641 Health Claims Jobs - Page 13

Key Responsibilities: Review and process insurance claims submitted by policyholders, providers, or third parties. Verify the accuracy and completeness of submitted claims and supporting documents. Investigate and validate claims using internal systems and guidelines. Coordinate with internal departments (e.g., underwriting, customer service) for clarification or additional information. Maintain accurate and organized records of all claims and transactions. Communicate claim decisions to stakeholders clearly and professionally. Escalate complex or disputed claims to senior team members or supervisors. Meet individual and team KPIs such as turnaround time, accuracy rate, and productivity. Ens...

Greetings From Scorelabs Inc ! Validate medical necessity and check eligibility Ensure accurate claim coding for inpatient, outpatient, and day-care procedures. Should Have Exp In 1-4 years of in claims Required Candidate profile Handle claim resubmissions, rejections, and audits from insurance providers. Collaborate with physicians, billing teams, and insurance officers for clarification or denials. Hr Mounika - 8688334476

Greetings From Scorelabs Inc! Dealing with patients health care related documents Ensuring error free processing of pre authorisation within agreed TAT (Turnaround time) Entering accurate information into the application defined by the organization Required Candidate profile TPA Experience Claims Processor Qualification (BAMS Or BHMS Or MBBS) BDS ,BPT,MPT Also Ok but person Should have 1 Year Of Under Writing or Medicl Scribing Hr Gowthami - 7842272470

Hiring For Voice Process !! Health Care Process !! Upto 6 lpa !! GGN 5 day working , Both side cabs UG / Grad + 1 Year health care experience required . Loc :- GGN 9911567769 / 9560028009 / 8860576337 Required Candidate profile Need excellent communication skills with bpo knowledge Loc :- GGN 7042297337 / 9211682478 / 7392095475

Role & Responsibilities Handling TPA related all process from billing to co-ordinate with TPA companies. Responsible for counseling patient's family & pre-Auth process. Maintaining & uploading patient's files on the portal. Couriering the hard copy of patient's medical file to the Insurance companies. Responsible for all co-ordination activities from patient's admission to discharge. Handling billing Department, Implants bill updating & reconciliation. Daily co-ordination with the patient and Hospital staff. Outstanding follow-up with TPA. To obtain and review referrals and authorizations for treatments. Must be aware of norms of the insurance sector. Daily follow up with Insurance companies...

Health Claims, Mass Claims & Provider Management good market knowledge and experience Market knowledge and experience in region, tariff level negotiation and claim level negotiations and inflation management Medical knowledge

Royal Sundaram General Insurance Co is looking for Specialist - Legal & TP Claims to join our dynamic team and embark on a rewarding career journey Diagnosing and treating illnesses, medical conditions, and injuries. Ordering, performing, and interpreting diagnostic tests. Collecting, recording, and maintaining patients' information and histories. Prescribing and administering treatments, therapies, medications, vaccinations, and other specialized medical care. Explaining procedures and discussing test results or prescribed treatments with patients and family members. Monitoring patients' conditions and progress. Directing, coordinating, consulting with, and referring patients to nurses, stu...

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

Educational Requirements: Medical Degree or Related Field: BAMS/BHMS only Understanding of Medical Terminology: Proficiency in medical terminology, procedures, and diagnoses. Certification: Certification in medical coding (such as CPC, CCS, or equivalent) can be advantageous. Experience: Healthcare Experience: Experience working in a non- clinical setting can be beneficial, providing a solid understanding of medical procedures and billing practices. Claims Processing Experience: Prior experience in medical billing, coding, or claims processing is required. Familiarity with Insurance Policies: Understanding of various health insurance policies and coverage criteria. Skills: Analytical Skills:...

Key Responsibilities: Review and process incoming healthcare or insurance claims accurately and efficiently. Verify patient, provider, and policy details to ensure claims meet all requirements. Investigate discrepancies, missing information, or potential fraud indicators. Coordinate with internal departments or external providers for claim clarification. Maintain accurate records and ensure compliance with regulatory and company standards. Meet daily productivity and quality targets while maintaining confidentiality. MAXIMUM CTC :3.5 Lakhs WORK FROM OFFICE Anyone who attended interview before 30 days are not eligible to attend walk-in. Disclaimer: Firstsource follows a fair, transparent, and...

About Us: Medi Assist is India's leading Health Tech and Insure Tech company focused on administering health benefits across employers, retail members, and public health schemes. We consistently strive to drive innovation and participate in such initiatives, to lower health care costs. Our Health Benefits: Administration model is designed to deliver the tools necessary for a health plan to succeed, whether its our modular claims management system, our technology that unveils data to make important decisions, or our service solutions built around the voice of the customer. In short, our goal is to link our success to that of our members Roles and Responsibilities: Check the medical admissibil...

