2030 Claims Processing Jobs - Page 42

We are seeking an experienced and highly motivated professional to join our team as a Revenue Cycle Services Manager , focusing on Inpatient Rehabilitation Facility (IRF) and Long-Term Acute Care Hospitals (LTACHs) billing. The ideal candidate will bring strong domain knowledge, leadership ability, and a track record of driving results through effective revenue cycle operations. Excellent communication, stakeholder coordination, and compliance management are essential. Role & responsibilities Manage full scope of RCM operations, including billing, denials, collections, AR management, and reporting. Collaborate with clients to define goals, resolve escalations, and improve service delivery. Track and report productivity metrics, TAT, AR aging, and denial trends on a regular basis. Lead and coach large teams (including TLs and AR specialists), ensuring alignment with SLA and performance targets. Conduct weekly/monthly/quarterly client business reviews (WBR/MBR/QBR) with actionable insights. Drive hiring decisions, attrition control, team development, and succession planning. Operational Oversight & Client Service: Oversee and coordinate with offshore billing partners for IRF & LTACH claims submission and follow-up. Monitor Discharge Not Billed (DNB) queues and collaborate with clients for timely resolution. Review payer contracts and escalate discrepancies in payments, rates, and allowances. Ensure AR and denial follow-ups are timely and accurate, adhering to payer and industry guidelines. Track and resolve issues in interface eligibility, claims submission, and remittance advice processes. Coordinate daily client communications and respond to inquiries with high professionalism. Claims & Billing Quality Control: Ensure claims are scrubbed and billed accurately by the billing partner. Address clearinghouse rejections and escalate unresolved issues. Review billing logs, rejection trends, and cash logs for accuracy and reconciliation. Access portals (Medicare, Medicaid, payer-specific) to review EOBs, RTPs, COBs, and claim statuses. Review credit balances and bad debts, including Medicare reporting. Process Improvement & Governance: Participate in regular RCM review meetings and escalate negative performance trends. Coordinate RCM meetings with clients and internal stakeholders. Support clearinghouse enrollments and lockbox access as needed. Ensure compliance with client SLAs, industry regulations, and internal policies. Baseline Competencies: Attention to Productivity and Quality Strong Customer Service Orientation Critical Thinking and Problem Solving Effective Communication Skills (Written and Verbal) Job Competencies: Proficient in Microsoft Office Suite (Word, Excel, Outlook) Sound knowledge of healthcare claims processing, AR follow-up, and collections Strong understanding of IRF & LTACH billing workflows and payer guidelines Comfortable with EMR systems, clearinghouses, and portal-based workflows Preferred candidate profile IRF & LTACH domain expertise Medical Billing Certification (AHIMA/AAPC or equivalent) Experience working with US healthcare clients or offshore delivery models Exposure to metric-based performance tracking and reporting

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 customer service skills. Able to work independently; strong analytic skills. Detail-oriented; ability to organize and multi-task. Ability to make decisions. Required computer skills: must have experience with data entry and word processing, possess a working knowledge of MS Office applications, and understand how to navigate through web-based applications. Demonstrate strong reading comprehension and writing skills. Cognitive Skills include language, basic math skills, reasoning ability and verbal communication skills. Ability to work in a team environment. Handling different Reports - IGO/NIGO and Production/Quality. To be in a position to handle training for new hires Work together with the team to come up with process improvements Strictly monitor the performance of all team members and ensure to report in case of any defaulters. Encourage the team to exceed their assigned targets. **Required schedule availability for this position is Monday-Friday 6PM/4AM IST. The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekend s basis business requirement. Requirements for this role include: Candidate should be flexible & support team during crisis period Should be confident, highly committed and result oriented Experience on working in an office environment set up utilizing Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools Experience in a professional/office related role that required you to communicate (oral/written) effectively with internal team members and external customers Experience in a role that required a focus on quality including attention to detail, accuracy, and accountability for your work product Candidate should be flexible to work from home and office environment. Broadband connection is must while working from home. Preferences for this role include: 3+ years of experience processing insurance claims in the health, life, or disability disciplines that required knowledge of CPT, HCPCS, ICD9/10, CDT. 2+ year(s) of experience in role that required understanding and interpreting complex documents such as medical records and legal contracts.

