17 Claims Resolution Jobs

JOB DESCRIPTION : RCM Denial Management - AR Caller Quality - Sr Executive JOB SUMMARY: As a QA RCM, you will be responsible for auditing the work of RCM Callers to ensure the highest standards of service delivery. Required Education/Experience Should be Graduate Should have worked as a Quality Controller for AR for at least one year with medical billing service providers or should have minimum 5 years experience into AR Must have very good knowledge of medical billing and be confident in process knowledge. Experience in the end-to-end Healthcare process and AR team for the audit Adapting to new situation challenges whenever required. Adhere to all company policies and procedures. Position R...

As a candidate for the role of drafting and formulation of subcontract documents, inviting bids/quotations, making comparison statements, negotiations, finalization of rates, and formulization/finalization of work orders for all subcontract works, you will be responsible for: - Quantities take off and preparation of Bill of Quantities (BOQs) for subcontractors. - Budget cost estimation for subcontractors and for procurement. - Preparation and submission of variations for project works, and following up with consultants/clients for variation approvals (Engineers Instruction). - Drafting and preparing all contractual letters with precision. - Specializing in correspondences related to claims/d...

As an Accident-sito Investigator, your role will involve being located in Sagar and focusing on claims resolution, handling, management, insurance, and on-site investigation of claims. You will be responsible for handling hospital administration and cooperating with police agencies. Key Responsibilities: - Resolve claims efficiently - Handle and manage claims effectively - Conduct thorough investigations into claims - Collaborate with hospital administration - Work closely with police agencies Qualifications Required: - Proficiency in claims resolution, handling, and management - Strong skills in insurance and claim investigation - Excellent analytical and problem-solving abilities - Excepti...

Claims Adjudicator US Healthcare (NSA Project) | 1+ Years | Mangalore | 3.5 LPA | Immediate Joiners Job Description Claims Adjudicator (US Healthcare NSA Project) We are seeking a detail-oriented and experienced Claims Adjudicator to join our No Surprises Act (NSA) project team . The ideal candidate will have a strong background in US healthcare claims adjudication with proven expertise in claims adjustments . Prior experience working on NSA-related initiatives will be a strong advantage. Key Responsibilities: Review, analyze, and adjudicate healthcare claims in line with US healthcare regulations and payer policies . Manage complex claim adjustments , ensuring accuracy and compliance with r...

Job Description_ Senior Executive - AR Analyst _ Denial management Job Name: Senior Executive Position Title: Senior Executive - AR Analyst Band: A2 LOB: Denial Management - AR Analyst - RCM Reporting to: Assistant Manager Location/Site: EXL India, Chennai Overview: Review, Analyze and Manage assigned outstanding receivables portfolio by ensuring outstanding/denied claims are resolved, follow up effectively for additional information as needed with insurance companies for claims resolution, follow up with the insurance company on the outstanding/denied claims and resolve them within the timelines and defined Service Level Agreements (SLA's), website checking and working on non-callable denia...

The Deputy Project Manager (DPM) should hold a BE/ B tech/ M tech in Civil. An MBA in Project/Construction/Finance will be an added advantage. With 9-12 years of experience in Irrigation/ Water Supply projects, the candidate should have successfully executed a single project with a volume exceeding 500 crores. As a Deputy Project Manager, you are required to possess the ability to oversee the entire project, with in-depth knowledge of Tender Clauses, Billings, Department Correspondence, and Claims. Your role will involve resolving various issues such as Forest Permissions, Highway Permissions, and Local Bodies Permissions. Having a strong understanding of Construction Methods, Materials, and...

The Manager - Sales Operations at Bunge, located in Mohali, Punjab, India, will be responsible for overseeing the service delivery management and transformation of the Customer Service & Sales Support function. You will lead a team engaged in service delivery, controls adherence, period end closing and reporting for different regions within BEMEA/BAS/BNA. Your role will involve identifying improvement and automation opportunities within existing processes and driving initiatives towards the digitalization of Customer Service & Sales Support function. Your main accountabilities will include operational leadership and team management, overseeing the end-to-end customer service & sales order pr...

About Us: Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, pathology, and radiology. Focused on Revenue Cycle Management, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities. Come Join Our Team! As part of our robust Rewards & Recognition program, this role is eligible for our Ventra performance-based incentive plan, because we believe great work deserves g...

