272 Health Claims Jobs - Page 10

Minimum Mandatory Skill Set Knowledge of Processing of claims, quality check and adherence to TAT, computer skills, excel. Candidate should be open to work in 24X7X365 shifts Brief Job Profile Claims adjudication, Fraud and leakage control, Client/provider feedback, Team training and retention, Investigation Desired Competencies/ Skill Set MS Excel and MIS skills, Candidate having work experience of claim processing, Investigation, computer skills. Preferred Industry Health Insurance, TPA, Hospitals, Healthcare

Responsibilities: * Manage health & motor claims from intake to settlement * Investigate claims, gather evidence & negotiate settlements * Ensure compliance with regulatory requirements

We are Conducting Mega Job fair for Top 10 Companies for AR calling. Job Title: AR Caller (Accounts Receivable Caller) Department: Revenue Cycle Management / Medical Billing Location: Bangalore / Hyderabad / Chennai / Noida Job Type: Full-Time. Experience: 0 to 10 years Job Summary: We are seeking an AR Caller to follow up on outstanding insurance claims and ensure timely reimbursement. The ideal candidate will be responsible for calling insurance companies (payers) to verify claim status, resolve denials, and secure payment for services rendered. Key Responsibilities: Call insurance companies and follow up on pending claims. Understand and interpret Explanation of Benefits (EOB) and denial codes. Identify reasons for claim denials or delays and take appropriate actions. Resubmit claims or file appeals when necessary. Document all call-related information accurately and clearly. Work with billing teams to resolve billing issues. Meet daily productivity and quality targets. Stay updated on payer policies and healthcare regulations. Required Skills: Excellent communication skills (verbal and written) in English. Basic knowledge of the US healthcare system and insurance claim process. Attention to detail and analytical thinking. Familiarity with denial management and RCM workflow is a plus. Experience using billing software like Athena, NextGen, eClinicalWorks, or similar is a bonus. Qualifications: Bachelors degree preferred, but not mandatory. Prior experience in AR calling/medical billing is an advantage. Willingness to work night shifts (for US clients). contact Hiring Manager : Aditya - 9900024811 / 7259027295 / 7760984460 / 7259027282 9900024951

Job Tile : Claims processing Doctor Job Description: Medical claims processor will have to look into claims where payment was denied. Commonly due to issues of insurance coverage eligibility , the claims handler may be tasked with reviewing documentation from the patient, their physicians, or the insurance. With the medical expertise ,need to master the various products and to apply the same during claim processing. Claims processors process any claim payments when applicable and must ensure they comply with federal, state, and company regulations and policies. List of Responsibilities: To validate the authenticity and the credibility of the claims. To coordinate with various persons (Claimant, Treating Physician, Hospital insurance desk, Field Visit Drs, Investigation officers)for hassle-free claim processing . To expertise ,the process of negotiation when necessitated. The claim handler owes a duty of care to the patient, ensuring that their needs are being met and that they re receiving the treatment or medicine they need. Job Qualifications and Requirements: Required BDS, BHMS, BAMS Graduates. Adapt and inbuilt the process of communication and coordination across the zones and the supporting verticals accordingly.

1. Looking after the corporate client & their empanelment’s 2. Preparing bills of TPA, ESIC, ECHS, CGHS and other Private clients Independently. 3. Handling all queries related to patients. Call me on +91 97739 85718

Urgently hiring a Medical Officer – Team Lead with 5+ years in TPA or insurance. Must have strong process knowledge to lead and manage a team of 20 doctors effectively. interested candidates can send resumes to kalyan.r@isbsindia.in or 9866005517.