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 Analyze customer queries to provide timely response that are detailed and ordered in logical sequencing Cognitive Skills include language, basic math skills, reasoning ability with excellent written and verbal communication skills Stay up to date on new policies, processes, and procedures impacting the outcome of Claims processing Continuous learning to ramp up on the knowledge curve to be the SME and to be compliant with any certification as required to perform the job Be a team player and work seamlessly with other team members on meeting customer goals Developing and maintaining a solid working knowledge of the insurance industry and of all products, services and processes performed by Claims function Handle reporting duties as identified by the team manager Handle claims processing across multiple products/accounts as per the needs of the business Requirements for this role include: Both Under Graduates and Post Graduates can apply. Excellent communication (verbal and written) and customer service skills. Able to work independently; strong analytic skills. Detail-oriented; ability to organize and multi-task. Ability to make decisions. Required computer skills: must have experience with data entry and word processing, possess a working knowledge of MS Office applications, and understand how to navigate through web-based applications. Demonstrate strong reading comprehension and writing skills. Cognitive Skills include language, basic math skills, reasoning ability and verbal communication skills. Ability to work in a team environment. Handling different Reports - IGO/NIGO and Production/Quality. To be in a position to handle training for new hires Work together with the team to come up with process improvements Strictly monitor the performance of all team members and ensure to report in case of any defaulters. Encourage the team to exceed their assigned targets. **Required schedule availability for this position is Monday-Friday 6PM/4AM IST. The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekend s basis business requirement. Requirements for this role include: Candidate should be flexible & support team during crisis period Should be confident, highly committed and result oriented Experience on working in an office environment set up utilizing Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools Experience in a professional/office related role that required you to communicate (oral/written) effectively with internal team members and external customers Experience in a role that required a focus on quality including attention to detail, accuracy, and accountability for your work product Candidate should be flexible to work from home and office environment. Broadband connection is must while working from home. Preferences for this role include: 5+ years of experience processing insurance claims in the health, life, or disability disciplines that required knowledge of CPT, HCPCS, ICD9/10, CDT. 2+ year(s) of experience in role that required understanding and interpreting complex documents such as medical records and legal contracts.

As a Process Analyst – Insurance (Claims), you will be involved in the Processing of Life and Annuity Insurance, Claims processing. You should be flexible to work in shifts. Your primary responsibilities include: Handling claims investigation, processing, and payments Claims document validation, calculating benefit amount, and releasing same to the beneficiary Meet productivity and quality targets on a daily, weekly, and monthly basis Required education Bachelor's Degree Preferred education Master's Degree Required technical and professional expertise Graduate (except B.Tech/Technical Graduation/Law) with a minimum of 1.5 years of experience in Life/Annuities products in Claims Good Communication skills – English (both written & verbal) Proactive and high analytical skills; should foresee issues and suggest solutions, with impactful data Basic Computer knowledge along with typing speed of 35 words/minute Preferred technical and professional experience Proficient in MS Office applications Self-directed and ambitious achiever Meeting targets effectively Demonstrated ability to analyze complex data, complemented by strong interpersonal and organizational skills

* Review AR claims, understand the denial reason, call the payers if required resolve the issue. *Research and interpret from the available data in billing software, EOB, MR, authorization & understand the reasons for denial/underpayment/no response. Required Candidate profile * All kinds of Denials * Strong Technical Knowledge * Authorization * Phyician Billing/Hospital billing * Commercial/Federal Payers * AR CALLER Share your CVs & for further info Call - 9384813917

Role & responsibilities Processing of Claims Health files. Claim Registration and Claim Adjudication. Identifying the Fraud. Adhering to SLAs and processing the claims with in the TAT as per policy terms and conditions. Supporting CRM, provider, sales and grievance teams. Preferred candidate profile Pharm-D, BSc Nursing, B .Pharmacy, BDS Any Graduate with minimum 2+ years of Claims Health processing experience. Salary Budget - up to 4 lakhs. Job location Chennai Evaluation would be based on competency, age, experience, stability

