641 Health Claims Jobs - Page 15

Hiring For Blended Process related to US Healthcare Gurgaon/Noida Graduate Fresher (No.Btech) Any UG/Grad with 1 yr exp. can apply Salary - 16k-23k inhand 5 days working Sat/Sun fixed off Fixed night shifts Both side cab Anjali: 9354911705 Required Candidate profile Candidates should have super excellent communication skills Candidates should be immediate joiner Candidates should be comfortable in Night shift and WFO Perks and benefits Meal/Medical Both side cab Sat &Sun off

Job Summary Join our dynamic team as a Claims Processing Specialist where you will play a crucial role in ensuring the accuracy and efficiency of claims adjudication. With a focus on Medicare and Medicaid claims you will contribute to the seamless processing of claims enhancing our service delivery. This hybrid role offers the flexibility of working both remotely and on-site during night shifts. Responsibilities Process claims with precision ensuring adherence to Medicare and Medicaid guidelines. Analyze claims data to identify discrepancies and resolve issues promptly. Collaborate with team members to streamline claims adjudication processes. Utilize claims adjudication software to enhance ...

Job Details: Job Process/Role: Claims Adjudication (US Healthcare) Experience: 1 - 3 Years of Relevant experience in Claims adjudication Skillset: CPT Codes, HIPAA, Co-pay and Co-insurance, Medicaid and Medicare, Denial claims, UB and CMS forms. Shift: Night shift Location: Chennai Mode of Work: Work from the office Notice Period Eligible: Immediate to 30 Days of Notice period is acceptable. Roles and Responsibilities: Process Adjudication claims and resolve for payment and Denials. Knowledge in handling authorization, COB, duplicate, pricing, and the corrected claims process. Knowledge of healthcare insurance policy concepts, including in-network, out-of-network providers, deductible, coins...

Job Description: Job Title : Senior Medical Officer Investigation Team Department : Investigation Location : [Insert Office Location] Reports To : Head Claims Investigation Employment Type : Full-time Job Purpose: The Senior Medical Officer will lead and support the investigation team by reviewing, evaluating, and investigating health insurance claims to ensure medical appropriateness and detect fraud, waste, or abuse. The Senior Medical Officer will act as a bridge between medical knowledge and investigator, playing a key role in ensuring fair and accurate claim settlements. Key Responsibilities: Evaluate high-value and suspicious claims by reviewing medical documents, patient history, and ...

You would be responsible for managing the end-to-end claims process for clients, ensuring seamless handling from claim intimation to settlement follow-ups. You will be the key point of contact for clients and AMCs regarding claim processes. You should be strategic and detail-oriented, ensuring timely documentation, filing, and resolution of claims while also contributing to business growth through lead generation and upselling. Requirements You have a bachelors degree in administration, commerce, or a related field. 2-3 years of hands-on experience in insurance claims processing. Ability to communicate correctly and clearly with all customers. Maintain a positive attitude with a focus on cus...

Immediate joiners or with in 15 days Salary goes up to 6LPA-6.5LPA Graduates with minimum 1.5 years into the specified domain, Sat, Sun fixed off ,2 way cab Fixed uk shift White field location Note : Experience candidates only - on same domain

Greetings from NTT DATA, Roles and Responsibilities: Process Adjudication claims and resolve for payment and Denials Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process Knowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of pocket, maximum inside limits and exclusions, state variations Ensuring accurate and timely completion of transactions to meet or exceed client SLAs Organizing and completing tasks according to assigned priorities. Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes perfor...

Job Responsibilities: ***ONLY BHMS GRADUATES CAN APPLY.*** Having experience (at least 5 yrs) in TPA claim processing. Having a Good relationship with Hospitals under the East Zone. Financial Contribute to renewal portfolio expansion through relationship building with the insurance companies and surveyors to ensure optimum claim settlement in minimum time During processing of claim analyse the following and communicate to underwriters: adequacy of sum insured anomalies in the policy scope of additional policies other related information Control expenses Business Process Facilitate proper settlement of the claim in the shortest possible time to the satisfaction of the client by ensuring the f...