We are Conducting Mega Job fair for Top 10 Companies for AR calling. Job Title: AR Caller (Accounts Receivable Caller) Department: Revenue Cycle Management / Medical Billing Location: Bangalore / Hyderabad / Chennai / Noida Job Type: Full-Time / Part-Time Experience: 110 years. Job Summary: We are seeking an AR Caller to follow up on outstanding insurance claims and ensure timely reimbursement. The ideal candidate will be responsible for calling insurance companies (payers) to verify claim status, resolve denials, and secure payment for services rendered. Key Responsibilities: Call insurance companies and follow up on pending claims. Understand and interpret Explanation of Benefits (EOB) and denial codes. Identify reasons for claim denials or delays and take appropriate actions. Resubmit claims or file appeals when necessary. Document all call-related information accurately and clearly. Work with billing teams to resolve billing issues. Meet daily productivity and quality targets. Stay updated on payer policies and healthcare regulations. Required Skills: Excellent communication skills (verbal and written) in English. Basic knowledge of the US healthcare system and insurance claim process. Attention to detail and analytical thinking. Familiarity with denial management and RCM workflow is a plus. Experience using billing software like Athena, NextGen, eClinicalWorks, or similar is a bonus. Qualifications: Bachelors degree preferred, but not mandatory. Prior experience in AR calling/medical billing is an advantage. Willingness to work night shifts (for US clients). contact Hiring Manager : Aditya - 7259027282 / 7259027295 / 7760984460 / 9900024811 / 9686682465

Responsibilities: * Process health claims accurately and efficiently * Maintain confidentiality at all times * Collaborate with healthcare providers on claim resolutions Office cab/shuttle Over time allowance Employee state insurance Accidental insurance Performance bonus Gratuity Provident fund Health insurance

Current Working: WFO Shift time- 8 AM- 5 PM Education- Graduate Exp- 0.6 Months- 2 Years US Healthcare ( Claims Adjudication) CTC: - 2.7 – 3.5 LPA Reach me- Tripti.srivastava@silverskills.com

Hello Job Seekers! Greeting from Shining Stars ITPL! New Opportunities are available hurry up! Any Graduate Who has minimum 6 month of experience in any Insurance Sales with excellent communication skills can easily apply Location: Noida Operation Executive Working -6 days Rotational day Shift Salary- Up to 3.5 LPA Roles and Responsibilities Process life and general insurance policies through Max Insurance platform. Handle backend operations for insurance policies, including policy renewal, claims processing, and customer retention. Communicate effectively with customers via phone calls (CSA) to resolve queries related to policy renewals, premiums, and other operational issues. Desired Candidate Profile 0-3 years of experience in insurance operations or a similar industry. Strong understanding of insurance sales principles, particularly life insurance products. Ready to take your career to new heights? Apply Now! For more details contact Monika(7266822602), Nishee(9214101672) or whatsapp your resume. Thanks and Regards, Monika Singh 7266822602 HR Executive Shining Stars ITPL

Wipro hiring for Insurance Back-office profile in Kolkata location. We are hiring Any Graduate fresher OR Experienced. Candidate must be comfortable with WORK FROM OFFICE. *Must BE* Gradutaion is Must The candidate must have good verbal communication skills. The candidate must be staying or ready to relocate to Kolkata. As it is WORK FROM OFFICE. Roles and Responsibilities Candidate will take care of Insurance claims of International customers. Desired Candidate Profile Any Grad fresher- 2.50 Lakhs Experienced- 3 Lakh + Inc.+ Cabs Other Benefits Fixed Shift time- 1:30 PM to 11 PM Complete Back-office Profile Cabs in odd hours only If you are meeting the above requirements. Then please please call our recruiter. Click on Apply NOW Tab Contact: Ravinder Singh Rawat - 7048959407

