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1.0 years
2 - 3 Lacs
India
On-site
We are Hiring: OPT Recruiters (Experience: 3 Months – 1 Year) Location: Kondapur, Hyderabad Experience: 3 Months – 1 Year Job Type: Full-Time/Night shifts Job Description: We are actively looking for enthusiastic and result-driven OPT Recruiters to join our dynamic team. Responsibilities: Market OPT, CPT, H4-EAD, and H1B candidates to various clients/vendors. Build and maintain strong relationships with candidates. Coordinate interviews, follow up, and ensure smooth onboarding. Maintain candidate database and reports. Understand market trends and optimize recruitment strategies. Requirements: 3 months to 1 year of hands-on experience in OPT recruiting. Good knowledge of job portals and social media recruiting. Strong communication and negotiation skills. Ability to work independently and in a team environment. To Apply: Send your resume to aiswarya@fluxteksol.com Contact: 9348125410 Job Type: Full-time Pay: ₹18,000.00 - ₹25,000.00 per month Schedule: Night shift Language: English (Required) Work Location: In person
Posted 1 week ago
2.0 - 3.0 years
2 - 3 Lacs
Gurgaon
On-site
Vidal is hiring for Claims-Executive Work Location: Gurgaon Work from Office only Key Responsibilities Claim Review & Validation - Examine submitted claims for completeness and accuracy - Verify policy coverage and eligibility - Identify discrepancies or missing documentation Claims Processing - Enter and adjudicate claims in the system (cashless & reimbursement) - Calculate payable amounts as per policy terms - Ensure timely processing within defined SLAs Stakeholder Communication - Liaise with policyholders, hospitals, and insurers for claim clarifications - Respond to queries and provide claim status updates - Coordinate with Preauth and Customer Care teams Documentation & Compliance - Maintain detailed records of claims and actions taken - Ensure adherence to IRDAI guidelines and internal SOPs - Flag potential fraud or irregularities for investigation Reporting & Analysis - Generate daily/weekly/monthly claim reports - Track claim trends and highlight recurring issues - Support audits and internal reviews with accurate data Skills & Competencies Strong attention to detail and data accuracy Familiarity with medical terminology, ICD/CPT codes Proficiency in claims software (Portal) Effective communication and problem-solving skills Ability to manage sensitive information with discretion Experience Required 2–3 years of experience in claims processing within the TPA or Health Insurance domain Exposure to group health policies and coordination with hospitals or corporate clients is preferred Interested candidate can connect 9971006988 Job Types: Full-time, Permanent Pay: ₹22,000.00 - ₹25,000.00 per month Experience: total work: 1 year (Preferred) Work Location: In person
Posted 1 week ago
1.0 - 5.0 years
2 - 7 Lacs
Chennai
Work from Office
About Client Hiring for one of the most prestigious multinational corporations Job Title: E/M Coder - Outpatient (CPC Certified ) Qualification : Any Graduate and Above Relevant Experience: 1- 5 Years in Evaluation and Management , Outpatient , CPC Certified Mandate Must Have Skills: Experience in risk adjustment coding (HCC) , outpatient , or E&M coding High attention to detail and accuracy in code assignment and documentation review Strong analytical and problem-solving skills Effective written and verbal communication for coder feedback and education Proficiency in Microsoft Office and EHR/coding software Ability to manage multiple tasks and meet strict deadlines in a fast-paced environment Familiarity with tools such as 3M , EPIC , or Optum Encoder Key Responsibilities: Conduct retrospective and prospective audits of E&M coded records for accuracy and compliance Assign ICD-10-CM, CPT, and HCPCS codes based on official guidelines and facility-specific protocol Identify coding errors or trends and provide constructive feedback to improve coder performance Collaborate with coding and clinical documentation teams to resolve discrepancies Lead or support coder education and training based on audit outcomes and coding updates Stay current on E&M coding standards, CMS regulations , and payer-specific requirements Participate in internal and external compliance audits; respond to audit requests as needed Generate audit reports and track coding performance metrics Ensure revenue integrity and regulatory compliance in coordination with billing, compliance, and HIM teams Location : Chennai CTC Range : Up to 7LPA Notice Period: Immediate to 15 Days only Shift : Day shift Mode of Work : Work From Office (WFO) Interview Mode : Virtual -- Thanks & Regards, Sumitha HR Specialist- TA-Delivery Black and White Business Solutions Pvt Ltd Bangalore, Karnataka, INDIA. Direct Number: 08067432442 / 9620242412 | sumitha@blackwhite.in | www.blackwhite.in ************************ Refer your Friends and Family ********************************
Posted 1 week ago
1.0 - 6.0 years
1 - 3 Lacs
Chennai
Work from Office
Dear Aspirants, Warm Greetings!! We are hiring for the following details, Position:- - AR Analyst ( Non voice Day shift ) Salary: Based on Performance & Experienced Exp : Min 1 year Required Joining: Immediate Joiner / Maximum 10 days NB: Freshers do not apply Work from office only (Direct Walkins Only) Monday to Friday ( 11 am to 6 Pm ) Everyday contact person Vineetha HR ( 9600082835 ) Interview time (10 Am to 5 Pm) Bring 2 updated resumes Refer ( HR Name Vineetha vs) Mail Id : vineetha@novigoservices.com Call / Whatsapp (9600082835) Refer HR Vineetha Location : Chennai , Ekkattuthangal Warm Regards, HR Recruiter Vineetha VS Novigo Integrated Services Pvt Ltd,Sai Sadhan, 1st Floor, TS # 125, North Phase,SIDCOIndustrial Estate, Ekkattuthangal, Chennai 32 Contact details:- HR Vineetha vineetha@novigoservices.com Call / Whatsapp ( 9600082835)
Posted 1 week ago
0 years
0 Lacs
Bhiwandi, Maharashtra, India
On-site
Industry Apparel / E commerce/ Retail Qualifications Any Graduate Roles & Responsibilities: · Handling the operations of B2C and B2B on daily basis · Maintaining dashboards and keeping records of daily activities performed in the Inventory OMS. · Inward, QC & Inventory Management operation in the Warehouse. · Handling Inward GRN “stowing Put away” complete unload vehicle within define TAT. ▪ Also process urgent orders according to feasibility of high performing Style. · Follow all SOP of TAT according to FIFO & LIFO board maintain Properly. · Monthly maintain Aging Report, and sellable & unsellable stock move to STN, RTV, and RVO “Removal” · Handling 120-140 Manpower and forecast manpower productivity on daily basis to achieve the targets. · Focus on Order Processing: Picking & packing with respect to the CPT order & SLA, Dispatch of shipments as per transporter /Courier Partner cutoff time. · Daily update “MIS” trackers, FC Management, Sales Dispatch Returns, Unable to Pack “NSZ/Channel errors orders” & shipped units RTO received & processed. · Inventory Heath- Daily focus on RECO-IRDR working at last SKU and last items check in inventory & following FIFO, LIFO concept “blockage, overhanding, overstuffing & similar, type of bin, above divider”. · Resolution of Technical or operational Error of OMS/ WMS of Increff. · Packaging Consumptions: - Handling Weekly Audit and Maintaining daily consumptions tracker to replenish shortage. · Sharing Sales Projection for the month i.e. Inbound, outbound & Returns Plan. · Quality Control: Checking the quality of all the stock, Refurbishment of bad Stocks, Storage area, Sku’s of the existing product to fulfill customer satisfaction by providing a right, Good quality product and with proper Packing with Transit worthiness.
