3155 Claims Processing Jobs - Page 5

Cognizant Walk-in drive for US Healthcare -Claims Process at Chennai location. Interview Date : 8th Nov 2025 (Saturday) Interview Time : 10:00 AM to 1:00 PM Venue - Cognizant CKC - SEZ Ave, Elcot Sez, Sholinganallur, Chennai, Tamil Nadu 600119 Building Details: Cafeteria - 1st floor, Wing - B. POC: Babu/Aswini Preferred candidates Profile: Overall experience required - 2 to 5 years Minimum 2 years of experience in US Healthcare Claims adjudication, Grievance and Appeal, PDM, Credentialing. Prior experience in claims/knowledge preferred Notice Period : Immediate to 30 days Preferred Education: Graduation is must Must have good communication skills Should be ready to work in Night shift (US Sh...

Job Description Zonal Claims Administrator- ZOCA Claims Processes 1. Each zone shall have a ZOCA responsible for claims functions at Zonal level and reporting into the Regional Claims Head. 2. ZOCA shall co-ordinate with Regional claims team and HO Claims to ensure that claims processing of Cashless and Reimbursement claims are smooth and effective. 3. Claims are processed within TAT and will coordinate in such a way that the Claims resolutions are quicker to ensure customer satisfaction. 4. Attend to any hurdles in full lifecycle of the claim. 5. Report and Resolve bottlenecks in upload of claims, processing and settlement of Reimbursement claims irrespective of source or collection of NEFT...

Job Description: 4+ years of experience with Guidewire BillingCenter development. Strong proficiency of Guidewire Data Model, Gosu programming & BillingCenter configuration. Solid understanding of Billing processes in the P&C insurance domain. Excellent problem-solving & communication skills. Familiarity with SOAP/REST APIs, integration tools & DevOps practices. Guidewire Certification (BillingCenter Developer or Architect). Experience with other Guidewire modules (PolicyCenter, ClaimCenter) a plus. Familiarity to Scrum methodologies. Experience with CI/CD pipelines & DevOps Tools. Configure and customize Guidewire BillingCenter modules. Knowledge of insurance domain & business processes. Co...

Claim Processing: - Receive and review insurance claims and related documents. - Enter claim information into the claims management system. - Acknowledge receipt of claims and communicate with claimants regarding the status of their claims. 2. Survey: - Conduct a thorough survey to determine the validity of claims. - Collect and analyze evidence, including photographs, witness statements, and other relevant documentation. - Coordinate with surveyors and other professionals to assess damage and determine the extent of loss. 3. Communication: - Serve as the primary point of contact for claimants, providing updates and answering inquiries. - Liaise with insurance companies, surveyors, and other...

Responsibilities of Team Lead - AR: 1. Provide expert knowledge and guidance in medical billing procedures, coding, and compliance standards. 2. Process Improvement: Analyze existing billing processes and systems to identify opportunities for improvement in efficiency and accuracy. 3. Training and Development: Develop training materials and conduct training sessions for staff on medical billing best practices, new regulations, and software updates. 4. Audit and Compliance: Conduct regular audits to ensure billing practices comply with regulatory requirements and internal policies. 5. Quality Assurance: Implement quality assurance measures to maintain high standards of accuracy and completene...

Overview TheClaims Investigator plays a critical role in safeguarding the integrity of lifeinsurance claims by conducting rigorous investigations into potentiallyfraudulent or high-risk cases. The role demands sharp analytical acumen,compliance awareness, and effective coordination with internal teams andexternal agencies. It also includes managing vendors and contributing tocontinuous risk mitigation strategies. Responsibilities Conduct thorough investigationson flagged life insurance claims for fraud, anomalies, or discrepancies. Review and analyze supportingevidence: medical records, PMRs, FIRs, employment history, and police reports. Collaborate with forensicexperts, legal advisors, and ...

