11 Claims Review Jobs

As a Service Experience Lead at Assurant-India, your role involves ensuring the delivery of exceptional customer service through claims review in accordance with SLA. You will be based at our Mumbai, India office. **Role Overview:** In this role, your duties and responsibilities will include: - Adjudicating each claim based on available defect and estimate details - Collecting, verifying, and analyzing information to ensure validity of claims and settlements are made as per company practices - Ensuring service partners adhere to agreed SLAs to maintain service standards - Generating monthly claims reports - Developing claim cost reduction plans and implementing necessary actions - Demonstrat...

Position: Senior Analyst/Process Lead- Oil & Gas Claims & Contract Management Location: Bangalore Shift: UK Shift Exp: 4 to 8 Years Salary: Upto 10 LPA Role: Experience of working on Oil and Gas Marine logistics *Experience of Marine claims management and processing Research, review and analyze contract terms, documents and events to prepare critical claim calculations Negotiation of claims with 3rd Party (regular phone calls and emails) and issue invoices for Receivable claims Timely escalation of relevant issues to supervisor and business line as appropriate Develop and review control reports to ensure receivable claims are submitted to 3rd party/Affiliate within contract limits; monitor a...

Position: Senior Analyst/Process Lead- Marine Claims (Oil & Gas) Location: Bangalore Shift: UK Shift Exp: 4 to 8 Years Salary: Upto 10 LPA Role: Experience of working on Oil and Gas Marine logistics *Experience of Marine claims management and processing Research, review and analyze contract terms, documents and events to prepare critical claim calculations Negotiation of claims with 3rd Party (regular phone calls and emails) and issue invoices for Receivable claims Timely escalation of relevant issues to supervisor and business line as appropriate Develop and review control reports to ensure receivable claims are submitted to 3rd party/Affiliate within contract limits; monitor additional con...

We are seeking a passionate and experienced SME with strong hands-on expertise in one/more of the following areas Claims prepayment review Clinical Coding Medical Code Denials Management Apply at https://coverself.keka.com/careers/jobdetails/99956 Health insurance

Hiring for Wns Please find below the JD and hiring inputs for Payment Posting Post all insurance ACH , manual checks and credit card payments to accounts in the practice management systems in a timely and accurate manner. Record and balance batch totals daily. Ensure payments, allowances, adjustments, denials and rejections are researched and posted with a high degree of accuracy. Research and clear unapplied payments and recoupment payments from payor. Identify payor fees not being paid at the allowed or contracted amount and communicate these findings to the Supervisor or Manager. Access payer websites to obtain Explanation of Benefits. Complete office requests for locating payments and ad...

Hiring for Wns Please find below the JD and hiring inputs for Payment Posting Post all insurance ACH , manual checks and credit card payments to accounts in the practice management systems in a timely and accurate manner. Record and balance batch totals daily. Ensure payments, allowances, adjustments, denials and rejections are researched and posted with a high degree of accuracy. Research and clear unapplied payments and recoupment payments from payor. Identify payor fees not being paid at the allowed or contracted amount and communicate these findings to the Supervisor or Manager. Access payer websites to obtain Explanation of Benefits. Complete office requests for locating payments and ad...

As a Sr. Process Associate- Behavioral Healthcare Billing at Med Karma, you will be responsible for handling medical billing solutions for healthcare providers specializing in behavioral health. With a minimum of 3 years of experience in this field, you will demonstrate expertise in behavioral health billing, coding, and reimbursement policies. Your role will involve managing a wide range of billing functions, including utilization management, prior authorization, claims review, and analyzing denials to develop effective appeal strategies. You should possess good communication skills and a strong understanding of revenue codes related to IOP/PHP services. Additionally, you must navigate carv...

You will play a crucial role in supporting various initiatives that enhance the healthcare financial experience at Zelis India. Your responsibilities will include reviewing claims within the Clinical Coding Policy queues and maintaining up-to-date clinical guidelines for these claims. You will also analyze specific coding scenarios, assist in edit ideation, and provide root-cause analysis of edit performance issues. Communication and teamwork are essential as you collaborate with the team and leadership to ensure edits are working as intended and to support decision-making with validation data. As the Clinical Coding Policy Analyst, you will work closely with leadership on departmental funct...

You will be responsible for creating and maintaining a sustainable portfolio in line with the underwriting policy of the company for Property, Engineering, Marine, and Miscellaneous Lines of Business (LOB) for both retail and SME channels. With a minimum of 5 years of experience, you will independently underwrite commercial lines products such as Property & Engineering, Marine, and Miscellaneous LOB for the retail and SME channels. Your key duties will include preparing quotations in full compliance with the company's approved guidelines and policies, reviewing all incoming quote requests, providing quotes within specified timelines, and ensuring profitable bottom-line results. Additionally,...

Regulatory Affairs Executive ( for Cosmetic Industry ) Kheda, Gujarat 3–5 Years Experience CTC up to 6 LPA Strong knowledge of global cosmetic regulations (EU/USA/ASEAN/Gulf) Expertise in labeling, claims review, and documentation

Greetings of the day ! Our reputed MNC Client is hiring for Clinical Policy Review Analyst role: Job Description: As a Clinical Policy Review Analyst, you will be responsible for providing in-depth clinical coding analysis of professional and facility claims, maintaining up-to-date clinical guidelines, and ensuring compliance with industry standards. Key Responsibilities: - Provide clinical coding analysis of professional and facility claims routed to the Clinical Policy Review queue - Maintain current industry knowledge of claim edit references, including AMA, CMS, NCCI, and other relevant guidelines - Conduct research on coding scenarios and provide data-driven insights and business recomm...