3155 Claims Processing Jobs - Page 6

Primary Responsibilities: Roles and Responsibilities post training: Coding the medical record using the ICD-10 and PCS with desired accuracy as per SLA Know and adhere to HIPAA regulations Recognize, interpret and evaluate inconsistencies, discrepancies and inaccuracies in the medical data received and appropriately alert and/or query the responsible party and supervisor Meet quality and productivity standards and deadlines/turnaround times Reports a discharge disposition for all records as required and in accordance with the Centers for Medicare and Medicaid Services (CMS) rules and regulations For inpatient encounters, applies coding conventions and official coding guidelines approved by t...

Overview Now Hiring: Remote Coding Specialists in South India 100% remote in South India – Andhra Pradesh, Tamil Nadu, Telangana, Kerala, & Karnataka Full-time opportunity Competitive salaries plus incentive in INR Day shift hours, 5-day (M-F) work schedule, & collaborative team culture Day 1 - 3 orientation onsite and equipment pickup in Chennai Service Delivery Day 4 training will begin remotely (WFH) We offer the following benefits – PF, Gratuity, ESI or Group Insurance Colleague Recognition Programs – Monthly VIP, Spot Recognition, & IJP Career Progression The Coding Specialist is responsible for reviewing documents to identify all procedures and diagnosis. The Coding Specialist must ens...

The ideal candidate will have 5+ years of experience in QA automation and at least 3 years of hands-on expertise with Tosca / Selenium for test automation (With US Healthcare and EDI Claims 837 & 834) Required Candidate profile Ensure test coverage for HIPAA-compliant healthcare systems and validate against regulatory standards. US Healthcare experience Integrate Tosca/Selenium automation into CI/CD pipelines

We are seeking a Specialist Fiduciary who will work to ensure seamless accounting of Fiduciary portfolio assigned for either Client / Insurer or Third Party agents (Commission Agents). Accountable for collection and settlement of premiums/Claims from/to client /Insurer and ensuring resolution of Insurance queries raised, to ensure timely delivery of the routine task expected on the accounts/portfolio assigned Ensuring highest proficient handling as per Fiduciary procedures and accuracy for the accounts assigned. We will count on you for: To ensure timely delivery of the routine task expected on the accounts/portfolio assigned Expect a basic standard on accuracy and productivity Focus on Debt...

Overview Managing Deduction claims and Invoice claims processing in SAP TPM Assist with promotional event enrolments / claim approvals. Ensure all customer contract legends are current to provide Trade Promotion Analyst guidance. Maintain a strong control environment with accurate trade accruals, contract approvals and verification. Manage exception through verbal and written interactions with Sales and Sales Finance. Responsibilities Managing Deduction claims and Invoice claims processing in SAP TPM Assist with promotional event enrolments / claim approvals. Ensure all customer contract legends are current to provide Trade Promotion Analyst guidance. Maintain a strong control environment wi...

Role Objective: Follow up is the most essential part in the RCM cycle. It is usually the last step in the cycle after cash posting. After Denial management (AR Follow up) again the cycle starts till the payment is made by the insurance company. Essential Duties and Responsibilities:Establishes and assures compliance with departmental policies and procedures in conformance with corporate policies and procedures. Manages people and drives retention.Analysis data to identify process gaps prepare reports.Performance managementFirst level of escalationWork in all shifts on a rotational basisNeed to be cost efficient with regards to processes resource utilization and overall constant cost manageme...

Payroll Company: Teamlease Digital Role & responsibilities: Accurately enter insurance data into the database Maintain Insurance Company database Maintain quality score Perform other duties as assigned Observe professional standards of conduct, including attendance, professional behaviour, and dress code. Required Candidate Profile: - Adaptable and flexible -Knowledge of excel basics - Ability to perform under pressure - Problem-solving skills - Detail orientation - Ability to establish strong client relationship -Comfortable with Night Shifts -Good Communication Skills -Stability Shifts- Night Shifts Mode of work- Work from Office Perks and benefits: -5 days working. -Apart from development...

Roles: Perform follow-up with US insurance companies on outstanding claims. Handle denials, rejections, underpayments, and appeals effectively. Understand EOBs, ERAs, and AR aging reports. Send resume to careers@osprosys.com contact : 9845701484

Role Proficiency: Manager - Consulting Mandatory skill-set required: 1.US Healthcare Payer / US Health Insurance experience 2. As a Healthcare Consultant, candidate should have experience with Assessments and Discoveries i. Current-state analysis (functional landscape (detailed), technical landscape (high-level)) and future-state definition (including study of Industry best practices, benchmarking, gap analysis) ii. Delivery of Recommendations and Implementation Roadmap - as outputs from the Assessment / Discovery exercise - for the actual Technical Remediation, next steps iii. Support to documentation work (including Statements of Work (SoWs)) for Discovery / Assessment phase, and for Imple...