Job Role 1. Reviewing and analyzing claim form 1500 to ensure accurate billing information. 2. Utilizing coding tools like CCI and McKesson to validate and optimize medical codes. 3. Familiarity with payer websites to verify claim status, eligibility, and coverage details. 4. Expertise in various medical specialties such as cardiology, radiology, gastroenterology, pediatrics, emergency medicine, and surgery. 5. Proficiency in using CPT range and modifiers for precise coding and billing. 6. Working with Clearing House systems like Waystar and other e-commerce platforms for claim submissions. 7. Conducting voice-based communication with payers and medical staff to resolve billing discrepancies...

Department : Health Claims Medical Position Overview Looking to leverage your medical expertise in a dynamic insurance environment As a Claims Associate Medical, you will play a key role in ensuring the accuracy, quality, and integrity of health claims decisions by applying clinical knowledge, regulatory awareness, and strong attention to detail. This role demands a balance of technical understanding and operational execution. Key Responsibilities Claims Processing: Review, analyze, and process health claims accurately and within turnaround time (TAT) as per internal SOPs and regulatory norms. Medical Review: Assess the clinical validity of diagnoses, treatments, and procedures in submitted ...

Be the voice and bridge of Digits health claims teamdeliveringexceptional service and communication to clients, partners, and internalstakeholders. Youll manage end-to-end claim servicing and play a key role inrelationship building and process awareness. Key Responsibilities Manage inbound and outbound calls/emails , resolving queries related tohealth claims swiftly and empathetically. Provide end-to-end service to clients , ensuring all touchpointsSales, HR, Brokers, Agentsare engagedand informed. Act as the central coordinator for query resolution by working closely withinternal teams (processing, tech, product, etc.). Conduct interactive sessions with employees/HR to explain coverage, pro...

You are applying for the role of Vice President - Insurance Operations for one of Weekday's clients based in the Delhi NCR region. As the VP - Insurance Operations, your primary responsibility will be to lead, mentor, and manage large, cross-functional operations teams focused on Property & Casualty insurance. You will provide strategic direction, ensure operational excellence, and drive compliance with global insurance standards. Additionally, you will collaborate with internal and client-side stakeholders to shape and execute a long-term strategy for growth and efficiency in insurance operations. **Key Responsibilities:** - Leadership & Strategy: Lead, mentor, and manage large, cross-funct...

About The Role As an International Claims Associate, you will investigate reports of accidents/incidents that occur throughout the region in connection with the app. You will report to our APAC Claims Manager. As a member of a growing international claims team, you will also have a unique opportunity to gain exposure to claims handling protocols in Europe/Middle East, India/South Asia/ANZ and Latin America. What You'll Do Manage an inventory of claims to evaluate covered losses and liability exposure. Investigate new claims by reviewing first reports of loss and supporting materials to determine the best initial contact; communicate with claimants, drivers, passengers, witnesses, etc. Advoca...

As an Insurance Advisor, your primary responsibility will be to understand a client's individual needs and financial situation in order to recommend appropriate insurance coverage. You will be expected to clearly explain the benefits, terms, and conditions of different insurance policies to clients. Your role will involve working closely with insurance companies to secure competitive premiums and negotiate favorable policy terms. Key Responsibilities: - Prepare and present insurance proposals with clear details and multiple options for clients to choose from. - Build and maintain strong relationships with clients to ensure their ongoing satisfaction and retention. - Identify and cultivate ne...

Document claim file by accurately capturing and updating claims data/information in compliance with best practices for low to moderate. exposure and complexity for Property and Content damage and Liability/Injury claims. Exercise judgement to determine policy verification and coverage determination by analysing applicable coverage for claims and determining whether the loss falls within the coverage. Exercise judgement to determine liability by gathering and analysing relevant facts, images; utilizing applicable coverages. Identify anomalies and patterns to identify fraudulent claims and refer to SIU team based on SOPs Work to have a timely resolution to claims with complete ownership from i...

