629 Health Claims Jobs - Page 2

Roles & Responsibilities Oversee end-to-end billing operations for OPD, IPD, Emergency, Day Care, Diagnostics, and Surgical cases. Ensure accurate and timely billing as per tariff, package, and doctor orders. Monitor daily billing activities including advances, deposits, interim bills, and discharge finalization. Implement revenue leakage control by ensuring all services, consumables, and investigations are posted. Manage TPA / Insurance / Corporate billing including pre-auth, approvals, final bill submissions, and claim settlements. Coordinate with clinical and support departments (Nursing, Pharmacy, MRD, Front Office, Finance). Maintain compliance with hospital billing policies, audit requ...

Medical Officer - Claims Processing Job Title: Medical Officer Claims Processing Location: IBC Knowledge Park, Bangalore (Work from Office) Department: Central Claims Operations Control Room Job Type: Full-time Salary: 3,00,000 3,60,000 per annum About the Role We’re hiring Medical Officers (Claims Processing) for our Control Room team at IBC, Bangalore. The role involves end-to-end medical claim processing with focus on accuracy, coordination, and timely resolution. You’ll work closely with multiple departments to ensure smooth claim operations and compliance with TAT standards. Key Responsibilities Process medical claims accurately within defined timelines. Review and validate claim docume...

Department: Health Claims (Cashless) Location: Hyderabad 1, Indore 1 Reporting To: Chief Manager Health Management Team Key Responsibilities: Claims Assessment: Evaluate and process health insurance claims in accordance with policy terms and conditions. Medical Review: Identify and flag potential cases of medical abuse or discrepancies in treatment protocols. Admissibility Decision: Determine claim eligibility based on thorough review of medical documentation and policy guidelines. Tariff Adjudication: Review and authorize cashless approvals, ensuring alignment with applicable tariffs and negotiated rates. Stakeholder Coordination: Liaise effectively with internal teams, network hospitals, a...

Manager / Assistant Manager Account Management - MediAssist Job Title: Manager / Account Management Company: Medi Assist Location: Bangalore CTC: 9 to 12 LPA Experience: 11 to 15 years Industry: Health Insurance / TPA / Healthcare Key Responsibilities:- Client Relationship & Strategy: Build and maintain long-term partnerships with insurers, corporate clients, and healthcare providers. Lead high-level review meetings and ensure strong relationship governance. Operations & Service Delivery: Oversee end-to-end account operations including claims, customer service, and issue resolution. Ensure compliance with TATs and SLAs. Performance Analysis & Reporting: Monitor KPIs, analyze client data, and...

Medical Officer responsible for reviewing and assessing medical claims, verifying documents, coordinating with hospitals, and ensuring accurate claim decisions as per policy and clinical standards. BAMS/BHMS preferred with TPA or insurance experience

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Voice hiring for AR calling and health insurance International Voice. Location :- Bangalore Shift :- US shift (Rotational) Pick and drop available, Food available. We are seeking a Patient Support Service Representative (Voice) to handle customer queries and provide assistance related to healthcare services. The role requires eective communication skills, attention to detail, and the ability to work in a fast- paced environment. What job duties can I expect to perform as a Customer Support Representative? Handle inbound and outbound calls related to healthcare services. Service customers seeking support with their monthly healthy benet package. This monthly benet can be used in pharmacies an...

Department: Health Claims (Cashless) Location: Hyderabad 1, Indore 1 Reporting To: Chief Manager Health Management Team Key Responsibilities: Claims Assessment: Evaluate and process health insurance claims in accordance with policy terms and conditions. Medical Review: Identify and flag potential cases of medical abuse or discrepancies in treatment protocols. Admissibility Decision: Determine claim eligibility based on thorough review of medical documentation and policy guidelines. Tariff Adjudication: Review and authorize cashless approvals, ensuring alignment with applicable tariffs and negotiated rates. Stakeholder Coordination: Liaise effectively with internal teams, network hospitals, a...

Seeking a male candidate with TPA/investigation agency experience, expertise in Mediclaim investigation/verification, team handling, client communication, and TAT management. Focus on reimbursement and cashless claims. Strong leadership required.

Ready to shape the future of work? At Genpact, we don't just adapt to change we drive it. AI and digital innovation are redefining industries and were leading the charge. Genpact's AI Gigafactory, our industry-first accelerator, is an example of how were scaling advanced technology solutions to help global enterprises work smarter, grow faster, and transform at scale. From large-scale models to agentic AI, our breakthrough solutions tackle companies most complex challenges. If you thrive in a fast-moving, tech-driven environment, love solving real-world problems, and want to be part of a team that's shaping the future, this is your moment Genpact (NYSE: G) is an advanced technology services ...

Role: Back End Operations -US Health Insurance Work Location: 2-15+ years' work experience in back-office US Health Insurance/Retirement pension domain /BFSI can apply Location: Wipro Elcot SEZ, Survey No. 602/03, Elcot Sez, Shollinganallur, Chennai, Tamil Nadu Shift Timing- 5.30pm to 3am Cab Facility- One way drop Work from Office: From Day 2 Onwards (Work from office ) Permanent work profile with Wipro Education - B.com, BA, BBA, Any B.sc (graduates only)/ NO BE/B TECH will be eligible for this hiring Job Summary Strong understanding of client plan provisions/product & processing guidelines and SLA metrics Able to manually perform Benefit processes and complex tasks/calculations that requi...