Job Summary Join our team as a Subject Matter Expert in Claims HC where you will leverage your expertise in Facets Claims and Claims Adjudication to optimize our claims processing systems. With a focus on Dental and Commercial Claims you will play a pivotal role in enhancing operational efficiency and ensuring compliance with industry standards. This office-based role offers the opportunity to work in a dynamic environment contributing to impactful projects that benefit both the company and society. Responsibilities Lead the analysis and optimization of claims processing workflows to enhance efficiency and accuracy. Oversee the implementation of Facets Claims and Claims Adjudication systems to ensure seamless integration and functionality. Provide expert guidance on Dental and Commercial Claims processes to ensure compliance with industry standards. Collaborate with cross-functional teams to identify and resolve system issues improving overall operational performance. Develop and maintain documentation for claims processing procedures to support training and knowledge sharing. Monitor and evaluate system performance recommending improvements to enhance service delivery. Conduct regular audits of claims processes to ensure adherence to regulatory requirements and company policies. Facilitate training sessions for team members to enhance their understanding of claims systems and processes. Analyze data trends to identify opportunities for process improvements and cost savings. Support the development of new claims processing initiatives to drive innovation and efficiency. Communicate effectively with stakeholders to provide updates on project progress and system enhancements. Ensure that all claims processing activities align with the companys strategic goals and objectives. Contribute to the development of best practices for claims management to support continuous improvement. Qualifications Demonstrate proficiency in Facets Claims and Claims Adjudication with a strong understanding of system functionalities. Possess in-depth knowledge of Dental and Commercial Claims processes and industry standards. Exhibit excellent analytical skills to identify and resolve complex system issues. Show strong communication skills in English both written and verbal to effectively collaborate with team members. Display a proactive approach to problem-solving and process improvement. Have a minimum of 5 years of experience in claims processing with a focus on Dental and Commercial Claims. Be able to work independently and manage multiple tasks in a fast-paced environment. Certifications Required Certified Professional Coder (CPC) or equivalent certification in claims processing.

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 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 deny the claims as per the terms and conditions within the TAT. Handle escalations and responding to mails accordingly. Work from Office only Address: 4th floor, AARPEE Chambers, Off Andheri-Kurla Road Industrail Estate Marol, Andheri East, , Marol Cooperative Next To Times Square, Shagbaug, Gamdevi, Marol, Mumbai, Maharashtra 400059 Interested candidates can share their CV to dona.antony@mediassist.in or WhatsApp to 9632777628

About Us At CIGNA Healthcare we are guided by a common purpose to help make financial lives better through the power of every connection. Responsible Growth is how we run our company and how we deliver for our clients, teammates, communities, and shareholders every day. One of the keys to driving Responsible Growth is being a great place to work for our teammates around the world. We are devoted to being a diverse and inclusive workplace for everyone. We hire individuals with a broad range of backgrounds and experiences and invest heavily in our teammates and their families by offering competitive benefits to support their physical, emotional, and financial well-being. CIGNA Healthcare believes both in the importance of working together and offering flexibility to our employees. We use a multi-faceted approach for flexibility, depending on the various roles in our organization. Working at CIGNA Healthcare will give you a great career with opportunities to learn, grow and make an impact, along with the power to make a difference. Join us! Process Overview International insurance claims processing for Member claims. Job Description* Delivers basic technical, administrative, or operative Claims tasks. Examines and processes paper claims and/or electronic claims. Completes data entry, maintains files, and provides support. Understands simple instructions and procedures. Performs Claims duties under direct instruction and close supervision. Work is allocated on a day-to-day or task-by-task basis with clear instructions. Entry point into professional roles. Responsibilities: - Adjudicate international pharmacy claims in accordance with policy terms and conditions to meet personal and team productivity and quality goals. Monitor and highlight high-cost claims and ensure relevant parties are aware. Monitor turnaround times to ensure your claims are settled within required time scales, highlighting to your Supervisor when this is not achievable. Respond within the time commitment given to enquiries regarding plan design, eligibility, claims status and perform necessary action as required, with first issue/call resolution where possible. Interface effectively with internal and external customers to resolve customer issues. Identify potential process improvements and make recommendations to team senior. Actively support other team members and provide resource to enable all team goals to be achieved. Work across International business in line with service needs. Carry out other ad hoc tasks as required in meeting business needs. Work cohesively in a team environment. Adhere to policies and practices, training, and certification requirements. Requirements*: Working knowledge of the insurance industry and relevant federal and state regulations. Good English language communication skills, both verbal and written. Computer literate and proficient in MS Office. Excellent critical thinking and decision-making skills. Ability to meet/exceed targets and manage multiple priorities. Must possess excellent attention to detail, with a high level of accuracy. Strong interpersonal skills. Strong customer focus with ability to identify and solve problems. Ability to work under own initiative and proactive in recommending and implementing process improvements. Ability to organise, prioritise and manage workflow to meet individual and team requirements. Experience in medical administration, claims environment or Contact Centre environment is advantageous but not essential. Education*: Graduate (Any) - medical, Paramedical, Pharmacy or Nursing. Experience Range*: Minimum 1 year of experience in healthcare services or processing of healthcare insurance claims. Foundational Skills- Expertise in international insurance claims processing Work Timings*: 7:30 am- 16:30 pm IST Job Location*: Bengaluru (Bangalore) About The Cigna Group