Posted 1 week ago
7.0 - 10.0 years
0 Lacs
Pune, Maharashtra, India
On-site
Title: Business Analyst - Life and Health Insurance Job Summary We are seeking a highly skilled and experienced Business Analyst with 7-10 years of focused experience in the life and health insurance industry, particularly in claims processing. Understanding the key KPIs that drive claims processing is critical. The candidate will play a crucial role in bridging the gap between business needs and IT solutions, contributing to the enhancement of our solution. The ideal candidate will have a strong techno-functional understanding of the insurance product benefits, coverages, claims rules, exclusions and fraud analytics and should know about Product Configuration in the system. Having a comprehensive grasp of Medical Codes ICD, PCS, and CPT codes would be an additional plus for this role. Key Responsibilities Collaborate with the Claims head, claims processing and provider management team to gather and analyse business requirements related to claims processing. Conduct in-depth analysis of the existing claims systems and processes, identifying areas for improvement and optimization. Previous experience in understanding and working with ICD, PCS, and CPT codes will be an advantage. Translate business requirements into clear and concise technical specifications for the IT development team. Understand and analyse the insurance product with respect to benefits, coverages, limits, exclusions etc to analyse the configuration of the product in the Product Configurator Create detailed documentation of business requirements, processes, and solutions. Develop and document business process models to illustrate current and future states Identify opportunities for process improvements and contribute to ongoing optimization efforts. Facilitate workshops and meetings with stakeholders to elicit and document requirements, ensuring all relevant information is captured accurately. Perform detailed data analysis to identify trends, patterns, and potential areas of concern related to claims processing and fraud detection. Develop and maintain comprehensive documentation, including functional requirements, use cases, process flows, and data mappings. Collaborate closely with tech teams throughout the development lifecycle to ensure proper implementation of business requirements. Assist in user acceptance testing (UAT) and provide support during the testing phase to validate that the solutions meet the business needs. Act as a subject matter expert (SME) on claims processing, offering insights, recommendations, and expertise to support decision-making processes. Qualifications And Skills Bachelor’s degree in business, Insurance, Computer Science, or a related field. 5-10 years of proven experience as a Business Analyst in the Life and Health insurance industry, with a strong focus on claims processing and product underestanding. Proficiency in claims rules, fraud analytics, and data analysis techniques. Strong communication and interpersonal skills to effectively collaborate with stakeholders at all levels of the organization. Ability to translate complex business requirements into clear and actionable technical specifications. Proven track record of successfully delivering business analysis projects in the insurance domain. Familiarity with Agile or other project management methodologies is a plus. Certification in Business Analysis (e.g., CBAP) is desirable but not mandatory. Skills: medical codes (icd, pcs, cpt),technical specifications,analytics,insurance,business requirements,health insurance,processing,business analysis,claims processing,agile methodology,business process modeling,fraud analytics,product configuration,stakeholder communication,data analysis
Posted 1 week ago
7.0 - 10.0 years
0 Lacs
Mumbai Metropolitan Region
On-site
Title: Business Analyst - Life and Health Insurance Job Summary We are seeking a highly skilled and experienced Business Analyst with 7-10 years of focused experience in the life and health insurance industry, particularly in claims processing. Understanding the key KPIs that drive claims processing is critical. The candidate will play a crucial role in bridging the gap between business needs and IT solutions, contributing to the enhancement of our solution. The ideal candidate will have a strong techno-functional understanding of the insurance product benefits, coverages, claims rules, exclusions and fraud analytics and should know about Product Configuration in the system. Having a comprehensive grasp of Medical Codes ICD, PCS, and CPT codes would be an additional plus for this role. Key Responsibilities Collaborate with the Claims head, claims processing and provider management team to gather and analyse business requirements related to claims processing. Conduct in-depth analysis of the existing claims systems and processes, identifying areas for improvement and optimization. Previous experience in understanding and working with ICD, PCS, and CPT codes will be an advantage. Translate business requirements into clear and concise technical specifications for the IT development team. Understand and analyse the insurance product with respect to benefits, coverages, limits, exclusions etc to analyse the configuration of the product in the Product Configurator Create detailed documentation of business requirements, processes, and solutions. Develop and document business process models to illustrate current and future states Identify opportunities for process improvements and contribute to ongoing optimization efforts. Facilitate workshops and meetings with stakeholders to elicit and document requirements, ensuring all relevant information is captured accurately. Perform detailed data analysis to identify trends, patterns, and potential areas of concern related to claims processing and fraud detection. Develop and maintain comprehensive documentation, including functional requirements, use cases, process flows, and data mappings. Collaborate closely with tech teams throughout the development lifecycle to ensure proper implementation of business requirements. Assist in user acceptance testing (UAT) and provide support during the testing phase to validate that the solutions meet the business needs. Act as a subject matter expert (SME) on claims processing, offering insights, recommendations, and expertise to support decision-making processes. Qualifications And Skills Bachelor’s degree in business, Insurance, Computer Science, or a related field. 5-10 years of proven experience as a Business Analyst in the Life and Health insurance industry, with a strong focus on claims processing and product underestanding. Proficiency in claims rules, fraud analytics, and data analysis techniques. Strong communication and interpersonal skills to effectively collaborate with stakeholders at all levels of the organization. Ability to translate complex business requirements into clear and actionable technical specifications. Proven track record of successfully delivering business analysis projects in the insurance domain. Familiarity with Agile or other project management methodologies is a plus. Certification in Business Analysis (e.g., CBAP) is desirable but not mandatory. Skills: medical codes (icd, pcs, cpt),technical specifications,analytics,insurance,business requirements,health insurance,processing,business analysis,claims processing,agile methodology,business process modeling,fraud analytics,product configuration,stakeholder communication,data analysis