NTT Data Services is Hiring! Position's Overview At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees are key factors in our company's growth, market presence and our ability to help our clients stay a step ahead of the competition. By hiring, the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here. NTT DATA, Inc. currently seeks an HC & Insurance Operations Senior Rep to join our team in Coimbatore/Chennai. Client's business problem to solve For more than 30 years, our Business Process Outsourcing (BPO) team has implemen...

As a part of this role, you will be responsible for working closely with insurance carriers to resolve escalated claims efficiently. You will play a crucial role in driving and influencing change to enhance automation processes. It will be your responsibility to share the results and successes achieved through root cause analysis with the business stakeholders. Your duties will also include reviewing client escalated issues and action items, conducting root-cause analysis, and utilizing this information to improve straight-through processing (STP) and enhance the overall client experience. You will be expected to build and maintain strong relationships with key stakeholders, including region...

As an EBO Accounts Receivable professional at Guidehouse in India, you will be responsible for initiating calls to request the status of claims in the queue. It will be your duty to take appropriate actions on claims to ensure resolution, along with ensuring accurate and timely follow-up when necessary. Documenting the actions taken in the claims billing summary notes is also a crucial part of this role. Your tasks will include prioritizing pending claims for calling from the aging basket and making physical calls in accordance with international norms and applicable rules for confidentiality and HIPAA compliance. You will be accountable for working on Denials, Rejections, and LOA's to accou...

As a member of the EBO Accounts Receivable team in India, you will be responsible for initiating calls to request the status of claims in the queue. Your main tasks will involve taking appropriate actions on claims to ensure timely resolution, accurate follow-up when necessary, and documenting all actions taken in the claims billing summary notes. Additionally, you will prioritize pending claims for calling from the aging basket and make physical calls following international norms and applicable rules for confidentiality and HIPAA compliance. You will also be tasked with working on denials, rejections, LOA's to accounts, and making necessary corrections to claims. To qualify for this role, ...

Job Description_ Senior Executive - AR Analyst _ Denial management Job Name: Senior Executive Position Title: Senior Executive - AR Analyst Band: A2 LOB: Denial Management - AR Analyst - RCM Reporting to: Assistant Manager Location/Site: EXL India, Chennai Overview: Review, Analyze and Manage assigned outstanding receivables portfolio by ensuring outstanding/denied claims are resolved, follow up effectively for additional information as needed with insurance companies for claims resolution, follow up with the insurance company on the outstanding/denied claims and resolve them within the timelines and defined Service Level Agreements (SLA's), website checking and working on non-callable denia...

JOB DESCRIPTION : HOSPITAL RELATIONS MANAGER Department: Hospital Relations Location: Hyderabad,Warangal,Nizamabad,Vijaywada,Visakhapatnam Job Type: Full-Time Job Summary: The Hospital Relations Manager will be responsible for managing and optimizing the relationship between the organization and hospital partners. This role involves overseeing pricing strategies, negotiating claims, resolving pending issues, and ensuring smooth coordination with internal stakeholders. The position also requires meticulous documentation related to training, meetings with internal and external stakeholders and updates to facilitate effective communication and decision-making. Key Responsibilities: 1. Hospital ...

Review and follow up on hospital billing claims for US healthcare providers Understand insurance denials, EOBs, and remittance advice for claim resolution Initiate outbound calls to insurance co Handle denials, underpayments, rejections effectively Required Candidate profile Hands-on exp in AR Calling Hospital Billing domain (US Healthcare). Knowledge of insurance follow-up, CPT/ICD codes, and claim lifecycle Strong understanding of revenue cycle management Excellent comm Perks and benefits Perks and Benefits

JOB DESCRIPTION HOSPITAL RELATIONS MANAGER Job Title: Chief Manager Department: Hospital Relations Location: Pune, Pimpri, Nagpur, Nashik, Kolhapur, Solapur, Aurangabad Job Type: Full-Time Job Summary: The Hospital Relations Manager will be responsible for managing and optimizing the relationship between the organization and hospital partners. This role involves overseeing pricing strategies, negotiating claims, resolving pending issues, and ensuring smooth coordination with internal stakeholders. The position also requires meticulous documentation related to training, meetings with internal and external stakeholders and updates to facilitate effective communication and decision-making. Key ...

Problem solving skills to resolve complex customer inquiries. Demonstrated ability to improve and/or transform team processes. Ability to adapt to changes quickly and think conceptually Billing and resubmitting claims Retrieving necessary documents for billing and account resolution Posting adjustments and resolving credit balances Resolving rejections and denials through corrections and appeals