About the Team The Process Excellence team at Navi is focused on maintaining and elevating the quality of customer interactions. As the quality audit function, the team conducts regular audits of agent communicationsacross calls, chats, and other channelsto ensure accuracy, consistency, and compliance. The team also ensures compliance across different verticals and runs multiple initiatives in coordination with business team stakeholders to drive key business metrics. Insights from these audits are used to drive continuous improvement through targeted training, helping agents close knowledge or process gaps and deliver a consistently excellent customer experience. About the Role We are seeki...

Role Overview: As a Certified Claim Editing Resolution Analyst II at Zelis India, you will be responsible for reviewing and researching medical records for complex, multi-specialty provider claims to ensure appropriately coded billed services according to the Zelis Claim Edits Product. Your role will involve processing, validating, routing, and responding to mid-level complex incoming Client and Provider corrected claims, disputes, and inquiries. You will play a crucial part in maintaining the editing product integrity and contributing towards identifying and retaining additional Client savings. Key Responsibilities: - Research medical records for complex and multi-specialty provider claims ...

Greetings!! Openings for " Immediate Openings-Claims Adjudication-Quality Analyst " -Coimbatore Required Skills: Subject matter expert in Claims process. Able to perform Quality Audits. Exceptional interpersonal, customer service, problem-solving, verbal and written communication, and conflict resolution skills. Proficiency with the necessary technology, including computers, software applications, phone systems, etc. Ability to improve and/or transform teams processes across functions within the organization. Ability to understand basic data and take appropriate action. Ability to drive individual and team efficiency and productivity through effective and efficient metric management. Ability...

Job Title: Team Leader-Claims Adjudication-Immediate Openings Experience: 5-8 years Qualification: Bachelors degree Shift: Night shift Transportation: Pick up and drop would be provided Job Summary: Team Leader - Claims Adjudication will oversee a team of healthcare professionals responsible for processing member enrollments and adjudicating claims in compliance with US healthcare regulations, client-specific guidelines, and quality standards. The role ensures efficient workflow, team performance, process improvement, and client satisfaction. Key Responsibilities: Team Management & Leadership: Lead, mentor, and manage a team handling enrollment, Provider configuration- Coimbatore and claims ...

Hiring !!!! AR Team Lead , AR Manager , AR Associate Director - ( RCM - US Healthcare) Designation :- Team Lead Experience :-1 year as a Team Lead On Papers, If 2 yrs is there well and good to process Package :- 9.5 LPA / Hike on CTC Max upto 25% Work Location :- Hyd Notice Period :- Immediate Joiners - If already serving notice period means upto 15 days is also fine to process, Relieving Letter from any 1 company is fine Qualification :- Any Graduate Virtual Interviews ================================= Designation :- AR Manager ( RCM - US Healthcare) Experience :- Overall 10+ yrs in AR Domain and Min 1 year as a Deputy Manager Or Manager On Papers is Mandate Package :- 18 LPA / Hike on CTC ...

To ensure accurate and timely verification of sales employees’ claims, attendance monitoring, sales application (Bizom/ERP/App) updates, and MIS support for smooth sales operations. Strong knowledge of Excel,coordinate with cross-functional teams Required Candidate profile Data accuracy,Process discipline,Analytical ability,Time management Problem solving.sales support, MIS, or claim processing, ERP systems,sales application

careers@manavatacancercentre.com ---------------------------------------------------------------------------------------------------- WALK IN INTERVIEW: 12 NOON - 6 PM WHATSAPP HR BOT: +91 93094 59794 ---------------------------------------------------------------------------------------------------- I.] THE SUCCESSFUL CANDIDATE SHOULD KNOW THE PROCESS OF: II.] CLAIM PRE AUTHORISATION / QUERY REPLY / FINAL AUTHORISATION III.] DOCUMENTATION OF FILES / DISPATCH OF FILES / FOLLOW UP WITH INSURANCE COMPANIES. IV.] TRACKING OF CLAIMS / MS EXCEL / MS OFFICE ---------------------------------------------------------------------------------------------------- 1. WE ARE THE LARGEST CHAIN OF CANCER HOS...