Posted 1 week ago
2.0 - 3.0 years
0 Lacs
Chennai, Tamil Nadu, India
On-site
Job Purpose The Insurance Verification Representative II is responsible for obtaining and providing accurate and complete data input for precertification/preauthorization from insurance companies Duties And Responsibilities Work effectively with insurance companies to obtain pre-certification/authorization for services Place calls to various health plans to obtain appropriate precertification prior to the patient`s appointment Ability to understand/interpret documented clinical information and relay pertinent medical/clinical information to the insurance company Fax to pre-certification request form to insurance company Maintain files and security of confidential information utilizing host system to scan and input data as per established procedures Verify medical insurance information and documents in scheduling/registration modules Review claim denials and rejections Accurately enter and update patient data, and other general data, into the computer system Patient intake; insurance verification, notification of copays/patient liability and confirmation of demographics Maintain account work progress, including but not limited to updating authorization logs, account referral in EMR, authorization paperwork and issue reports Demonstrate knowledge of varied managed care insurance and regulatory guidelines Meet and maintain daily productivity/quality standards established in departmental policies Use the MPower workflow system, client host system and other tools available to collect payments and resolve accounts Adhere to the policies and procedures established for the client/team Communicate effectively with physician offices and patients Place outbound call to patients with precertification notification Work independently from assigned work queues Maintain confidentiality at all times Maintain a professional attitude Other duties as assigned by the management team Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards Qualifications High school diploma or equivalent required Medical terminology knowledge required Minimum of 2-3 years of healthcare or physician's office related experience in obtaining and handling pre-authorizations Proficiency with MS Office. Must have basic Excel skillset Experience with GE Centricity, EPIC PB, Allscripts, Cerner, preferred Extensive knowledge of individual payor websites, including eviCore, Navinet and Novitasphere Knowledge of Medical Terminology, CPT Codes, Modifiers and Diagnosis Codes Ability to work well individually and in a team environment Strong organizational and task prioritization skills Strong communication skills/oral and written Working Conditions Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear. Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress. Work Environment: The noise level in the work environment is usually minimal. Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.
Posted 1 week ago
0 years
0 Lacs
Gurgaon, Haryana, India
Remote
Triple Role Triple is leading the way in remote work solutions, helping small and medium-sized businesses in North America build highly efficient remote teams for Administration, Customer Service, Accounting, Operations, and back-office roles. Our focus has always been on our Clients, People, and Planet, ensuring our operations contribute positively across these key areas. Distinguished by its rigorous standards, Triple excels in: Selectively recruiting the top 1% of industry professionals Delivering in-depth training to ensure peak performance Offering superior account management for seamless operations Embrace unparalleled professionalism and efficiency with Triple—where we redefine the essence of remote hiring. Summary As a Medical Biller, you'll play a crucial role in healthcare administration by ensuring patient information is accurately coded for insurance claims and billing purposes. You will be responsible for reviewing medical records, assigning standardized codes (such as ICD-10 and CPT) to diagnoses, procedures, and treatments, and ensuring these codes are used to process claims with insurance companies. Responsibilities Perform charge and demo entries. Analyze patient medical records to assign appropriate codes to diagnoses, procedures, and medical services using standardized coding systems (ICD-10 and CPT) Review bills for accuracy and completeness and obtain any missing information. Knowledge of insurance guidelines especially Medicare and state Medicaid. Check each insurance payment for accuracy and compliance with the contract. Understands the medical billing process, insurance rules and regulations, and can enforce/abide by policies and procedures. Document all actions taken in the company or Client host system. Adhere to HIPAA, patient confidentiality, and compliance requirements at all times. Research payor rules and regulations to maintain current payor knowledge. Qualifications Proficiency in medical coding (ICD-10, CPT, HCPCS). Strong attention to detail to ensure accuracy in billing and coding. Knowledge of medical terminology and anatomy. Familiarity with healthcare billing software and electronic health records (EHR). Ability to navigate insurance claim processes and resolve issues. Schedule (US Shifts Only) Eastern Time - 6:30 p.m. - 3:30 a.m. IST, Monday - Friday Logistical Requirements Quiet and brightly illuminated work environment Laptop with Minimum 8GB RAM, I5 8th gen processor 720P Webcam and Headset A reliable ISP with a minimum speed of 100 Mbps Smartphone
Posted 1 week ago
0 years
0 Lacs
Tiruchirappalli, Tamil Nadu, India
On-site
Hiring for Recruiters We are looking for Sr US IT Recruiter Location : Trichy, Tamil Nadu. Experience : 2 Plus Yrs . Salary : Industry Standard. Key Responsibilities: • Recruit candidates with H1B, OPT, CPT, TN, GC, USC, and EAD visas. • Manage relationships with vendors and clients. • Handle the recruitment process from start to finish. • Understand W2, Corp-to-Corp, and 1099 employment types. • Negotiate rates and support consultants. Inbox your profile to gopi@lorventech.com
Posted 1 week ago
2.0 - 6.0 years
0 Lacs
noida, uttar pradesh
On-site