We are hiring for International Healthcare Customer Support. Role & responsibilities : Handle outbound calls related to healthcare services within the US healthcare system. Proactively reach out to members to provide support, resolve issues, and ensure a positive experience. Identify and address varying levels of member complexity and communicate effectively. Ensure strict compliance with HIPAA regulations and other healthcare-related guidelines. Resolve member inquiries efficiently and professionally, escalating complex cases as required. Preferred candidate profile Proven experience in outbound voice processes, preferably in the US healthcare sector. Strong verbal and written communication...

Key Responsibilities 1. Insurance Billing 1. Prepare and submit accurate and timely insurance claims to various payers. 2. Ensure compliance with insurance company guidelines and regulations. 3. Maintain up-to-date knowledge of insurance policies, procedures, and coding requirements. 2. Claims Management 1. Monitor and resolve billing-related issues, including denied claims and appeals. 2. Communicate with insurance companies, patients, and healthcare providers to resolve billing issues. 3. Ensure accurate and timely follow-up on outstanding claims. 3. Data Entry and Record-Keeping 1. Accurately enter patient and billing information into the practice management system. 2. Maintain organized ...

Urgent Hiring For Health Insurance EXP:-Min 6 Months to 1 Year in Health Insurance Sales/Agency sales CTC:-Upto 5 LPA+Incentives Contact Person:HR Snehal:8788255050

Role & responsibilities Verify the accuracy and completeness of claim documents, including medical records and billing information Handle customer inquiries related to claims status and provide resolution. Maintain and update claim records in the system. Identify discrepancies, fraudulent claims, and escalate cases as necessary.

Skill required: Claims Appeals - Claims Administration Designation: Health Admin Services Associate Qualifications: Any Graduation Years of Experience: 1 to 3 years About Accenture 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. Visit us at www.accenture.com What would you do Embedding digital transformation in healthcare operations end-to...

Skill required: HM- Utilization Management - Healthcare Management Designation: Customer Service Associate Qualifications: Any Graduation Years of Experience: 1 to 3 years About Accenture 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. Visit us at www.accenture.com What would you do Embedding digital transformation in healthcare operations...

Skill required: Claims Appeals - Claims Administration Designation: Health Admin Services Associate Qualifications: Any Graduation Years of Experience: 1 to 3 years About Accenture 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. Visit us at www.accenture.com What would you do Embedding digital transformation in healthcare operations end-to...

We are hiring for International Healthcare Customer Support. Role & responsibilities : Handle outbound calls related to healthcare services within the US healthcare system. Proactively reach out to members to provide support, resolve issues, and ensure a positive experience. Identify and address varying levels of member complexity and communicate effectively. Ensure strict compliance with HIPAA regulations and other healthcare-related guidelines. Resolve member inquiries efficiently and professionally, escalating complex cases as required. Preferred candidate profile Proven experience in outbound voice processes, preferably in the US healthcare sector. Strong verbal and written communication...

Warm Greetings from RIVERA MANPOWER SERVICES!!!! Kindly Note : We are looking @ Minimum 4 Years of an experience into International Voice Process(Health Care/ US Insurance) Excellent Communication Skills. We are looking @ only Immediate Joiners! CHETHANA @ 7829336034 rivera.chethana@gmail.com Primary Responsibilities Act as the primary point of contact for the branch (US onshore), providing comprehensive support Understanding and implementation of US Health Insurance regulatory standards, guidelines, policies and procedures Ensure end-to-end support of the policy lifecycle services. Conduct end-to-end renewal activities as a US Health Insurance domain expert. Coordinate with internal operati...

Urgent requirement for BHMS/BAMS -Jharkhand(Ranchi) Freshers/candidate with clinical or TPA experience. Interested candidates can call on 9371762436 or share their updated resumes to career@mdindia.com Job Description: 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. Required Candidate profile: BAMS / BHMS graduate. Male candidate prefer. Good Medical & basic computer knowledge Should have completed internship (Permanent Registration number is mandatory) Freshers can also apply. Wo...

Processing transactions into the system as per the communication received from customers Reviewing documents to determine type of request(s) & process them Process Payment Processing and Manual Calc transactions for Retirement insurance Required Candidate profile Graduate with 2 yrs Experience in US Healthcare Retirement Retirement Payment Processing Defined Benefits Manual Calculations Comfortable with US shift Noida Location WFO info.aspiringmantra@gmail.com

Review and assess group health insurance claims for accuracy and completeness. Verify claim eligibility and coverage based on policy terms and conditions. Adjudicate claims and make determinations regarding approval, denial.

Responsibilities: * Conduct field investigations on health claims. * Gather evidence and interview witnesses. * Prepare detailed reports with findings. * Maintain confidentiality at all times. Annual bonus

Key Responsibilities: Analyze and document existing healthcare processes across international healthcare facilities and systems. Identify opportunities for process improvement and optimization to enhance patient care and operational efficiency. Collaborate with cross-functional teams including clinical, administrative, and IT to implement process changes. Ensure compliance with international healthcare regulations, standards, and best practices. Develop and maintain process documentation, workflows, and training materials for global teams. Monitor key performance indicators (KPIs) and prepare reports to track process improvements. Support implementation of healthcare technologies and digital...