646 Health Claims Jobs - Page 20

Location: Chennai Shift : US Shift Timing (6.30PM 3.30AM) Job Qualification : Looking for voice process only. Experience in Claims Operations Candidate should have good communication skills. Responsibilities : End to End domain knowledge on US Healthcare and Payer Services life Cycle. Knowledge on Payer workflows like Enrollment, Claims Adjudication, Appeals and Grievances, Payment Integrity & Authorization Expertise on Payer terminologies (Related to Medicare Advantage programs) and concepts like Credentialing, Authorization, Out of network and In Network concepts & Subrogation. Basic knowledge on Revenue Cycle Management Interested candidates Contact : kowsalya.k HR (8122343331)

GOOD KNOWLEDGE IN INSURANCE ,CASHLESS PROCESS INTO HOSPITAL

To be liaison between the patient, the hospital, and TPA, managing claim processing by coordinating with the TPA to facilitate timely claim settlements and patient billing, all while adhering to insurance guidelines and regulations.

We are looking for a highly skilled and experienced AR Associate to join our team at Omega Healthcare Management Services Pvt. Ltd., Location - Omega Healthcare - F2 Airport Bengaluru, Karnataka Rustam Bagh Layout, Bengaluru, Karnataka 560017 https://lnkd.in/gKk48dh5 Date - 28-Jun-2025 ( 2 PM ) - Saturday Roles and Responsibility Manage and process accounts receivable transactions with high accuracy and attention to detail. Develop and implement effective strategies to improve cash flow and reduce outstanding balances. Collaborate with cross-functional teams to resolve billing discrepancies and ensure timely payments. Analyze and report on key performance indicators, such as delinquency rate...

Positions General Duties and Tasks: Process Insurance Claims timely and qualitatively Meet & Exceed Production, Productivity and Quality goals Review medical documents, policy documents, policy history, Claims history, system notes and apply the trained client level business rules to make appropriate Claims decisions, call out claims trends and flag fraud activities Stay up to date on new policies, processes, and procedures impacting the outcome of Claims processing Be a team player and work seamlessly with other team members on meeting customer goals Preferences for this role include: 1.5+ years of experience processing insurance claims in the health, life, or disability disciplines that re...

Long Term Disability Claim Manager Role Overview: The LTD Claim Manager will manage an assigned caseload of Long Term Disability cases. This includes management of claims with longer duration and evolving medical conditions. LTD Claim Managers will have meaningful and transparent conversations with their customers and clinical partners in order to gather the information that is most relevant to each claim. It also requires potentially complex benefit calculations on a monthly basis. The candidate will also evaluate customer eligibility and interact with internal and external customers including, but not limited to, customers, employers, physicians, internal business matrix partners and attor...

Interested Candidates may connect with Ms.Zoya Shamsi +91 7251000195 (11am-5pm) About the Role: We are seeking a highly motivated and experienced individual with a medical background to join our dynamic team as a Medical Claims Call Center Representative. In this role, you will be the frontline of our customer service, handling inbound calls related to medical claims and rejections. Your primary focus will be to provide exceptional customer service while resolving inquiries and concerns effectively, ensuring a positive experience for every Niva Bupa member. Key Responsibilities: Answer incoming customer calls promptly and professionally. Assist customers with navigating medical claims, inclu...

Location: Chennai Shift : US Shift Timing (6.30PM 3.30AM) Job Qualification : Looking for voice process only. Experience in Claims Operations Candidate should have good communication skills. Responsibilities : End to End domain knowledge on US Healthcare and Payer Services life Cycle. Knowledge on Payer workflows like Enrollment, Claims Adjudication, Appeals and Grievances, Payment Integrity & Authorization Expertise on Payer terminologies (Related to Medicare Advantage programs) and concepts like Credentialing, Authorization, Out of network and In Network concepts & Subrogation. Basic knowledge on Revenue Cycle Management Interested candidates Contact : Lithan Kumar HR (7339696444) Those wh...

Location: Chennai Shift : US Shift Timing (6.30PM 3.30AM) Job Qualification : Experience in Claims Operations Candidate should have good communication skills. Responsibilities : End to End domain knowledge on US Healthcare and Payer Services life Cycle. Knowledge on Payer workflows like Enrollment, Claims Adjudication, Appeals and Grievances, Payment Integrity & Authorization Expertise on Payer terminologies (Related to Medicare Advantage programs) and concepts like Credentialing, Authorization, Out of network and In Network concepts & Subrogation. Basic knowledge on Revenue Cycle Management Interested candidates Contact : Varsha HR (8056370297) Those who have experience in Non voice please ...

# Location- Ahmedabad # Shift Timing: US Shift (Night Shift) # Facilities - Cab Facility # Working- 5 days # Week - Fixed off # Fluent English # Saturday, Sunday fixed off # Freshers & Experienced both can apply

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...