You will be responsible for analyzing medical records and documentation to identify services provided during patient evaluations and management. Your main task will be to assign appropriate E&M codes based on the level of service rendered and in accordance with coding guidelines and regulations such as CPT, ICD-10-CM, and HCPCS. It is crucial to ensure coding accuracy and compliance with coding standards, including documentation requirements for various E&M levels. Staying up-to-date with relevant coding guidelines, including updates from regulatory bodies like the Centers for Medicare and Medicaid Services and the American Medical Association, is essential. Adherence to coding regulations, such as HIPAA guidelines, is necessary to ensure patient privacy and confidentiality. Following coding best practices and maintaining a thorough understanding of coding conventions and principles are also key aspects of the role. Collaboration with healthcare professionals, including physicians, nurses, and other staff members, is required to obtain necessary information for coding purposes. You will need to communicate with providers to address coding-related queries and clarify documentation discrepancies. Working closely with billing and revenue cycle teams to ensure accurate claims submission and facilitate timely reimbursement is part of the job responsibilities. Conducting regular audits and quality checks on coded medical records to identify errors, inconsistencies, or opportunities for improvement is also a key aspect of the role. Participation in coding compliance programs and initiatives to maintain accuracy and quality standards is expected. To be considered for this position, applicants need to meet the following qualification criteria: - Certified Professional Coder (CPC) or equivalent coding certification (e.g., CCS-P, CRC) - In-depth knowledge of Evaluation and Management coding guidelines and principles - Proficient in using coding software and Electronic Health Record (EHR) systems - Familiarity with medical terminology, anatomy, and physiology - Strong attention to detail and analytical skills - Excellent communication and interpersonal skills - Ability to work independently and as part of a team - Compliance-oriented mindset and understanding of healthcare regulations - Strong organizational and time management abilities - Continuous learning mindset to stay updated on coding practices and changes,
Posted 1 week ago
5.0 years
0 Lacs
India
Remote
Triple Triple is leading the way in remote work solutions, helping small and medium-sized businesses in North America build highly efficient remote teams for Administration, Customer Service, Accounting, Operations, and back-office roles. Our focus has always been on our Clients, People, and Planet, ensuring our operations contribute positively across these key areas. Distinguished by its rigorous standards, Triple excels in: Selectively recruiting the top 1% of industry professionals Delivering in-depth training to ensure peak performance Offering superior account management for seamless operations Embrace unparalleled professionalism and efficiency with Triple—where we redefine the essence of remote hiring. Summary The Accounts Receivable (AR) Specialist in US Healthcare is responsible for managing and resolving insurance and patient payment collections to ensure timely revenue realization. This role involves claim follow-up, denial management, appeal submissions, and maintaining accurate records in compliance with payer regulations and healthcare policies. The AR Specialist collaborates with billing, coding, and customer service teams to optimize cash flow and reduce aged AR. Responsibilities Claims Follow-Up: Proactively follow up with insurance companies (Medicare, Medicaid, Commercial) via phone, portal, or email for unpaid or underpaid claims. Analyze Explanation of Benefits (EOBs)/Electronic Remittance Advices (ERAs) for claim status. Denial Management & Appeals: Review and identify reasons for claim denials and underpayments. Prepare and submit accurate appeals and corrected claims within payer deadlines. Payment Posting Coordination: Work with the payment posting team to resolve misapplied payments, overpayments, and unposted remittances. Flag refunds or adjustments as needed. Aging Report Analysis: Review aging reports and prioritize high-dollar or timely filing claims. Document all actions taken and maintain notes in billing software. Compliance & Quality: Ensure all follow-up activities comply with HIPAA and payer-specific guidelines. Meet daily/weekly productivity and quality benchmarks (e.g., # of claims worked, resolution rate). Communication & Coordination: Coordinate with clients, internal teams (billing, coding), and insurance representatives to resolve issues efficiently. Escalate complex issues to the team lead or AR manager as necessary. Qualifications Bachelor’s degree. 2–5 years of AR experience in US medical billing/RCM industry is a must Knowledge of payer guidelines (Medicare, Medicaid, BCBS, UHC, etc.). Hands-on experience with billing software (e.g., Kareo, AdvancedMD, Athenahealth, eClinicalWorks, NextGen, etc.). Proficiency in MS Excel and claim tracking tools. Strong understanding of the US healthcare revenue cycle and AR lifecycle. Excellent analytical and problem-solving skills. Effective verbal and written communication skills. Ability to work independently and manage time effectively. Knowledge of CPT, ICD-10, and HCPCS codes is an added advantage. Schedule (US Shifts Only) Eastern Time - 6:30 p.m. - 3:30 a.m. IST, Monday - Friday Logistical Requirements Quiet and brightly illuminated work environment Laptop with Minimum 8GB RAM, I5 8th gen processor 720P Webcam and Headset A reliable ISP with a minimum speed of 100 Mbps Smartphone
Posted 1 week ago
5.0 years
0 Lacs
Bhubaneshwar, Odisha, India
On-site
Intellectt Inc. is actively hiring a Staffing Sales Recruiter with hands-on experience in bench sales and vendor development within the US staffing market, specifically focused on Medical Devices, Pharma, and Engineering. This role is ideal for someone with a proven vendor network across the U.S., capable of rapidly submitting and placing consultants by leveraging deep industry connections. Key Responsibilities: Submit internal bench consultants to active job requirements from US-based vendors, MSPs, and direct clients. Build, nurture, and expand vendor networks specifically within the Medical Device, Engineering, and Pharma domains. Maintain relationships with existing vendor contacts to ensure repeat business and faster turnarounds. Utilize job portals (Dice, Monster, CareerBuilder, Indeed) for requirement tracking and submittals. Collaborate with internal sourcing teams for quick profile delivery and alignment. Provide weekly updates on submittals, interview feedback, and placement status. Required Qualifications: 2–5 years of bench sales experience in US staffing, with a focus on Medical Device, Pharma, and Engineering clients. Strong working relationships with USA-based vendors, implementation partners, or direct clients in the target industries. Demonstrated ability to generate submittals, interviews, and closures through existing vendor contacts. Solid understanding of VMS/MSP systems, contract staffing, and rate negotiations. Experience in consultant marketing and managing full sales life cycles. Excellent communication and follow-up skills with US-based clients. Experience working with OPT/CPT/H1B bench consultants.