Vidal is hiring for claim Processor Designation: Executive-Claims Location: Gurgaon, Key Responsibilities: Review and validate claim documents submitted by hospitals or insured members Scrutinize medical records and bills for completeness and accuracy Apply policy terms, conditions, and exclusions to adjudicate claims Perform ICD and procedure coding as per ailment and treatment Coordinate with medical officers for clinical opinion when required Maintain claim logs and update CRM systems with claim status Ensure adherence to defined SLAs and minimize processing errors Flag suspicious or potentially fraudulent claims for investigation Communicate with stakeholders for clarifications or missin...

Job Details: Job Process/Role: Claims Adjudication (US Healthcare) Experience: 1 - 3 Years of Relevant experience in Claims adjudication Skillset: CPT Codes, HIPAA, Co-pay and Co-insurance, Medicaid and Medicare, Denial claims, UB and CMS forms. Shift: Night shift Location: Chennai & Coimbatore Mode of Work: Work from office Notice Period Eligible: Immediate to 30 Days of Notice period is acceptable. Roles and Responsibilities: Process Adjudication claims and resolve for payment and Denials. Knowledge in handling authorization, COB, duplicate, pricing, and the corrected claims process. Knowledge of healthcare insurance policy concepts, including in-network, out-of-network providers, deductib...

operations of the healthcare claims processing team (Mediclaim, RCM, and denial management) Ensure claims, including verification, validation, coding .Monitor & manage denials, rejections, and appeals in accordance with Payer & Provider guidelines. Required Candidate profile knowledge of healthcare claims, RCM workflows, & denial management. Should have Team Management , Client Management. Analyze RCM data to identify trends, gaps, & opportunities for process improvement

Looking Immediate joiners Roles and Responsibilities: Process Adjudication claims and resolve for payment and Denials Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process Knowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of pocket, maximum inside limits and exclusions, state variations Ensuring accurate and timely completion of transactions to meet or exceed client SLAs Organizing and completing tasks according to assigned priorities. Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes perfo...

Job Title: Operations - Investigations Job Role : Team Leader Minimum Mandatory Qualification : Graduate Experience :2-5 Years of experience in investigation Mandatory Skill : Computer Operations, Computer proficiency, MS Excel, Communication in English & Hindi, Open to work in shifts. Brief Job : Generic job profile includes document processing, data entry process, maintaining trackers, escalate issues as required within organization and follow up to ensure timely resolution . Profile Desired Competencies/ Skill Set : Working knowledge of MS Excel with data entry speed and accuracy, ability to communicate in English and Hindi effectively, Insurance / Health Insurance Knowledge. Should be op...

Job Title: Operations - Investigations Job Role : Team Leader Minimum Mandatory Qualification : Graduate Experience :2-5 Years of experience in investigation Mandatory Skill : Computer Operations, Computer proficiency, MS Excel, Communication in English & Hindi, Open to work in shifts. Brief Job : Generic job profile includes document processing, data entry process, maintaining trackers, escalate issues as required within organization and follow up to ensure timely resolution . Profile Desired Competencies/ Skill Set : Working knowledge of MS Excel with data entry speed and accuracy, ability to communicate in English and Hindi effectively, Insurance / Health Insurance Knowledge. Should be op...

Job Title: Operations - Investigations Job Role : Team Leader Minimum Mandatory Qualification : Graduate Experience :2-5 Years of experience in investigation Mandatory Skill : Computer Operations, Computer proficiency, MS Excel, Communication in English & Hindi, Open to work in shifts. Brief Job : Generic job profile includes document processing, data entry process, maintaining trackers, escalate issues as required within organization and follow up to ensure timely resolution . Profile Desired Competencies/ Skill Set : Working knowledge of MS Excel with data entry speed and accuracy, ability to communicate in English and Hindi effectively, Insurance / Health Insurance Knowledge. Should be op...

Roles and Responsibilities: Process Adjudication claims and resolve for payment and Denials Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process Knowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of pocket, maximum inside limits and exclusions, state variations Ensuring accurate and timely completion of transactions to meet or exceed client SLAs Organizing and completing tasks according to assigned priorities. Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team Resolving...

Job Title: Operations - Investigations Job Role : Team Leader Minimum Mandatory Qualification : Graduate Experience :2-5 Years of experience in investigation Mandatory Skill : Computer Operations, Computer proficiency, MS Excel, Communication in English & Hindi, Open to work in shifts. Brief Job : Generic job profile includes document processing, data entry process, maintaining trackers, escalate issues as required within organization and follow up to ensure timely resolution . Profile Desired Competencies/ Skill Set : Working knowledge of MS Excel with data entry speed and accuracy, ability to communicate in English and Hindi effectively, Insurance / Health Insurance Knowledge. Should be op...