Skill required: Claims Services - Payer Claims Processing Designation: Health Admin Services New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years About Accenture Accenture is a global professional services company with leading capabilities in digital, cloud and security.Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. We embrace the power of change to create value and shared success for our clients, people, shareholders, partners and communities.Visit us at www.accenture.com What would you do Embedding digital transformation in healthcare operations end-to-end, driving superior outcomes and value realization today, and enabling streamlined operations to serve the emerging health care market of tomorrowYou will be a part of the Healthcare Claims team which is responsible for the administration of health claims. This team is involved in core claim processing such as registering claims, editing & verification, claims evaluation, and examination & litigation.Business solutions that support the healthcare claim function, leveraging a knowledge of the processes and systems to receive, edit, price, adjudicate, and process payments for claims. What are we looking for Contract conversion Roles and Responsibilities: In this role you are required to solve routine problems, largely through precedent and referral to general guidelines Your primary interaction is within your own team and your direct supervisor In this role you will be given detailed instructions on all tasks The decisions that you make impact your own work and are closely supervised You will be an individual contributor as a part of a team with a predetermined, narrow scope of work Please note that this role may require you to work in rotational shifts Qualification Any Graduation

Role & responsibilities Sending Monthly Reports to insurance co (new additions, deletions etc) He/she will be a SPOC for all employees with reference to handling queries regarding their medical benefits/hospitalizations To close Service tickets pertaining to medical matters within a specified TAT Managing emergency support to employees Liasing closely with the insurance company for faster processing of claims Monitoring CD balance and replenishing the same in co-ordination with the accounts team

Skill required: Claims Services - Payer Claims Processing Designation: Health Admin Services New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years What would you do? Embedding digital transformation in healthcare operations end-to-end, driving superior outcomes and value realization today, and enabling streamlined operations to serve the emerging health care market of tomorrowYou will be a part of the Healthcare Claims team which is responsible for the administration of health claims. This team is involved in core claim processing such as registering claims, editing & verification, claims evaluation, and examination & litigation.Business solutions that support the healthcare claim function, leveraging a knowledge of the processes and systems to receive, edit, price, adjudicate, and process payments for claims. What are we looking for? Us shiftsQuick learner Roles and Responsibilities: In this role you are required to solve routine problems, largely through precedent and referral to general guidelines Your primary interaction is within your own team and your direct supervisor In this role you will be given detailed instructions on all tasks The decisions that you make impact your own work and are closely supervised You will be an individual contributor as a part of a team with a predetermined, narrow scope of work Please note that this role may require you to work in rotational shifts Qualifications Any Graduation

Skill required: Claims Services - Claims Administration Designation: Health Admin Services New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years About Accenture Accenture is a global professional services company with leading capabilities in digital, cloud and security.Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. We embrace the power of change to create value and shared success for our clients, people, shareholders, partners and communities.Visit us at www.accenture.com What would you do Embedding digital transformation in healthcare operations end-to-end, driving superior outcomes and value realization today, and enabling streamlined operations to serve the emerging health care market of tomorrowYou will be a part of the Healthcare Claims team which is responsible for the administration of health claims. This team is involved in core claim processing such as registering claims, editing & verification, claims evaluation, and examination & litigation.Includes the administration of health, life, and property & causality claims. Includes activities involved in core claim processing such as registering claims, editing & verification, claims evaluation, and examination & litigation. What are we looking for Adaptable and flexibleProcess-orientationResults orientationWritten and verbal communicationCommitment to quality Roles and Responsibilities: In this role you are required to solve routine problems, largely through precedent and referral to general guidelines Your primary interaction is within your own team and your direct supervisor In this role you will be given detailed instructions on all tasks The decisions that you make impact your own work and are closely supervised You will be an individual contributor as a part of a team with a predetermined, narrow scope of work Please note that this role may require you to work in rotational shifts Qualification Any Graduation