Posted 1 week ago
1.0 - 5.0 years
2 - 4 Lacs
Bengaluru
Work from Office
About Client Hiring for one of the most prestigious multinational corporations !!! Job Title : AR Caller Denial Management Qualification : Any Graduate and Undergraduate Relevant Experience : 1 to 3 Years Must Have Skills : 1. Experience as an AR Caller in Denial Management. 2. Good understanding of denial reasons (CO, OA, PR codes) and appeal processes. 3. Familiarity with healthcare insurance terminology, CPT/ICD coding basics. 4. Strong analytical and problem-solving skills. 5. Excellent communication skills (both verbal and written). 6. Proficiency in working with RCM software/tools like EPIC, Athena, eClinicalWorks, etc. 7. Typing speed of at least 30 WPM with accuracy. 8. Ability to multitask and meet deadlines under pressure. Good Have Skills : Knowledge and expertise AR Caller in Denial Management. Roles and Responsibilities : 1. Review and analyze insurance claim denials from payers. 2. Make outbound calls to insurance companies to resolve denied or unpaid claims. 3. Identify the root cause of denials (e.g., coding errors, eligibility issues, authorization lapses). 4. Take appropriate actions such as appeal filing, claim corrections, or rebilling. 5. Document all activities accurately in the client system or internal tools. 6. Follow-up on pending claims within the specified TAT. 7. Communicate effectively with insurance representatives and escalate complex issues when needed. 8. Work collaboratively with internal teams (coding, billing) to resolve denial trends. 9. Stay updated with payer-specific guidelines and industry regulations (HIPAA compliance). Location : Bangalore CTC Range : 3 to 4.8 LPA (Lakhs Per Annum) Notice Period : Immediate Mode of Interview : Virtual Shift Timing : Night Shift Mode of Work : Work From Office -- Thanks & Regards, Amala Subject Matter Expert Black and White Business Solutions Pvt Ltd Bangalore, Karnataka, INDIA. Direct Number: 080-67432406 amala@blackwhite.in | www.blackwhite.in
Posted 1 week ago
5.0 years
0 Lacs
Pune, Maharashtra, India
On-site
Intellectt Inc. is actively hiring a Staffing Sales Recruiter with hands-on experience in bench sales and vendor development within the US staffing market, specifically focused on Medical Devices, Pharma, and Engineering. This role is ideal for someone with a proven vendor network across the U.S., capable of rapidly submitting and placing consultants by leveraging deep industry connections. Key Responsibilities: Submit internal bench consultants to active job requirements from US-based vendors, MSPs, and direct clients. Build, nurture, and expand vendor networks specifically within the Medical Device, Engineering, and Pharma domains. Maintain relationships with existing vendor contacts to ensure repeat business and faster turnarounds. Utilize job portals (Dice, Monster, CareerBuilder, Indeed) for requirement tracking and submittals. Collaborate with internal sourcing teams for quick profile delivery and alignment. Provide weekly updates on submittals, interview feedback, and placement status. Required Qualifications: 2–5 years of bench sales experience in US staffing, with a focus on Medical Device, Pharma, and Engineering clients. Strong working relationships with USA-based vendors, implementation partners, or direct clients in the target industries. Demonstrated ability to generate submittals, interviews, and closures through existing vendor contacts. Solid understanding of VMS/MSP systems, contract staffing, and rate negotiations. Experience in consultant marketing and managing full sales life cycles. Excellent communication and follow-up skills with US-based clients. Experience working with OPT/CPT/H1B bench consultants.
Posted 1 week ago
7.0 - 12.0 years
12 - 20 Lacs
Hyderabad, Chennai, Bengaluru
Work from Office
Who Have Experience in Operations/Delivery Quality of Medical Coding Process. Team Handling Experience and Coordinating with Heads to fulfil the projects success. Any Two Dual Specialty/Multi Specialty Experience during their Career Experience. Required Candidate profile Who Have Experience in Operations of Medical Coding Process - 10's Who Have Experience in Quality/Auditing of Medical Coding Process - 8 No's Who have Sr Quality designation or Designated TL
Posted 1 week ago
3.0 - 7.0 years
11 - 15 Lacs
Gurugram
Work from Office
Overview We are seeking an experienced Data Modeller with expertise in designing and implementing data models for modern data platforms. This role requires deep knowledge of data modeling techniques, healthcare data structures, and experience with Databricks Lakehouse architecture. The ideal candidate will have a proven track record of translating complex business requirements into efficient, scalable data models that support analytics and reporting needs. About the Role As a Data Modeller, you will be responsible for designing and implementing data models for our Databricks-based Modern Data Platform. You will work closely with business stakeholders, data architects, and data engineers to create logical and physical data models that support the migration from legacy systems to the Databricks Lakehouse architecture, ensuring data integrity, performance, and compliance with healthcare industry standards. Key Responsibilities Design and implement logical and physical data models for Databricks Lakehouse implementations Translate business requirements into efficient, scalable data models Create and maintain data dictionaries, entity relationship diagrams, and model documentation Develop dimensional models, data vault models, and other modeling approaches as appropriate Support the migration of data models from legacy systems to Databricks platform Collaborate with data architects to ensure alignment with overall data architecture Work with data engineers to implement and optimize data models Ensure data models comply with healthcare industry regulations and standards Implement data modeling best practices and standards Provide guidance on data modeling approaches and techniques Participate in data governance initiatives and data quality assessments Stay current with evolving data modeling techniques and industry trends Qualifications Extensive experience in data modeling for analytics and reporting systems Strong knowledge of dimensional modeling, data vault, and other modeling methodologies Experience with Databricks platform and Delta Lake architecture Expertise in healthcare data modeling and industry standards Experience migrating data models from legacy systems to modern platforms Strong SQL skills and experience with data definition languages Understanding of data governance principles and practices Experience with data modeling tools and technologies Knowledge of performance optimization techniques for data models Bachelor's degree in Computer Science, Information Systems, or related field; advanced degree preferred Professional certifications in data modeling or related areas Technical Skills Data modeling methodologies (dimensional, data vault, etc.) Databricks platform and Delta Lake SQL and data definition languages Data modeling tools (erwin, ER/Studio, etc.) Data warehousing concepts and principles ETL/ELT processes and data integration Performance tuning for data models Metadata management and data cataloging Cloud platforms (AWS, Azure, GCP) Big data technologies and distributed computing Healthcare Industry Knowledge Healthcare data structures and relationships Healthcare terminology and coding systems (ICD, CPT, SNOMED, etc.) Healthcare data standards (HL7, FHIR, etc.) Healthcare analytics use cases and requirements Optionally Healthcare regulatory requirements (HIPAA, HITECH, etc.) Clinical and operational data modeling challenges Population health and value-based care data needs Personal Attributes Strong analytical and problem-solving skills Excellent attention to detail and data quality focus Ability to translate complex business requirements into technical solutions Effective communication skills with both technical and non-technical stakeholders Collaborative approach to working with cross-functional teams Self-motivated with ability to work independently Continuous learner who stays current with industry trends What We Offer Opportunity to design data models for cutting-edge healthcare analytics Collaborative and innovative work environment Competitive compensation package Professional development opportunities Work with leading technologies in the data space This position requires a unique combination of data modeling expertise, technical knowledge, and healthcare industry understanding. The ideal candidate will have demonstrated success in designing efficient, scalable data models and a passion for creating data structures that enable powerful analytics and insights.