HIRING US Healthcare Medical Records Openings for experienced in any US Healthcare Process at Advantum Health, Hitech City, Hyderabad. Should have experience of atleast 2 years in any US Healthcare Voice process. Salary upto 50k Per Month based on experience. One way cab + Rs. 2000 Transportation allowance is provided. For 2 way, Rs. 4000 is the Transport allowance Job Description Assigned Facilities : The Medical Records Specialist has a set of facilities to manage. Bi-Weekly Work Schedule : The Medical Records Specialist needs to work on these facilities every two weeks. Facility Touchpoints : Each facility needs to be visited or worked on every 10 days to ensure the necessary documents (therapy evaluations and re-certifications) are signed by the physician. Location : Hyderabad Work from office Shift: Night Shift (5.30pm to 2.30am) WALK -IN with your resume from 6pm to 10pm on any day from Monday to Friday. Interviews would be completed on same day. Ph: 9100337774, 7382307530, 8247410763, 9059683624 Address for WALK-IN: Advantum Health Private Limited, Cyber gateway, Block C, 4th floor Hitech City, Hyderabad. Location: https://www.google.com/maps/place/17%C2%B026'50.0%22N+78%C2%B022'30.9%22E/@17.44721,78.3726691,636m/data=!3m2!1e3!4b1!4m4!3m3!8m2!3d17.44721!4d78.375244?entry=ttu&g_ep=EgoyMDI1MDEwOC4wIKXMDSoASAFQAw%3D%3D Follow us on LinkedIn, Facebook and Instagram for all updates: Advantum Health Linkedin Page: https://www.linkedin.com/showcase/advantum-health-india/ Advantum Health Facebook Page: https://www.facebook.com/profile.php?id=61564435551477 Advantum Health Instagram Page: https://www.instagram.com/reel/DCXISlIO2os/?igsh=dHd3czVtc3Fyb2hk Advantum Health India Youtube link: https://youtube.com/@advantumhealthindia-rcmandcodi?si=265M1T2IF0gF-oF1 Advantum Health Threads link: https://www.threads.net/@advantum.health.india HR Dept, Advantum Health Pvt Ltd Cybergateway, Block C, Hitech City, Hyderabad Ph: 9100337774, 7382307530, 8247410763, 9059683624

Exciting opportunity for AR Callers with Laboratory exposure. We Data Marshall is hiring AR Callers with Laboratory experience folks at our Hyderabad office. Total experience: 1 + years Skillset: AR Follow-up, Denial Management, Laboratory -mandatory Work location: Hyderabad Mode of Work: Work from Office. Below provided is the company profile: Data Marshall is a Healthcare Revenue Cycle Management organization that has provided niche services to Providers and Payers for almost 2 decades. Since our inception, we have strived to expand our domain knowledge and expertise across the healthcare claim life cycle, by exploring a gamut of opportunities and avenues. Data Marshalls core specialization stems from the fact that we possess the experience and expertise spanning the entire life cycle of the claim, and the capability to leverage on the experience to enhance specific process deliverables. Data Marshall has endeavoured to stay ahead of the curve, by constantly and continuously innovating and incubating new service offerings to our clients. Our audit services cater to the under-explored and unaddressed segments in the healthcare sector, adding value to the Hospitals and Health Plans in ensuring accurate claims reimbursement and recovery of millions of incorrectly paid dollars. Contact us to assist in the following essential service areas: Provider Revenue Cycle/Revenue Enhancement Services • Audit • Billing • Clinical Documentation Improvement • Coding • Coding Audit • Credit Balance Overpayment Resolution • Correspondence Letter Defense/Resolution • Denials Management • Eligibility Verification • Follow Up • Pre/Post Systems Conversion Reconciliation/Clean Up • Self-Pay Overpayment Resolution • Underpayment Recovery and More Insurance Payer/TPA Based Services • Appeals/Grievances • Claims Adjudication • Data Entry • Member Enrollments • Out of Network Fee Negotiation Support • Provider Contracting • Provider Credentialing Support • Provider Database Management/Data Maintenance • Risk Adjustment Analytics • Utilization Review and more For more information login to http://www.datamarshall.com Job Description Roles and Responsibilities Follow up on submitted claims, monitor unpaid claims, and identify underpaid and unbilled claims, ensuring all necessary corrections and documentation are completed. Analyze claims and manage denials effectively. Review Explanation of Benefits (EOB) and Electronic Remittance Advice (ERA) denials, along with patient history notes, to understand and resolve discrepancies in claims. Identify claims requiring balance transfers to patients and secondary balances, as well as appropriate financial classifications for further resolution. Track and follow up on claims due for future review within the designated time frames. Identify global issues impacting single or multiple patient accounts. Required Experience, Skills, and Qualifications 1 to 2 years of Accounts Receivable experience. Strong knowledge of denial management concepts is essential. Excellent communication skills are required. Flexibility to work night shifts is necessary. Candidates available for immediate joining or those who can serve a notice. Experience in Laboratory AR is an additional benefit. Competency Excellent communication, analytical skills, and logical reasoning. For more details Kindly reach out to: HR Keerthi Contact: 8639447794 Email: keerthi.kasoji@datamarshall.com

