3165 Claims Processing Jobs - Page 47

•Provider Enrollment experience with multiple payers is must •Create and maintain files for Credentialing applications and renewals • Compile and maintain current and accurate data for all providers • Completion, submission, Follow up of applications Required Candidate profile • Minimum of 2 year of Provider Enrollment experience • Experience using PECOS, processing enrollment with Medicaid, and using CAQH Immediate joiners preferred. Send CV to recruitment1.hipl@gmail.com

Join our team as an AR Caller & Denials Management Specialist! Resolve denials and ensure timely payments. Immediate openings available. Permanent Work From Home. Apply now! Required Candidate profile Seeking experienced AR Callers & Denials Specialists! Must have ECW expertise, AR calling, denials resolution skills. Immediate joiners preferred. Send CV: recruitment1.hipl@gmail.com.

Experience: 3+ years of experience in medical billing, coding, or claims management, with a strong understanding of insurance claims processes and denial management.

Join our team as an AR Caller & Denials Management Specialist! Resolve denials and ensure timely payments. Immediate openings available. Permanent Work From Home. Apply now! Required Candidate profile Seeking experienced AR Callers & Denials Specialists! Must have ECW expertise, AR calling, denials resolution skills. Immediate joiners preferred. Send CV: recruitment1.hipl@gmail.com.

Experience: 3+ years of experience in medical billing, coding, or claims management, with a strong understanding of insurance claims processes and denial management. Must Require ECW software Experience.

Join our team as Denials Management Specialist! Resolve denials and ensure timely payments. Immediate openings available. Permanent Work From Home. Apply now! Required Candidate profile Seeking experienced AR Callers & Denials Specialists! Must have ECW expertise, AR calling, denials resolution skills. Immediate joiners preferred. Send CV: recruitment1.hipl@gmail.com.

Denials Management Specialist! Resolve denials and ensure timely payments. Immediate openings available. Maintain knowledge of payer policies and changes in denial/appeal regulations Permanent Work From Home. Required Candidate profile Seeking experienced AR Callers & Denials Specialists! Must have ECW expertise, AR calling, denials resolution skills with Appeal process.

Seeking a skilled Denials Management Specialist with ModMed (Modernizing Medicine) EMR/EHR expertise. The specialist will be responsible for analyzing, resolving, preventing claim denials while working closely with payers, providers. Required Candidate profile Must have experience in denials management for US healthcare billing and proficiency in ModMed (Modernizing Medicine) EMR/EHR system.

•Provider Enrollment experience with multiple payers is must •Create and maintain files for Credentialing applications and renewals • Compile and maintain current and accurate data for all providers • Completion, submission, Follow up of applications Required Candidate profile • Minimum of 2 year of Provider Enrollment experience • Experience using PECOS, processing enrollment with Medicaid, and using CAQH Immediate joiners preferred. Send CV to recruitment1.hipl@gmail.com

About The Role Skill required: Retirement Solutions - Claims Case Mgmt - Claims Processing Designation: Claims Management Associate Qualifications: Any Graduation Years of Experience: 1 to 3 years What would you do? Tower:UK Life and Pensions-Claims Processing What are we looking for? Skillset:Graduate in any stream.Open to flexible shifts based on business requirements.Good verbal & written communication skillsGood typing skill and attention to detail.Good time management skills. Ability work independentlyMust have/ minimum requirementMinimum of 2 years experience in the UK Life, Pensions and Investment domain, specifically Claims processing with equivalent experience in U.S. retirement ser...

Assisting with the preparation of operating budgets, financial statements, and reports. Processing requisition and other business forms, checking account balances, and approving purchases. Advising other departments on best practices related to fiscal procedures. Managing account records, issuing invoices, and handling payments. Collaborating with internal departments to reconcile any accounting discrepancies. Analyzing financial data and assisting with audits, reviews, and tax preparations. Updating financial spreadsheets and reports with the latest available data. Reviewing existing financial policies and procedures to ensure regulatory compliance. Providing assistance with payroll adminis...

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...

Positions General Duties and Tasks: Process Insurance Claims timely and qualitativelyMeet & 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 custome...

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...

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 processin...