Posted 1 week ago
10.0 - 20.0 years
15 - 30 Lacs
Hyderabad, Chennai, Bengaluru
Work from Office
Should have experience in any Two Specialty specifically. Team Handling, Team Call. Heading Operation, Reporting and Analytics. Audit manage.... Required Candidate profile For Manager should be Assistant Manager designation for Sr.Manager should be a Manager Designation for Assistant Manager should be a TL Experience.
Posted 1 week ago
1.0 - 6.0 years
2 - 5 Lacs
Bengaluru
Work from Office
We are looking for a skilled AR Caller to join our team at Prodat IT Solutions, responsible for medical billing and ensuring timely payments. The ideal candidate will have 1-6 years of experience in the field. Roles and Responsibility Manage and resolve outstanding accounts receivable issues. Conduct thorough reviews of patient records and billing information. Develop and implement effective strategies to improve cash flow. Collaborate with internal teams to ensure accurate and efficient billing processes. Identify and address denials by investigating root causes and resubmitting claims as necessary. Maintain accurate and up-to-date records of all interactions with patients and insurance companies. Job Requirements Strong knowledge of medical billing principles and practices. Excellent communication and problem-solving skills. Ability to work effectively in a fast-paced environment and meet deadlines. Proficiency in using computer software applications and technology. Strong analytical and organizational skills with attention to detail. Ability to maintain confidentiality and handle sensitive information with discretion.
Posted 1 week ago
0 years
0 Lacs
Thrissur, Kerala, India
On-site
We are looking for passionate and skilled cybersecurity professionals to join our team as Cyber Security Trainers. If you are enthusiastic about sharing knowledge, staying updated with cybersecurity trends, and making an impact in the industry, this opportunity is for you. Responsibilities * Develop, update, and maintain high-quality training content and modules. * Deliver engaging and informative training sessions (online and offline) for RedTeam courses, including: ADCD, CPT, CICSA, CSA, CCSA, CRTA, CEH, P+, S+, CYSAt, CHFI * Guide and mentor students and junior trainers across various Red Team branches. * Ensure timely course completion and maintain training quality. * Prepare students for success with assessments, mock interviews, and career guidance. * Maintain training documentation: attendance, course diaries, feedback, and evaluations. * Represent RedTeam in college workshops, webinars, and events like the Red Team Security Summit. * Collaborate with the R&D team for innovation and content enhancement. * Conduct corporate training based on your area of expertise. Qualifications * Strong knowledge of cybersecurity concepts and tools * Prior experience in training or mentoring is a plus * Relevant certifications (CEH, CompTIA, etc.) preferred * Excellent communication and presentation skills
Posted 1 week ago
2.0 years
0 Lacs
Chennai, Tamil Nadu, India
On-site
Company Description Sutherland is a global leader driving digital outcomes by combining advanced technologies with expertise in customer experience and business process transformation. By improving interactions and personalizing experiences, Sutherland helps clients build better customer relationships through its digital-first approach. Are you a fast thinker with strong typing skills and a passion for solving problems? Are you curious, detail-oriented, and excited to support global clients? If this sounds like you, we want you on our team! Job Description Sutherland is now hiring individuals who are passionate to start/ build their career in the BPO Industry. Job Title: Sr Associate Role & Responsibilities: Reviewing and analyzing claim form 1500 to ensure accurate billing information Utilizing coding tools like CCI and McKesson to validate and optimize medical codes Familiarity with payer websites to verify claim status, eligibility, and coverage details Expertise in various medical specialties such as cardiology, radiology, gastroenterology, pediatrics, emergency medicine, and surgery Proficiency in using CPT range and modifiers for precise coding and billing Working with Clearing House systems like Waystar and other e-commerce platforms for claim submissions Conducting voice-based communication with payers and medical staff to resolve billing discrepancies and facilitate claims processing Qualifications Skills Required: Should be a complete Graduate Minimum of 2 years of experience in physician revenue cycle management and AR calling Basic knowledge of claim form 1500 and other healthcare billing forms Holding experience in medical coding tools such as CCI and McKesson is an added advantage Familiarity with payer websites and their processes Expertise in specialties including cardiology, radiology, gastroenterology, pediatrics, orthopedics, emergency medicine, and surgery is also an added advantage Understanding of Clearing House systems Excellent communication skills Comfortable to Work in Night Shifts. Ready to join immediately or within 15 days’ notice period Additional Information A fast-paced, global work environment where your voice matters. Skills for life: problem-solving, professionalism, adaptability, and communication. A team that feels like family and celebrates every win—big or small. A platform to grow quickly within a global MNC with learning and development opportunities. Recognition and rewards as you shape your career journey. Disclaimer Sutherland never asks for payments or favours for job opportunities. If you receive any suspicious request, please report it to: TAHelpdesk@Sutherlandglobal.com
Posted 1 week ago
0 years
0 Lacs
Lucknow, Uttar Pradesh, India
On-site