Process: Insurance BPO Designation: Executive & Sr. Executive Job Responsibilities: Efficiently handle and process insurance claims, ensuring accurate documentation, timely initiation, and resolution of claims such as First Notice of Loss (FNOL) and First Report of Injury (FROI). Collaborate with clients, claimants, and internal/external teams to gather necessary information, evaluate claims for coverage and liability, and determine appropriate payment amounts. Maintain detailed and accurate records of claims transactions, ensuring compliance with industry regulations and company policies while safeguarding sensitive client information. Identify potential fraud or discrepancies in claims, escalating issues for further investigation, and resolving claim-related concerns professionally to provide exceptional customer service. Support continuous process improvement initiatives to enhance the efficiency and effectiveness of claims management workflows. Criteria : 1 to 2 years of experience in P&C or Specialty Insurance BPO. Exposure to FNOL and FROI processes. Experience in claim management and payment processing. Willingness to work in US shifts. Week Off: 5 days working Transport: One-way transport provided for candidates within transport boundary Location - LOMA IT PARK, GHANSOLI If Interested share your resume on JuiliD@hexaware.com or 8657971384

To address the phone calls and emails from patients. Scheduling appointments and follow-ups for patients. Maintaining patient accounts by obtaining, recording, and updating personal and financial information. Required Candidate profile • Should have relevant BPO experience with sound US Accent. • She should possess a very high level of understanding and Marketing skills. • Should ready to work and support Admin Team.

Guidewire Policy Tester Position : Senior Test Engineer / Test Analyst / Test Specialist Experience: 04 to 08 Years Job Location : Greater Noida, Pune & Hyderabad Mandatory Skills: P&C, Property & Casualty, Test Management Tools, Guidewire Cloud, E2E, Ratings, Forms & Guidewire Policy Centre Job Description: Demonstrates a thorough level of abilities with, and/or a proven record of success as both an individual contributor and team member with focus on deep expertise, continuous execution, throughput and quality. As Test Engineer, you'll work as part of a team of problem solvers, helping to solve complex business issues from strategy to execution. Anticipate stakeholder needs, and develop and discuss potential solutions, even before the stakeholder realizes they are required. Contribute functional knowledge in your area of expertise. Contribute to an environment where people and technology thrive together to accomplish more than they could apart. Navigate the complexities of cross-border and/or diverse teams and engagements. Uphold the firm's code of ethics and business conduct. Experience in User Acceptance Testing in Guidewire (PC, CC, BC, CM, Portal) and Integrations with Oracle & Documents Strong understanding of Guidewire applications and their integration with other systems. Working experience in Agile methodologies Should be well versed with UAT Testing & Guidewire Cloud. Walkthrough of E2E Business scenarios with Business stakeholders Execute user acceptance tests spanning across GW core, Documents, Finance testing and integrations. Identify, document, and track defects to closure. Experience with cloud-based Guidewire implementations. Environment : GW (PC,BC,CC,CM) Core in Cloud, Mule, Datahub, Oracle & Finance, Document Management, Mule, ESB, Globalscape. Design and execute test plans, manual and automated test scripts, and test cases based on project requirements and objectives. Perform system, integration, functional, data validation, and automation testing as well as facilitate user acceptance testing. Utilize test automation tools and scripts, where feasible, to streamline test cycle execution. Utilize test management tools to document test plans and to report test results and defects Participate in troubleshooting and triaging of issues with different teams to drive towards root cause identification and resolution Proficient in Test Management Tools JIRA/Rally/HP-QC/VSTS/TFS Guidewire functional knowledge on Billingcenter, PolicyCenter, ClaimsCenter, Datahub, Forms and ContactManager. Guidewire Certificate is an added advantage. Preferred Skills: Guidewire PolicyCenter, BillingCenter, ClaimCenter, Datahub, Forms and ContactManager, including leading related project teams. Familiarity with GOSU, Guidewire Event and Rules Framework Please share your resume at anshul.meshram@coforge.com