-Guidewire Claim center 10 or later (DEVELOPER ONLY) -Claim Center Configuration and Integration Interested candidate can contact- ashi@yeslandmark.com +91 9120205383 Perks and benefits Joining bonus, insurance , ESOP, Maternity Leaves

Role & responsibilities Transcom Hiring for day shift premium proceess Role & responsibilities - Handle customer inquiries & queries via phone calls, to resolve their concerns in a timely and professional manner. Provide accurate information on products/services offered by the company to meet customers' needs. Identify opportunities to upsell/cross-sell relevant products/services based on customer feedback. Maintain records of all interactions with customers using CRM software (e.g., Salesforce). Escalate complex issues to senior team members when necessary. Preferred candidate profile Must Have Graduation Degree. Must have good communication skills, Interpersonal skills. Contact Person: MAN...

Deputy Manager - Claims(P&C)--8+Years-Pune/Bangalore/Mumbai Summary Are you a seasoned insurance claims professional with over 8 years of experience? Do you possess a strong acumen for handling claims and want to be instrumental in driving efficiency and accuracy in claim processes? If yes, this is the perfect opportunity for you to advance your career and make an impact in the insurance industry! We are looking for a proactive and detail-oriented Deputy Manager - Claims, who will work collaboratively with cross-functional teams to ensure seamless claims management while fostering innovation and compliance. Location-Pune/Mumbai/Bangalore (India) Your Future Employer A globally renowned organ...

JOB TITLE: Process Analyst - Claims LOCATION: Pune Shift : 3pm-12am (GMT) This position is to work in a Hybrid model and Any Finance Graduate/Postgraduate with min 1 years of relevant experience in insurance claims role with excellent communications and excel skills. ******************************************************************************************* *IMMEDIATE JOINERS ALERT!* We're looking for candidates who can *join immediately*. If you're available, please *send your CV via WhatsApp only* to: *9076159575* Please note: *No calls* will be entertained. ******************************************************************************************* Role & responsibilities : Graduates with ...

As a Senior Process Associate - Insurance, your role will involve managing end-to-end insurance operations, including policy processing, renewals, claims, compliance, and endorsements. Your expertise in multiple insurance domains and strong communication skills will be key in effectively liaising with clients and underwriters. Key Responsibilities: - Communicate with clients and underwriters to clarify policies and facilitate smooth deal closures. - Process new business, renewals, claims, and endorsements in Domestic, Commercial, and Transport insurance lines. - Ensure compliance with renewal timelines, Certificates of Currency (COC), and documentation standards. - Manage compliance-related ...

Job Purpose The incumbent will be on customer contact, garage contact, claim survey pick up and survey arrangement (within in-house limit), assessment and processing of auto claims), queries on claim flow, admissibility. Liability and status of claims. Manage & take decisions on process and settlement of auto claims over the call based on photographs shared by the customer using technological passement tools available in the claims function. Technical explanation of claim decision, type of settlement and assessments to the customer during the conversation. Transfer and reassign major and complex claims to region based on defined allocation parameters in consultation with team leaders and sen...

Medcare Hospitals Medical Centres is looking for Senior Executive - Revenue Cycle Management to join our dynamic team and embark on a rewarding career journey Assisting Managers in implementing a system to ensure that accurate billing information is entered into the billing system. Help him in supervising the revenue cycle department in various duties, such as account management, communications with insurance providers, collections, cash posting, contract analysis, and billing. Assist in managing staff performance by providing regular feedback, performance reviews, and one-on-one meetings. Reviewing financial hardship applications. Overseeing the hiring and training of staff. Planning and st...

Medcare Hospitals Medical Centres is looking for Senior Executive - Revenue Cycle Management to join our dynamic team and embark on a rewarding career journey Assisting Managers in implementing a system to ensure that accurate billing information is entered into the billing system. Help him in supervising the revenue cycle department in various duties, such as account management, communications with insurance providers, collections, cash posting, contract analysis, and billing. Assist in managing staff performance by providing regular feedback, performance reviews, and one-on-one meetings. Reviewing financial hardship applications. Overseeing the hiring and training of staff. Planning and st...

Medcare Hospitals Medical Centres is looking for Senior Executive - Revenue Cycle Management to join our dynamic team and embark on a rewarding career journey Assisting Managers in implementing a system to ensure that accurate billing information is entered into the billing system. Help him in supervising the revenue cycle department in various duties, such as account management, communications with insurance providers, collections, cash posting, contract analysis, and billing. Assist in managing staff performance by providing regular feedback, performance reviews, and one-on-one meetings. Reviewing financial hardship applications. Overseeing the hiring and training of staff. Planning and st...