Company Description Anytime Fitness is the fastest-growing fitness franchise in the world, helping over three million members across more than three thousand gyms globally to achieve better health. Recently recognized as the world’s "Top Global Franchise" by Entrepreneur magazine, Anytime Fitness offers franchisees a supportive and flexible business model that fosters a healthy work/life balance. With a commitment to making a positive difference in people's lives, Anytime Fitness provides its franchisees with the resources needed to succeed. Role Description This is a full-time on-site role for a Certified Personal Trainer located in Lucknow. The Certified Personal Trainer will be responsible for designing and implementing personalized fitness programs, leading individual and group fitness sessions, and providing nutritional and wellness guidance. Daily tasks include conducting fitness assessments, demonstrating exercise techniques, offering motivation and support, and ensuring a safe and effective workout environment for clients. Qualifications Personal Training and Fitness Instruction skills Experience in Nutrition and providing dietary advice Skills in Circuit Training and Sports Coaching Excellent communication and motivational skills Ability to work independently and as part of a team Certified Personal Trainer (CPT) certification from a recognized organization CPR and First Aid certification is a plus Bachelor’s degree in Exercise Science, Kinesiology, or related field is preferred
Posted 1 week ago
4.0 years
0 Lacs
Kerala, India
On-site
Purplle Operations: Purplle Operations in India drives a fast and efficient Quick Commerce network that delivers beauty and personal care products with agility. Designed to meet the needs of today’s high-speed market, Purplle’s Quick Commerce Operations uses strategically located micro-fulfillment centers to ensure rapid order processing, inventory precision, and streamlined dispatches. The team collaborates closely with logistics, sourcing, and facility management to uphold rigorous standards in safety, quality, and efficiency. Focusing on continuous improvement, Purplle leverages data-driven insights to maximize productivity, streamline operations, and reduce costs. Key Job Responsibilities Operations Management and Execution - Lead and supervise the daily operations of all dark stores across the city to ensure timely and accurate order processing and delivery. - Drive strict adherence to inventory accuracy, stock hygiene, and dispatch standards across all locations. - Implement best practices and SOPs to ensure consistent operations, high throughput, and low order defects. Team Management and Development - Lead a team of Store Managers, each responsible for two or more dark stores. - Monitor store-level performance and coach Store Managers to deliver operational excellence. - Drive employee engagement, staff training, performance management, and team morale across the city cluster. Planning and Execution - Own manpower and resource planning across all stores under the city cluster. - Align manpower deployment with demand forecasts, seasonal spikes, and promotional events. - Coordinate with central supply chain and sourcing teams to ensure optimal inventory levels and replenishment. City-Level Governance and Reporting - Establish city-level reporting and dashboards to monitor daily operational metrics including TAT, IWT Replenishment, CPT Breach %, inventory variance, and cost per order. - Conduct regular review meetings with the Network Operations Manager to communicate progress, bottlenecks, and key action plans. - Build a structured audit and compliance review cadence for all city stores. Stakeholder Management - Collaborate with central teams (Sourcing, Logistics, Projects, HR) to ensure alignment and resolution of city-level challenges. - Act as the nodal point for internal escalations, vendor communication, and local issue resolution. - Liaise with HR and Admin teams for hiring, onboarding, infrastructure, and staff grievance handling. Expansion and Special Projects - Work closely with the Projects and Procurement teams for new dark store launches and expansion ramp-ups. - Drive special initiatives like WMS rollout, layout optimization, packaging reduction, or automation pilots at the city level. Qualifications Education: Bachelor’s degree in Engineering, Business Administration, Supply Chain, or related field. Experience: Minimum 4-6 years of experience in e-commerce, retail operations, or FMCG, with at least 2 years of experience in a city/regional role Skills: - Strong team and stakeholder management skills - Analytical mindset with a hands-on approach to metrics, dashboards, and performance improvement - Ability to handle multi-site operations with agility and ownership - Good understanding of WMS, manpower planning, and safety practices Preferred Skills: - Exposure to Quick Commerce or rapid fulfillment models - Proficiency in Excel, MIS reporting, and basic inventory tools What We Offer: - Competitive compensation package with performance-linked rewards - Opportunity to drive high-impact operations in a growing e-commerce segment - Exposure to multi-functional problem-solving and network scale-up About Company Founded in 2011, Purplle has emerged as one of India’s premier omnichannel beauty destinations, redefining the way millions shop for beauty. With 1,000+ brands, 60,000+ products, and over 7 million monthly active users, Purplle has built a powerhouse platform that seamlessly blends online and offline experiences. Expanding its footprint in 2022, Purplle introduced 6,000+ offline touchpoints and launched 8 exclusive stores, strengthening its presence beyond digital. Beyond hosting third-party brands, Purplle has successfully scaled its own D2C powerhouses—FACES CANADA, Good Vibes, Carmesi, Purplle, and NY Bae—offering trend-driven, high-quality beauty essentials. What sets Purplle apart is its technology driven hyper-personalized shopping experience. By curating detailed user personas, enabling virtual makeup trials, and delivering tailored product recommendations based on personality, search intent, and purchase behavior, Purplle ensures a unique, customer-first approach. In 2022, Purplle achieved unicorn status, becoming India’s 102nd unicorn, backed by an esteemed group of investors including ADIA, Kedaara, Premji Invest, Sequoia Capital India, JSW Ventures, Goldman Sachs, Verlinvest, Blume Ventures, and Paramark Ventures. With a 3,000+ strong team and an unstoppable vision, Purplle is set to lead the charge in India’s booming beauty landscape, revolutionizing the way the nation experiences beauty.