Roles and Responsibilities Detailed analysis and processing of commercial insurance applications Making updates to certificate management system and issuing certs Premium calculations and generation of quotes & binders using carrier quote management systems Detailed loss analysis & preparation of loss projections and client reviews Issuance of policies using carrier policy management systems; endorsements to existing policies throughout the policy term Policy administration using agency management systems with adherence to service calendars Make relevant updates in certificate management system and issuance of proof of coverage and other certs Conducting policy and premium audits at expirati...

Quality executive is responsible to perform activities outlined in the Service Quality Plan and identify agent / program level improvement opportunities. Executive is required to work closely with the production resource to ensure adherence to the client and process specific requirements. Ensure that regular feedback and error sharing sessions are conducted to avoid repetition of errors and help improve overall performance. Other activities of the quality executive include reporting, calibrations, process analysis and attending client and internal meetings. Responsibilities: Responsible for call/data quality monitoring. Provide feedback to agents using prescribed feedback model. Mentoring an...

Inviting applications for the role of Dispute Management Analyst/OTC Note- This is Night Shift Office- Onsite Role- (Return to office) Must have experience in Advance Excel. Note- Only Apply if you have Effective Communication Skills In this role associate will work with a team to provide analytical support on deductions recovery. Such analytical support may include data management, data interpretation, reporting, structuring an analysis, interpreting the results in a business context, and providing insights to team to drive deduction recovery. The analyst should be able to identify pattern emerging from data and reports and establish the linkage for the same with business problems. Incumben...

Required experience : 5 + years, GW CC experience 2+ years Experience of working as a business analyst in a major consultancy and the ability to demonstrate core consulting values Experience in GW ClaimCenter is a must Excellent client facing skills/collaboration Experience and understanding of end-to-end system integration deliveries A sound approach to problem solving, knowledge of the change control process and the ability to analyse change to minimise impact on requirements and implementation. Analysing, documenting and managing business requirements and providing functional assurance Workshop planning and facilitation Change planning, delivery planning, impact assessment, deliverables a...

Role: Guidewire ClaimCenter Business Analyst Position Type: Full-Time Contract (40hrs/week) Contract Duration: 6-12 months+ Work Hours: Standard IST Work Schedule: 8 hours/day (Mon-Fri) Location: Hybrid - India (3x days onsite/week in India) The Claims Business Analyst for Guidewire ClaimCenter is responsible for developing detailed business and functional requirements for claims processing and administration systems, as well as ensuring proper integration with downstream systems for reporting purposes. Their role also includes planning and conducting User Acceptance Testing to guarantee that the systems meet the necessary specifications. Additionally, the Claims Business Analyst provides an...

Review, analyze, adjudicate US healthcare claims in line with payer policies regulations Handle complex claims adjustments, ensuring compliance with guidelines Collaborate with cross-functional teams to ensure NSA compliance in claims processing Required Candidate profile Investigate and resolve discrepancies in claims data and documentation Support audit and quality assurance functions related to claims Stay updated with NSA regulations healthcare compliance standards Perks and benefits Perks and Benefits

Roles and Responsibilities: Process Adjudication claims and resolve for payment and Denials Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process Knowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of pocket, maximum inside limits and exclusions, state variations Ensuring accurate and timely completion of transactions to meet or exceed client SLAs Organizing and completing tasks according to assigned priorities. Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team Resolving...

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

Hiring for US Healthcare - Claims & Premium Billing Education: BE/B.Tech/MCA/M.Tech/MSc./MS ,Bcom Responsibilities A day in the life of an Infoscion As part of the Infosys consulting team, your primary role would be to actively aid the consulting team in different phases of the project including problem definition, effort estimation, diagnosis, solution generation and design and deployment You will explore the alternatives to the recommended solutions based on research that includes literature surveys, information available in public domains, vendor evaluation information, etc. and build POCs You will create requirement specifications from the business needs, define the to-be-processes and d...

Looking for US Healthcare - Claims & Premium Billing with experience range 2 to 3 years Education: BE/B.Tech/MCA/M.Tech/MSc./MS ,B.com Responsibilities A day in the life of an Infoscion As part of the Infosys consulting team, your primary role would be to actively aid the consulting team in different phases of the project including problem definition, effort estimation, diagnosis, solution generation and design and deployment You will explore the alternatives to the recommended solutions based on research that includes literature surveys, information available in public domains, vendor evaluation information, etc. and build POCs You will create requirement specifications from the business ne...