Responsibilities: * Manage AR calls, denials & appeals * Meet revenue cycle targets * Execute RCM processes from start to finish * Authorize claims & manage exceptions * Handle medical billing tasks with accuracy Health insurance Provident fund

Greeting from Medi assist TPA Pvt ltd. Hiring Medical officer for Insurance Claim processing Profile Location- Mumbai -Andheri East. Role - Medical officer Exp : 0-8 years Job description : * Check the medical admissibility of claim by confirming diagnosis and treatment details * Verify the required documents for processing claims and raise an information request in case of an insufficiency * Approve or deny claims as per T&C within TAT Interested candidate can drop there resume in my Mail ID : varsha.kumari@mediassist.in We are looking for fresher or exp candidates BAMS, BHMS- 7631162388 Whatsapp CV mail id -varsha.kumari@mediassist.in

Job Description: Processing of Claims Health files. Claim Registration and Claim Adjudication. Identifying the Fraud. Adhering to SLAs and processing the claims with in the TAT as per policy terms and conditions. Supporting CRM, provider, sales and grievance teams. Eligibility Criteria: Pharm-D, BSc Nursing, B .Pharmacy freshers only(Qualified Graduates with all certificates in hand). Any Graduate with minimum 2+ years of Claims Health processing experience. Salary Budget - up to 4 lakhs. Job location Ameerpet, Hyderabad. Evaluation would be based on competency, age, experience, stability

Hiring for a medical billing role Need Graduates - min.1yr US healthcare expereince - Medical/ Physician/ AR Billing Salary - up to 40k in hand Gurgaon WFO - Rotational shifts & offs Share CVs: harleenkaur.imaginators@gmail.com 9717279212 (Harleen) Required Candidate profile . Should have a good understanding of medical billing. Should be an Immediate Joiner. Should be comfortable with rotational shifts & work from Office.

Greeting from Medi assist TPA Pvt ltd. Hiring Medical officer for Insurance Claim processing Profile Location- Mumbai -Andheri East. Role - Medical officer Exp : 0-8 years Job description : * Check the medical admissibility of claim by confirming diagnosis and treatment details * Verify the required documents for processing claims and raise an information request in case of an insufficiency * Approve or deny claims as per T&C within TAT Interested candidate can drop there resume in my Mail ID : varsha.kumari@mediassist.in We are looking for fresher or exp candidates BAMS, BHMS mail id - varsha.kumari@mediassist.in Thanks & Regards Email: varsha.kumari@mediassist.in

Role & responsibilities Knowledge of claim in Motor Insurance (International) / Marine Insurance or Liability Insurance like Employee's professional liability, Public liability & bodily liability due to accident. Preferred candidate profile Claim end to end experience in BPO industry with international exposer