Role & responsibilities A key member of Customer Service Operations team, responsible for providing an efficient, effective and compliant service to policyholders. Key accountabilities include handling of simple and complex cases, quality in service delivery, accuracy in providing and capturing information while adhering to compliance guidelines and support to team managers. Preferred candidate profile Good verbal and written communication skills Freshers eligible ; Preference would be given to individuals from an insurance background with approximately 1 years experience (Insurance Associate) with experience in handling written communication Perks and benefits Hybrid working mode - 3 days i...

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 Services - Payer Claims Processing Designation: Health Admin Services New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 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...

Key Responsibilities: Handle end-to-end reimbursement and cashless claims for corporate clients' employees and dependents. Scrutinize claim documents for completeness, medical validity, and compliance with policy terms. Coordinate with empaneled hospitals, insured members, and insurance companies for claim clarification, queries, and approvals. Maintain TAT and SLA commitments for smooth and timely processing. Ensure compliance with IRDAI guidelines and internal company SOPs. Update and manage claims data in the internal system accurately. Prepare and share MIS reports with internal stakeholders and corporate clients. Manage escalated and high-value claims with detailed attention and resolut...

Job Description Acts as an interface between the TPA, Insurance Company and the hospital. Responsible for investigation of suspicious claims. Effective usage of Fraud control measures. Act as a backend support to the TPA. Responsible for data mining and analytics related to Fraud and Investigation (IFD) Field visit for investigation purpose. Open to travel. Desired Candidates Profile Qualification Any Graduate Experience Fresher - 2 Years Exp. Profile – Executive If interested kindly share your resume to recruitment1@mdindia.com

Resolve customer queries over calls, chat Address and resolve customer complaint or issues related to healthcare services, ensuring a positive and satisfactory experience Inform customers about health plans, insurance coverage, and healthcare service Required Candidate profile Excellent communication skills in English Only B.Pharma/ M.Pharma/ D.Pharma passed Freshers or Experienced can apply Strong understanding of medical terminology Immediate Joiners Rotational shifts Perks and benefits Incentives Health Insurance

# Location- Ahmedabad # Shift Timing: US Shift (Night Shift) # Facilities - Cab Facility # Working- 5 days # Week - Fixed off # Fluent English # Saturday, Sunday fixed off # Freshers & Experienced both can apply

Skill required: HM- Utilization Management - Healthcare Management Designation: Customer Service New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 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 operat...

Hurry up Authentic Healthcare is hiring Medical officers Non clinical job AT Noida, HYD , Bangalore Location Role/Position: Permanent Experience: 1 to 2 yrs in TPA or clinical Education: BPT, MPT,BDS, BAMS, BHMS Shifts: Day shift work from office

Job Description (IFD) Communicating with clients and understanding the investigation requirements. • Meeting with clients to discuss the nature of the investigation. • Conducting field investigations on appointed cases, insurance claims, or client requests. • Conducting in-depth research on various appointed cases. • Decide the extent and validity of a claim, and in so doing, prevent fraudulent claims by determining the claim's authenticity. • Gathering and analyzing evidence reports. • Conducting photographic and audio surveillance to gather evidence • Reviewing and solving cases by authenticating insurance claims. • Coordinating with agents to understand insurance claims matters. • Answeri...

Job description We Are Hiring for International Semi voice Process Profile -: Claim Processing associate ( Semi voice) Languages req: Excellent English communication Requirement -: Good Communication Skills Exp-: 6m- 5 yrs in claims Shifts:Rotational Location : Bangalore Immediate joiners only *** Only 2 rounds of interview Job description Document claim file by accurately capturing and updating claims data/information in compliance with best practices for low to moderate. exposure and complexity for Property and Content damage and Liability/Injury claims. Exercise judgement to determine policy verification and coverage determination by analysing applicable coverage for claims and determinin...

Job Summary: We are looking for a dynamic and experienced Manager Employee Benefits to join our team in Bangalore. The ideal candidate will have strong experience in employee benefits program management, relationship management, data analytics, and coordination with insurers and TPAs. Prior experience in a brokerage firm will be an added advantage. Key Responsibilities: 1. Client Relationship & Account Management: Act as the primary point of contact for assigned corporate clients. Build and maintain strong relationships with HR and employee stakeholders. Conduct regular review meetings with clients to understand needs, resolve issues, and offer strategic advice. Support renewals and policy u...

Role & responsibilities - Due Diligence - Document Indexing & Management - Sanction Screening - Compliance checks - Premium Bordereaux Processing - Knowledge of insurance systems like Acturis, Applied Epic/Eclipse will be added advantage - Experience in the insurance sector, preferably with brokers or MGAs, will be an added advantage - Familiarity with Lloyds systems integration (XIS, XCS, ICOS/IPOS) is a plus - Updating the process documents - Providing supporting documents during various internal/external audits - Advance excel knowledge Preferred candidate profile Need Fresher or who have experience into claims and settlement Must be fluent with communication

UK Health Care Process Nature of Work : Claim Processing/ Backend Candidates should have their own system and internet connection Configuration required Windows 10 Processor - i3/i5 RAM - 4 GB Speed - 10mbps rotational shifts, 5 days working Required Candidate profile Rounds of Interviews - HR - Medical Test - Email Test - Amcat - Ops