Skill required: Claims Services - Claims Administration Designation: Health Admin Services New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years About Accenture Accenture is a global professional services company with leading capabilities in digital, cloud and security.Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. We embrace the power of change to create value and shared success for our clients, people, shareholders, partners and communities.Visit us at www.accenture.com What would you do Embedding digital transformation in healthcare operations end-to-end, driving superior outcomes and value realization today, and enabling streamlined operations to serve the emerging health care market of tomorrowYou will be a part of the Healthcare Claims team which is responsible for the administration of health claims. This team is involved in core claim processing such as registering claims, editing & verification, claims evaluation, and examination & litigation.Includes the administration of health, life, and property & causality claims. Includes activities involved in core claim processing such as registering claims, editing & verification, claims evaluation, and examination & litigation. What are we looking for Adaptable and flexibleCommitment to qualityProcess-orientationWritten and verbal communicationResults orientation Roles and Responsibilities: In this role you are required to solve routine problems, largely through precedent and referral to general guidelines Your primary interaction is within your own team and your direct supervisor In this role you will be given detailed instructions on all tasks The decisions that you make impact your own work and are closely supervised You will be an individual contributor as a part of a team with a predetermined, narrow scope of work Please note that this role may require you to work in rotational shifts Qualification Any Graduation

Skill required: Claims Services - Claims Administration Designation: Health Admin Services New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years About Accenture Accenture is a global professional services company with leading capabilities in digital, cloud and security.Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. We embrace the power of change to create value and shared success for our clients, people, shareholders, partners and communities.Visit us at www.accenture.com What would you do Embedding digital transformation in healthcare operations end-to-end, driving superior outcomes and value realization today, and enabling streamlined operations to serve the emerging health care market of tomorrowYou will be a part of the Healthcare Claims team which is responsible for the administration of health claims. This team is involved in core claim processing such as registering claims, editing & verification, claims evaluation, and examination & litigation.Includes the administration of health, life, and property & causality claims. Includes activities involved in core claim processing such as registering claims, editing & verification, claims evaluation, and examination & litigation. What are we looking for Adaptable and flexibleCommitment to qualityProcess-orientationResults orientationWritten and verbal communication Roles and Responsibilities: In this role you are required to solve routine problems, largely through precedent and referral to general guidelines Your primary interaction is within your own team and your direct supervisor In this role you will be given detailed instructions on all tasks The decisions that you make impact your own work and are closely supervised You will be an individual contributor as a part of a team with a predetermined, narrow scope of work Please note that this role may require you to work in rotational shifts Qualification Any Graduation

Role & responsibilities • Scrutiny of medical documents and adjudication. • Assess the eligibility of medical claims and determine financial outcomes. • Identification of trigger factors of insurance related frauds and inform the concerned department. • Determine accuracy of medical documents ADDITIONAL SKILLS • Good communication • Familiarity with Computers and interest in learning on the job. Pratiksha Shitole, Sr.Executive Talent Acquisition, MDIndia Health Insurance TPA Pvt. Ltd. S. No. 46/1, E-space, A-2 Building, 3rd floor, Pune Nagar Road, Vadgaonsheri, Pune 411014. Email Address: hr9@mdindia.com Contact No. 7058036074 Visit us @ www.mdindiaonline.com

Claims Executive- EB website Link: www.dishainsurance.com Job Summary: We are seeking a qualified Claims executive to help our clients in claims and any other query solution through their own skills. Our ideal Claims executive has to have in-depth knowledge of and experience with the Claim process, Policy terms and conditions, relationship building and MIS management. We are seeking a quick learner with strong communication skills, and someone with a track record of success who can inspire the same in others Roles & Responsibilities: One stop solution for all client queries and requirements Represent our company, with a comprehensive understanding of our services in the area of claim process and policy terms and conditions. Providing the timely help to clients in claim settlements in both cashless and reimbursements claims. Co-ordinating with Insurance Company in updating endorsements, CD Balance and claims reports. Co-ordinating with TPA in claim settlements, in solving the issues due to any calculation error and any data error with the MIS reports. Co-ordinating with clients, HR Head and Finance Head in resolving any issues. Maintaining MIS reports. Co-ordinating with the Retention team. Visiting clients to understand if they have any concerns and help them in fixing the issues. Visiting the TPA and Insurance Company to maintain good relationship with the customer relation team. Desired Profile/ Who should join: Should have 3 to 6 years of experience in a general insurance company/ insurance broker / surveyor Proficient in Microsoft Excel and MS office Fair knowledge about the Insurance processes Good communication skills Problem solving attitude Flexibility with calls and mails