Job Title: Operations - Investigations Job Role : Team Leader Minimum Mandatory Qualification : Graduate Experience :2-5 Years of experience in investigation Mandatory Skill : Computer Operations, Computer proficiency, MS Excel, Communication in English & Hindi, Open to work in shifts. Brief Job : Generic job profile includes document processing, data entry process, maintaining trackers, escalate issues as required within organization and follow up to ensure timely resolution . Profile Desired Competencies/ Skill Set : Working knowledge of MS Excel with data entry speed and accuracy, ability to communicate in English and Hindi effectively, Insurance / Health Insurance Knowledge. Should be op...

Job Title: Operations - Investigations Job Role : Team Leader Minimum Mandatory Qualification : Graduate Experience :2-5 Years of experience in investigation Mandatory Skill : Computer Operations, Computer proficiency, MS Excel, Communication in English & Hindi, Open to work in shifts. Brief Job : Generic job profile includes document processing, data entry process, maintaining trackers, escalate issues as required within organization and follow up to ensure timely resolution . Profile Desired Competencies/ Skill Set : Working knowledge of MS Excel with data entry speed and accuracy, ability to communicate in English and Hindi effectively, Insurance / Health Insurance Knowledge. Should be op...

Hiring for Medical Underwriters- Health Insurance Only M.B.B.S - BPT, BDS, BMS, MPT Job Role- To assess the risk associated with insuring individuals or groups, evaluate medical history, and determine policy terms, coverage limits, and premiums, all while adhering to company policies and industry regulations. Experience Required - Minimum 2+Years of Experience Locations - Gurgaon , Kochi, Bangalore & MumbaiRole & responsibilities Preferred candidate profile

Hiring for Medical Underwriters- Health Insurance Only M.B.B.S - BPT, BDS, BMS, MPT Job Role- To assess the risk associated with insuring individuals or groups, evaluate medical history, and determine policy terms, coverage limits, and premiums, all while adhering to company policies and industry regulations. Experience Required - Minimum 2+Years of Experience Locations - Gurgaon Chennai (Tamil) Kochi (Malayalam) Interested candidates can directly share their resumes on simranbagga@policybazaar.com or 9311501270

Position : Operations - Investigation Brief Job Profile : Claims adjudication, fraud and leakage control, client/provider feedback, team training and retention, Investigation Career Level : Medical Officer/ Deputy Manager/ Manager Medical Graduate Minimum Mandatory Qualification : BAMS, BHMS, BDS, For Manager MBBS (Preferred) Experience (in years) : 3 - 7 years of experience in investigation 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 Desired Competencies/ Skill Set : MS Excel and MIS skills, Candidate having work experience of claim processing, Investigation, ...

Position : Operations - Investigation Brief Job Profile : Claims adjudication, fraud and leakage control, client/provider feedback, team training and retention, Investigation Career Level : Medical Officer/ Deputy Manager/ Manager Medical Graduate Minimum Mandatory Qualification : BAMS, BHMS, BDS, For Manager MBBS (Preferred) Experience (in years) : 3 - 7 years of experience in investigation 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 Desired Competencies/ Skill Set : MS Excel and MIS skills, Candidate having work experience of claim processing, Investigation, ...

Position : Operations - Investigation Brief Job Profile : Claims adjudication, fraud and leakage control, client/provider feedback, team training and retention, Investigation Career Level : Medical Officer/ Deputy Manager/ Manager Medical Graduate Minimum Mandatory Qualification : BAMS, BHMS, BDS, For Manager MBBS (Preferred) Experience (in years) : 3 - 7 years of experience in investigation 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 Desired Competencies/ Skill Set : MS Excel and MIS skills, Candidate having work experience of claim processing, Investigation, ...

Role & responsibilities:- HEAPS is a health tech platform and Software as a Service (SAAS) provider which leverages advanced data analytics, artificial intelligence and machine learning to revolutionize healthcare delivery and payments model by building a Healthcare Network and a Value Based Care model. Responsibilities:- Provide patients with the psychosocial support needed to cope with chronic, acute or terminal illnesses Communicate with patients suffering from various ailments post discharge to understand the status of their health and counsel them To enroll new patients into the system once they call in Role & responsibilities HR Contact Details:- HR Namrata Contact No:- 8624868754