Designation: Senior Medical Officer Function: Claims PA/RI Approver Reporting to: Assistant Manager/Manager Location: Andheri East, Mumbai Educational Qualification: BAMS, BHMS, BPT, MBBS, BSc. Nursing Additional Qualification: None Specialization: General Medicine Related courses attended: None Management Level: Junior Management Level Industry Type: Hospital/TPA/Healthcare/Insurance Roles and Responsibilities : Check the medical admissibility of a High Value claim, scrutinize and process it as per terms & conditions of insurance policy. Handle escalations, customer queries and responding to mails accordingly Effectively manage the team so that the targets are met while reducing the no. of ...

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...

Roles and Responsibilities Handle health claims from receipt to settlement, ensuring timely processing and quality service delivery. Conduct thorough audits on insurance claims, identifying areas for improvement and implementing corrective actions. Prepare accurate and detailed audit reports, highlighting key findings and recommendations. Manage email communication with clients, agents, and internal stakeholders regarding claim status updates and queries. Utilize MS Office skills to maintain efficient records management systems. Salary- 25k/month + other benefits Work Location-Gurgaon work from Office only Timings: 9:30am to 5:30pm (Monday-Saturday) Contact No-9971006988 through whats app ch...

Role & Responsibilities: Claims Specialists are responsible for accurately reviewing and processing claims for Flexible Spending Accounts and Health Reimbursement Arrangements in accordance with IRS regulations and specific employer plan rules. Claims Specialists spend their entire day working through the automatically fed claims queues within OnBase in the designated order to ensure turnaround times are met for our clients. Preferred Candidate Profile A candidate with claims adjudication experience is preferred. Freshers are also encouraged to apply. (Should have provisional / Consolidated certificate) The candidate should be flexible with working in 24-hour rotational shifts. "Sutherland n...

Urgent requirement for BHMS/BAMS/BDS -Chennai(Annasalai) 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 / BDS graduate. Male candidate prefer. Good Medical & basic computer knowledge Should have completed internship (Permanent Registration number is mandatory) Freshers can als...

We are hiring FRESHERS for "NON-VOICE / CLAIM BENEFITS PROCESS" for one of the MNC. Carries good analytical skills. Salary : 15k to 16K (In hand) Working Days : 5 Days Shift : Day Shift (9am to 6pm) ONLY GRADUATES CAN APPLY Work from office Required Candidate profile Claims processing/Verify Handle claim Denials and acceptance Create excel reports Handle clients call for new updates and quality feed backs Good comm skills and 25 WPM typing speed Call - 9643583769

Walk-In Interview Alert! Join us at WTW Vikhroli Office for an exciting opportunity with our Global Certification Centre ! Date: Monday, 3 November 2025 Time: 1:30 PM 3:00 PM Location: WTW, Vikhroli Job Title : Advisor / Sr Advisor Job Shift Timing : US Evening shift Experience - 2 - 7 Years Note: Candidate who have worked in Evening shift or Night Shift are eligible for this role Role Role & responsibilities Deliver as per the KPIs defined for the role. To always maintain set SLA Accuracy/quality, TAT standards prescribed by the Business Unit. Manage volumes and delivery expectations as per business requirement Being apt in managing time sensitive work with high level of eye for detail and ...

Responsibilities: * Manage medical billing process from start to finish * Ensure accurate coding and compliance with HIPAA * Identify denials, appeal disputes, and optimize payments Provident fund

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...

TATA AIG General Insurance Company Limited is looking for Manager - Health Claims to join our dynamic team and embark on a rewarding career journey Collaborate with cross-functional teams to achieve strategic outcomes Apply subject expertise to support operations, planning, and decision-making Utilize tools, analytics, or platforms relevant to the job domain Ensure compliance with policies while improving efficiency and outcomes

Role & responsibilities Review incoming healthcare claims for accuracy and completeness, ensuring all necessary information is provided for adjudication. Analyze claims data against payer policies and industry regulations to determine eligibility for payment or denial. Communicate effectively with healthcare providers, policyholders, and internal teams to resolve discrepancies or gather additional information. Utilize claims processing systems and software to enter, update, and retrieve claims information accurately. Identify and report any trends or patterns in claims submissions that may indicate potential fraud or abuse. Ensure timely processing of claims to meet internal and external dea...

Management Profile: Provider Management/Healthcare Purchasing Roles & Responsibilities: Tariff Negotiations and cost management Conducting surprise audits and checks of the claims and case to case negotiations Manage workload of both field and office effectively Experience in dealing with providers (Hospitals/Diagnostics & OPD Clinics) Understanding of Health Claims and claim related processes Good understanding of Health Insurance and related products Managing relationship with the providers Flexible to travel across locations based on the organizational requirements Managing internal (Claims Team, Sales and Central Teams and external stakeholders (Brokers, Channel partners & Corporates) Ma...

Responsibilities: * Process claims from intake to payment * Collaborate with stakeholders on claim resolution * Ensure accurate adjudication & payment processing * Meet service level agreements (SLAs) for turnaround time

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. For more clarification about this job role, please feel free to reach out to us on the below mentioned number: Maria - 9986584828 (Please send us a message on WhatsApp in case the numbers are busy) 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....