Hiring TPA Incharge/Officer for a hospital in Gurgaon. Min 4 yrs exp in TPA desk. Must handle claims, pre-auths, billing, discharges & patient queries. Strong communication & TPA workflow knowledge required. Send cv on-82808 33507

Hiring Clinical Investigator for Mohali location ! Eligibility Criteria: Education BHMS,BAMS,MBBS,BPT Candidates with prior US Healthcare or Clinical experience will be preferred. Noncertified Physicians can apply however should be ready to complete the same within specified timeline. (CPC/CIC) Good communication skills. Candidates with corporate experience will be preferred. Immediate joiners preferred. Should be ready to work from office. Should be ready to work in night shift. Job Location - Mohali Interested candidates can share resume - Jitendra.pandey@cotiviti.com Regards, Jitendra 7350534498

Hiring Clinical Doctors for Medical coding role in Mohali !! Eligibility Criteria: Education BHMS,BAMS,MBBS,BPT Candidates with prior US Healthcare or Clinical experience will be preferred. Fresher Physicians can also apply with good clinical knowledge. Noncertified Physicians can apply however should be ready to complete the same within specified timeline. (CPC/CIC) Good communication skills. Candidates with corporate experience will be preferred. Immediate joiners preferred. Should be ready to work from office. Should be ready to work in night shift. Job Location - Mohali Interested candidates can share resume - Jitendra.pandey@cotiviti.com Regards, Jitendra 7350534498

1 Responsible for gathering business requirements to create clear, concise and complete business/functional requirement documents (BRD) for assigned projects 2 Coordinate with all required stakeholders and come up with best solutions 3 Understanding the needs of multiple stakeholders 4 Identifying the current- and future-state business processes 5 This role will be a bridge between all the business users and IT App team and cater to their systems needs and requirements 6 Activity to set priorities, strengthen operations, establish agreement around intended outcomes/results and adjust the organizations growth in response to a changing environment 7 BRD to include the scope, detailed existing process and proposed process flows and relevant sign offs 8 Prepared BRD to be signed by all respective stakeholders and the same has to be forwarded to IT team for development 9 Must have Motor/Health Claim & policy experience of 3 years

Job Description Handle Calls/E-mails/Tickets/Walk-ins Assist the Internal/External customer in resolving Queries or complaints Represent the organization at all times Key Responsibilities : Answer Internal/External customer queries and clarifying them by providing accurate information Resolve queries/complaints by exploring the answers and relevant alternative solutions Determine the customers requirements and assisting them as per the process Enhances organization reputation by accepting ownership & represent the department/company and work towards End 2 End solution Keep a tab on the changes in process & be update Route the escalations as and when required Identify the process gaps and looks at ways to bridge them Open to work from Office Balance between Quality and Productivity Candidate Requirements Must be a Graduate Candidates with1-2 yrs of experience in any General Insurance company/TPA on the same role Commitment & Dedication to work and grow along with the organization Customer First Attitude Adaptive to change and pick-up any new task/role Flexible to work in any shift & any day Documents to carry Copy of the updated resume Copies of all Educational Documents Copies of all Work Experience Documents Copies of Last three Months pay slips Copy of Aadhar Card and pan Card Skills Required & Competencies Evaluated Good Communication Skills (English, Hindi, Regional language will be added advantage) Good computer Knowledge & working on Microsoft Tools Good Convincing Skill Ability to do multi-tasking Good Listening Skills Zeal to learn new things and self motivated

Role & responsibilities : The end-to-end insurance process, from a customer's perspective, involves multiple steps, including initiating a claim, submitting necessary documents, and eventually receiving payment . For insurers, it involves verifying the claim, assessing the loss, and processing the claim for settlement.