646 Health Claims Jobs - Page 25

We Have Urgent Requirement of TPA Manager

Looking for Fresher candidates Fresher graduate health insurance claim validation

Role: Closed file review & audit 1-Handling closed / open file review for third party administrator & inhouse claims 2-Recoveries from third party administrator for claims processed with errors 3-Highlight areas of improvement 4-Monthly reports to be published Candidate must have: 1-In-depth knowledge of medical cases with exposure to ailment treatments, policy coverages for OPD/hospitalization/personal accident/ travel claims 2-Good interpersonal skills 3-Must be proactive & effective learner 4- Must have previous experience of Audit 5- Good Analytical, Communication and Negotiation skills 6- Familiar with Basic Microsoft Excel and regulatory changes 7- Minimum 7 years of experience in gene...

Skill required: HM- Utilization Management - Healthcare Management Designation: Customer Service 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.The administration of hospitals, o...

Skill required: HM- Utilization Management - Healthcare Management Designation: Customer Service Associate Qualifications: Any Graduation Years of Experience: 1 to 3 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.The administration of hospitals, outpa...

About Navi Navi is one of the fastest-growing financial services companies in India providing Personal & Home Loans, UPI, Insurance, Mutual Funds, and Gold. Navi's mission is to deliver digital-first financial products that are simple, accessible, and affordable. Drawing on our in-house AI/ML capabilities, technology, and product expertise, Navi is dedicated to building delightful customer experiences. Founders: Sachin Bansal & Ankit Agarwal Know what makes you a Navi_ite : 1. Perseverance, Passion and Commitment Passionate about Navis mission and vision Demonstrates dedication, perseverance, and high ownership Goes above and beyond by taking on additional responsibilities 2. Obsession with ...

Skill required: HM- Utilization Management - Healthcare Management Designation: Customer Service 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.The Healthcare Delivery team focus...

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.In Payer Claims Processing you will be...

TPA Liaison: Serve as the primary point of contact between the hospital and TPAs, ensuring smooth claims processing and reimbursement. Collaborate with TPAs to verify patient eligibility, approve pre-authorizations, and facilitate smooth discharge procedures. Ensure timely submission of claims, follow up on outstanding claims, and resolve any discrepancies or issues related to TPA reimbursements. Corporate Client Coordination: Act as a liaison for corporate clients, addressing their queries and ensuring employees medical needs are met efficiently. Coordinate with corporate clients to manage employee health programs, including corporate insurance policies, wellness programs, and preventive he...

Role & responsibilities: Analyzing and summarizing medical records for pre and post settlement projects. Interpreting clinical data in terms of medical terminology and diagnosis. Adhering to company policies/ARCHER principles and hence taking good care of Archer culture. Adhere to Health Insurance Portability and Accountability Act (HIPPA) all the time. Daily reporting to Medical team lead for productivity & quality EDUCATIONAL QUALIFICATION AND EXPERIENCE REQUIRE: MBBS graduate (No experience required) BHMS/BAMS graduate (Minimum 2 years of experience with Claims Processing in the Insurance sector).

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...

Investigate health insurance claims, verify medical records, detect fraud, conduct field visits, and prepare detailed reports. Coordinate with hospitals and ensure compliance with TPA policies and IRDAI guidelines. Medical background preferred.

Skill required: Claims Services - Payer Claims Processing Designation: Health Admin Services Associate Qualifications: Any Graduation Years of Experience: 1 to 3 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 health...

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-:2yrs- 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 determini...

l To Audit daily allotted cases as per Target l To compare the audit remarks received from the claims team l To maintain quality while doing the audit l To co ordinate with the provider network team and account managers or internal teams for additional Information about claims,tariff etc. l To complete the Audit finding to a Logical end l To share the responses to the insurer within the TAT. To assess the RCA for the errors and suggest the resolutions to avoid future audit

Job Summary To register new patients under TPA, attend queries, pre-authorization of request, claims, bill recovery. Job Responsibilities Handling all debtor receivables, Solving all queries, which are related to bill. Checking all IP files before dispatch. Checking the reasons of cancellation of bill, free bill, discount bill, refund bill. Preauthorization request will be sent to the respective scheme office for the approval of the concerned treatment (surgical / medical) Making the changes of packages rates/tests rates as per the Company Agreement. Maintaining the Debtors aging report for OP & IP All the inpatient bills will be sent for the claims to the respective scheme office. Communica...

Policy Decoding Executive Company Description Care.fi is a new age Health fintech startup in Gurgaon, offering smart financing and claim management solutions to hospitals. With a focus on driving efficiencies through technology, Care.fi provides seamless financing and revenue cycle management solution for healthcare providers. The company has strong institutional investor backing and founders with over 20 years of experience in the industry. Role Description As a Policy Decoding Executive, you will be responsible for handling health-related insurance claims processing, policy decoding, and follow-up on insurance settlements. This role requires meticulous attention to detail, effective commun...

Role & responsibilities The role is responsible for developing products for health claim automation and developing algorithms for solutions to control fraud waste and abuse in health insurance. Preferred candidate profile Mus have experience is claim investigatiuon, claim quality assessment, medical coding, basic knowledge of data science

WERE HIRING CUSTOMER SERVICE ASSOCIATE (Night Shift) Location: Mumbai (Airoli) Work from Office Shift: Rotational (Night shift allowance applicable) Joining: Immediate Joiners Preferred Role Customer Support – US Healthcare (International Voice Process) Eligibility Education: Graduate Freshers welcome | 12th Pass, BBA, BA, B.Com, BMS, BAMS, B.Pharma, MBA, B.Sc. (Chemistry/Biotech) Skills: Excellent English communication (mandatory) Experience: Freshers & candidates with 1+ year international voice experience Your Impact Handle US healthcare customer calls Deliver accurate resolutions in the first conversation Meet SLA targets (CSAT, Service Level, Handle Time, Customer Effort) Maintain quali...

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...

Skill required: Group Core Benefits- Claims Case Mgmt. Group Disability Insurance Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 year 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 We help insurers redefine their custom...

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...

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...

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 Mahek Contact No:- 7559401618

Ahmedabad #Salary: Up to 3.6 LPA #US Shifts #CareerGrowth #RecordRetrieval #MedicalRecords #USShifts(Night) #JobOpening #Manage medical/legal record requests, ensure timely retrieval #5 days #Fixed off #Fluent English