Posted 1 week ago
8.0 years
6 - 9 Lacs
Hyderābād
On-site
Job Description Identify, analyze, and manage all issues about accounts receivable and member service inquiries. Coordinate, assign, audit, and supervise work with all India BSO teams to ensure productivity standards and goals are consistently met. Review and analyze past-due receivables with BSO global team every week. Monitor cash inflow and identify the roadblock which hindering the cash and highlight the same to the leadership team Active participation in weekly AR calls; denial review call with onshore team Oversee monthly A/R reporting, weekly ATB, monthly performance deck, Supervise staff including performance management, training and development, workflow planning, hiring, and disciplinary actions. Implement and maintain department compliance with new and existing policies and procedures. Ensure timely completion of month-end duties and perform other duties as assigned. Continually evaluate AR operations and make suggestions for improvement. Knowledgeable in revenue cycle management Reliable and punctual in reporting for work and taking designated breaks. Required Skillset 8+ years of background in AR and denial management aspects of revenue cycle management. Preference will be given if have hospital AR experience. 2+ years of People Management experience leading or supervising billers. Must possess strong working knowledge of CPT, ICD10, Denials, Appeals, & Correspondence, AR and Denial Management . Demonstrate ability in managing projects with multi-disciplinary teams, with exceptional relationship-building skills. Ability to effectively speak with providers, employees, and all levels of staff within the company. Practical work experience desired in client relations, implementation and support, and process planning and improvement. Proficient in Microsoft Office (Excel, Word, PowerPoint, Outlook). Strong work ethic and professional communication. Be organized, ahead of schedule, communicative, and accountable. In short, own your role entirely, while being open to critiques, suggestions, and new ideas. Strong attention to detail and keep a constant eye out for opportunities to improve efficiency. Be passionate about customer service. You love helping people, and you constantly strive to deliver great solutions. Have experience with hospital billing and Meditech software will be given preference. Ability to adapt to changing priorities and handle multiple tasks simultaneously. R1 is a leading provider of technology-driven solutions that help hospitals and health systems to manage their financial systems and improve patients’ experience. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry's most advanced technology platform, encompassing sophisticated analytics, Al, intelligent automation and workflow orchestration. R1 is a place where we think boldly to create opportunities for everyone to innovate and grow. A place where we partner with purpose through transparency and inclusion. We are a global community of engineers, front-line associates, healthcare operators, and RCM experts that work together to go beyond for all those we serve. Because we know that all this adds up to something more, a place where we're all together better. R1 India is proud to be recognized amongst Top 25 Best Companies to Work For 2024, by the Great Place to Work Institute. This is our second consecutive recognition on this prestigious Best Workplaces list, building on the Top 50 recognition we achieved in 2023. Our focus on employee wellbeing and inclusion and diversity is demonstrated through prestigious recognitions with R1 India being ranked amongst Best in Healthcare, Top 100 Best Companies for Women by Avtar & Seramount, and amongst Top 10 Best Workplaces in Health & Wellness. We are committed to transform the healthcare industry with our innovative revenue cycle management services. Our goal is to ‘make healthcare work better for all’ by enabling efficiency for healthcare systems, hospitals, and physician practices. With over 30,000 employees globally, we are about 16,000+ strong in India with presence in Delhi NCR, Hyderabad, Bangalore, and Chennai. Our inclusive culture ensures that every employee feels valued, respected, and appreciated with a robust set of employee benefits and engagement activities. Working in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast-growing team has opportunities to learn and grow through rewarding interactions, collaboration and the freedom to explore professional interests. Our associates are given valuable opportunities to contribute, to innovate and create meaningful work that makes an impact in the communities we serve around the world. We also offer a culture of excellence that drives customer success and improves patient care. We believe in giving back to the community and offer a competitive benefits package. To learn more, visit: r1rcm.com Visit us on Facebook
Posted 1 week ago
3.0 years
4 Lacs
India
On-site
Dynamic and results-driven US IT Recruiter with 3 years of hands-on experience in end-to-end recruitment processes for IT positions across various domains. Proficient in sourcing, screening, and onboarding candidates for contract, contract-to-hire, and full-time roles for direct clients and Tier 1 vendors in the US market. Key Responsibilities: Perform full-cycle recruitment: requirement gathering, sourcing, screening, scheduling interviews, negotiating rates, and closing offers. Source potential candidates through job portals (Dice, Monster, CareerBuilder, TechFetch), social media (LinkedIn), internal databases, and referrals. Review resumes for appropriate skills, experience, and knowledge based on job descriptions. Conduct initial HR screenings to assess communication skills, technical fit, visa status (H1B, GC, USC, OPT, CPT, etc.), and availability. Coordinate interviews with account managers and clients, and ensure timely feedback. Negotiate compensation with consultants and vendors, ensuring compliance with company margins and client budgets. Maintain regular follow-ups with consultants post-placement to ensure smooth onboarding and retention. Work closely with account managers to understand job requirements and deliver qualified candidates within deadlines. Maintain applicant tracking systems and recruitment reports to ensure compliance and transparency. Stay updated on current hiring trends, technologies, and immigration regulations affecting US staffing. Technical Skills & Tools: Job Boards: Dice, Monster, CareerBuilder, TechFetch, Indeed ATS: CEIPAL, JobDiva, Bullhorn (or others) Communication: Zoom, Microsoft Teams, Skype CRM & Email: Outlook, Gmail, Salesforce (if applicable) Knowledge of W2, C2C, and 1099 employment types and tax terms Required Qualifications: Bachelor’s degree in HR, Business Administration, IT, or related field. Minimum 3 years of hands-on US IT recruitment experience. Strong understanding of various IT technologies and market trends. Excellent communication and interpersonal skills. Ability to work independently in a fast-paced environment and handle multiple requisitions simultaneously. Job Type: Full-time Pay: From ₹40,000.00 per month Benefits: Health insurance Internet reimbursement Paid sick time Paid time off Schedule: Monday to Friday Supplemental Pay: Commission pay Performance bonus Quarterly bonus Yearly bonus Work Location: In person Application Deadline: 30/06/2025 Expected Start Date: 25/07/2025
Posted 1 week ago
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