As a Claims Management Associate at Accenture, your role will involve assessing claims to determine coverage eligibility and benefit entitlements in line with policy terms and regulatory guidelines. You will need to conduct thorough research to validate policy details, support documentation, and calculate the correct benefit amount. Additionally, you will review proof of employment, salary history, and other information needed to calculate benefits for Pensions claims. Your responsibilities will also include verifying the information and eligibility for the benefits of Pensions claims, complying with all regulatory requirements and procedures, and researching any queries or requests sent by ...

Role Overview: As a part of Zelis India's team, your role is crucial in supporting initiatives that enhance the healthcare financial experience. You will contribute to the development and implementation of innovative solutions, ensuring optimized technology and processes for efficiency. Additionally, you will be part of a collaborative work culture with leadership development opportunities, global exposure, and professional growth in a dynamic environment. With hybrid work flexibility, comprehensive healthcare benefits, financial wellness programs, and cultural celebrations, Zelis India fosters a holistic workplace experience. Your contribution will play a vital role in maintaining high serv...

As a PE-Ins Claims specialist, you will play a crucial role in enhancing claims processing efficiency in the Property & Casualty Insurance sector. Your customer service skills and domain knowledge will be pivotal in ensuring timely resolution of insurance claims and maintaining high customer satisfaction levels. **Key Responsibilities:** - Assist in processing insurance claims efficiently to ensure timely resolution and customer satisfaction. - Collaborate with team members to analyze and verify claim information for accuracy and completeness. - Utilize customer service skills to address inquiries and provide clear information to clients regarding their claims. - Support the team in maintain...

Description The Finance Operations organization works with every part of Amazon to provide operations accounting and operations excellence services with the highest level of controllership at the lowest cost to the company. We provide the backbone systems and operational processes which completely, accurately, and validly pay Amazon's suppliers, invoice our customers and report financial results. Amazon is quickly building the Finance Operations capabilities in the healthcare industry by creating the Healthcare Finance Operations Services. As part of the Amazon Healthcare Global Finance Operations Services team, you will find yourself working with exceptionally talented and determined people...

About The Role Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years Language - Ability: English(Domestic) - Intermediate Accenture is a global professional services company with leading capabilities in digital, cloud and security.Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song"” all powered by the world's largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and ...

{ Hiring for Record Retrieval } #Location: Ahmedabad, Gujarat #Fresher and Experience can apply #Fresher : Upto 30KCTC / Experience : Upto 35KCTC #US Shift #Excellent Communication Required

About The Role Skill required: Claims Services - Payer Claims Processing Designation: Health Operations New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years Accenture is a global professional services company with leading capabilities in digital, cloud and security.Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song"” all powered by the world's largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries...

Open Roles: Marine Claims Analyst Location: Bangalore Shift: UK Shift Exp: Min 2+ years exp Requirements: (Marine) Good understanding of Marine logistics/claims process Clear written & oral communication skills with internal customers. Strong analytical & interpersonal skills Strong troubleshooting and diagnosis skills Training experience is preferred. Exp in demmurrage, port operations, marine insurance For more details, pls share Cv at Sakshi.n@manningconsulting.in | Call/whatsapp 9368820159

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...

Greeting from Medi assist TPA Pvt ltd. Hiring Medical officer for Insurance Claim processing Profile Location- Noida Sector 3 Role - Medical officer Exp : 0-3 years WORK FROM OFFICE ONLY. Job description : 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 ...

Hiring for US mortage voice process Grad with minimum 1 year insurance voice experience Excellent comminication skills ONLY US Shift TWO OFFS L2- 33K 1 year + exp L3- 40K 3 + Year experience CALL NOW 9226639337 / 9049078453 Kharadi, Pune

Job Summary: RSM is looking for a detail-oriented and client-care focused Background Check & Pre Hire Specialist to join our offices in Gurugram or Bengaluru! Reporting to the Background Check & Pre-Hire Manager, you will use your investigative and organizational skills to support the Talent Operations Teams objective to provide and manage centralized, highly repeatable solutions that allow RSM to achieve business goals while balancing the needs of our employees. As an integral part of the TA Operations team, you will be responsible for centralized delivery of activities and processes related to pre-boarding, background check verification and compliance requirements. The Background Check & P...