methodologies Drive automation and efficiency through reusable utilities and process improvements Technical Expertise & Guidance Provide hands-on technical guidance in RPG, CL, and Synon (CA 2E) development Troubl...

Overview Coding Denial Supervisor to provide direction to a team of Coding Denial Specialists, who are responsible for working on assigned claim edits and rejection work queues. The Coding Denial Supervisor will ensure timely investigation and resolution of health plan denials. Additionally, the Coding Denial Supervisor will assist in determining appropriate actions and providing resolutions for health plan denials. Responsibilities Ensuring the timely investigation and resolution of health plan denials Assist in Implementing and maintaining policies and procedures for denial management Providing training and support to the team members to enhance their skills and knowledge Escalate coding a...

Responsible for the Sales enrollments/Sales in the city. Do the market race and prepare the list of prospective customers , Handle the Team Members and motivate them for better sales , Ensure the team members are in market where enrollments & usage are done regularly. Should have good networking capabilities and be willing to travel extensively throughout their specified areas Key Role: Manage an assigned geographic sales area to maximize sales target and meet corporate. Objectives Build Database of key contact persons in the assigned geography. Build and maintain relationships with key client personnel Manage Category leads from qualification to closure.

Role Summary: This job takes the lead in providing effective team handling and timely delivery of assigned task and required a strong knowledge in denial management, Trend analysis and should be an expert in reports management and process analytics and a proven job knowledge in Hospital Billing. JOB SUMMARY This job gives an opportunity to work in a challenging environment to deliver high quality Solutions to meet the demands for our Global Customer. An ideal candidate should have experience in Hospital Billing and Denial Management. The candidate should be able to lead & own the Development of any Technical deliverables assigned to him\her & thereby delivering high quality & Innovative solu...

TPA/Ayushmaan Operator required for Basna near Raipur (C.G.)Location Note- Good Knowledge of TPA 1- Basna near Raipur C.G. Call/WhatsApp-8090286126/7897900209 Regards ARTI SONI Linking Jobs

Hiring for Medical Billing {Various Posts} #Job location : Ahmedabad #CTC: Upto 40k #Shift : Night Shift #Cab facility available

Hiring for AR Caller #Graduate fresher #Fluent in English #Both side cab facility #Voice process #Us shift #5 Days working #Location: Prahlad Nagar

Hiring for Medical Billing / AR Caller Location : Ahmedabad US Shift(Cab facility available) Fresher and Experience can apply Good Communication in English required

Hiring for InternationalMedical billing,AR Caller:- # Salary- 15k(in hand) for fresher, 25k CTC-30K CTC(experience) #Graduate fresher #Fluent & Good in English #Both side cab facility #Voice process #Us shift #5 Days working #Location: Makarba

Shift : US Shift Salary: UPTO 30k CTC (Depends On Interview & Experience) Location: Ahmedabad Fluent English Required In Verbal & Written Graduation Required

Hiring for Medical Billing / AR Caller Salary-Freshers:15k(in hand), Experience-upto 25K-30k CTC Job Location : Ahmedabad US Shift(Cab facility available) Fresher and Experience can apply Good Communication in English required

Hiring for Medical Billing / AR Caller Location : Ahmedabad As Fresher Salary -15K in hand For Experience 25K to 30K US Shift(Cab facility available) Fresher and Experience can apply Good Communication in English required

Hiring for Medical Billing / AR Caller Location : Ahmedabad As Fresher Salary -15K in hand For Experience 25K to 30K CTC US Shift(Cab facility available) Fresher and Experience can apply Good Communication in English required

Hiring for Medical Billing / AR Caller Location : Ahmedabad As Fresher Salary -15K in hand For Experience 25K to 30K US Shift(Cab facility available) Fresher and Experience can apply Good Communication in English required

Hiring for Medical Billing / AR Caller Location : Ahmedabad As Fresher Salary -15K in hand For Experience 25K to 30K US Shift(Cab facility available) Fresher and Experience can apply Good Communication in English required

Hiring for Medical Billing / AR Caller Location : Ahmedabad As Fresher Salary -15K in hand For Experience 25K to 30K US Shift(Cab facility available) Fresher and Experience can apply Good Communication in English required

Hiring for Medical Billing / AR Caller/ RCM Location : Ahmedabad As Fresher Salary -15K in hand For Experience 25K to 30K CTC US Shift(Cab facility available) Fresher and Experience can apply Good Communication in English required

Hiring for Medical Billing / AR Caller/ RCM Location : Ahmedabad As Fresher Salary -15K in hand For Experience 25K to 30K CTC US Shift(Cab facility available) Fresher and Experience can apply Good Communication in English required

Shift - US Shift 5days working Cab Facility Available Salary - upto 30k CTC Location - Ahmedabad Freshers can Apply

Shift - US Shift 5days working Salary - upto 30k CTC Cab Facility Available Fresher can apply Location - Ahmedabad Good English Communication

Hiring for Fresher in AR Caller(US HealthCare) Location : Ahmedabad US Shift(Cab Facility available) Salary 15K in hand Good Communication is required

Shift - US Shift Cab Facility Available Salary - 15k Inhand 5days working Freshers Apply - 9687676536

International Medical Billing Position: Record Retrival Shift: US Shift Working Days: 5 days a week Location: Ahmedabad Meal facility Fix Saturday & Sunday Off Career Growth