Job Responsibilities Scrutinizing dental claim documents & settlements Process claims as per the set healthcare guidelines Follow HIPAA guidelines Accurate processing of Dental claims and meeting productivity targets Good understanding of Claims adjudication fundamentals Good understanding of ICT & CPT Codes Knowledge of policy concepts like Deductible, coinsurance, copay, out of pocket Able to learn, adapt, implement process guideline into practice, work as a natural team-player in the process Handle escalations Need to ensure quality and productivity targets are met Ensure compliance with internal policies and procedures, external regulations and information Technical Skills/other skills Computer navigation skills Keyboarding and data entry speed (minimum 30 wpm with 90% accuracy) Working knowledge of MS Excel and MS Word. Process Specific Skills Knowledge of Insurance principles in relation to the US Insurance industry Knowledge about US Culture Knowledge of Dental claims terminologies and processes will be an added advantage Strong organizational skills Good communication skills Demonstrate ability to work independently and in a team environment Self-disciplined and results oriented Ability to multi task Strong understanding and comprehension of the English language Good PC skills Attention to detail Team player Positive attitude

Job Title: AR Follow-ups Analyst US Healthcare Location: [Gurugram] Salary: Up to 7 LPA Working Days: Monday to Friday (Saturday & Sunday Fixed Off) Transport: Both Side Transport Provided Job Description: We are hiring experienced AR Follow-ups Analysts with a background in US Healthcare to join our dynamic revenue cycle management team. This role is ideal for candidates with strong analytical skills and a passion for resolving complex accounts receivable issues from the hospital or physician side . Key Responsibilities: Perform accounts receivable follow-ups with insurance companies to ensure timely payments. Analyze and resolve denied claims, underpayments, and unpaid accounts. Work on hospital or physician billing (as per assigned client). Document call activities and findings in appropriate systems. Meet daily and monthly productivity and quality targets. Escalate unresolved claims to the appropriate departments. Required Skills & Qualifications: Minimum 1 year of experience in US Healthcare AR Follow-ups (hospital or physician side). Graduation in any discipline is mandatory. Familiarity with denial management, CPT codes, ICD-10, and insurance guidelines. Strong communication and interpersonal skills. Ability to work in a fast-paced, process-driven environment. Perks & Benefits: Competitive salary up to 7 LPA based on experience. Both side transport facility provided. Fixed weekends off Work-life balance ensured. Opportunities for growth and learning in a leading healthcare BPO. Apply Now: If you meet the above criteria and are looking for a rewarding opportunity in the US healthcare domain, call or Whatsaap your resume at 6291864166

General Insurance Surveyors & Loss Assessors or Non Motor Claims processors. Processing Non Motor Insurance Claims Locations - Hyderabad, Bangalore, Cochin People experienced in Non Motor Insurance Surveyor Industry and holding IRDAI license are preferable.

Position Vacant Non EB - Claims (Manger /Senior Manager) No. of Vacancy 1 Qualification Academic - Graduate and above Job Description / Responsibilities Good Interpersonal connection with IBAI. Knowledge of Claim intimation process Knowledge of Surveyor appointments based on quantum of loss. Coordinating with Insurance co. & Customer for documentation. Knowledge of claim documents required for various LOB. Claim processing & settlement of admissible claims. Handling Customer Grievances. Handling escalations, solving the Queries. Scrutiny of claims. Arranging Joint meetings with all stake holders for claims discussions in case of ambiguity. Conducting survey of vehicles. Building relationships with repairers and stakeholders. Loss minimization based on technical and soft skills. Maintaining good working relationship with insurance Company, Dealers, Surveyors and customers, Understanding the issues, Follow up with Insurers for settlement like DV , submission of signed DV and claims consent from Insured etc. Desired profile of the candidate Good Communication Skills English and Local Language. Negotiation, questioning and decision-making skills Organizational and time management skills the ability to work well under pressure the ability to think strategically initiative and the ability to adapt quickly to different situations discernment and the ability to assess a situation objectively Attention to detail and sound report-writing skills. Experience- 6 to 8 years Compensation range 12 LPA Max Location Gurgaon

Role & Responsibilities Handling TPA related all process from billing to co-ordinate with TPA companies. Responsible for counseling patient's family & pre-Auth process. Maintaining & uploading patient's files on the portal. Couriering the hard copy of patient's medical file to the Insurance companies. Responsible for all co-ordination activities from patient's admission to discharge. Handling billing Department, Implants bill updating & reconciliation. Daily co-ordination with the patient and Hospital staff. Outstanding follow-up with TPA. To obtain and review referrals and authorizations for treatments. Must be aware of norms of the insurance sector. Daily follow up with Insurance companies to pass or clear the Health Insurance claims. Qualifications Bachelor's degree. Previous experience in TPA management or Banking. Good interpersonal and communication skills. Isha Thakur 9056448144 HRD