629 Health Claims Jobs - Page 3

Job Summary: We are seeking a Domain Specialist to join our team in Chennai. The ideal candidate will have expertise in one or more domains such as SaaS, HRTECH, EDTECH, MANUFACTURING, FINANCE, or IT. This role will involve providing specialized knowledge and support within the specified domain. Key Responsibilities: Provide expert domain knowledge and support to internal teams and clients. Conduct market research and analysis to identify industry trends and opportunities. Develop and deliver training programs and presentations on domain-specific topics. Collaborate with cross-functional teams to develop and implement domain-specific solutions. Stay up-to-date with industry best practices an...

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 ...

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! Contact: HR JOY 7996004799 (SEND CV ON WHATSAPP IF LINE IS 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. Conduct end-to-end renewal activities as a US Health Insurance domain expert. Coordinate with...

Job description Job purpose To manage the end-to-end claims reimbursement process efficiently and accuratelyensuring timely claim submission, verification, adjudication, and resolutionwhile maintaining compliance, improving customer satisfaction, and contributing to the organization’s operational excellence. Duties and responsibilities 1. Claim Submission Initiation: The insured individual or the service provider submits a claim to the insurance company for reimbursement. Required Documentation: Policy details (policy number, coverage specifics). Proof of service or expense (invoices, bills, or receipts). Supporting documents (e.g., medical reports, repair estimates, or loss reports). Submis...

Hiring for MNC's Banglore Job Requirement Aircover Vertical - Insurance/Claims Education - Only Graduates Experience - Min 2 Years experience into International Claims/Insurance or Health Care Location - Brookfield,Banglore Boundary Limits - 20Kms from Office location - Kundalahalli Process - Blended Shifts - Rotational Shifts with Rotational Weekoffs 2 Way Transport will be provided for all shifts Salary - 4.5LPA - 5LPA Interview mode -Virtual For more info Call Sharanya - 8143987111 Shireesha - 8143876111 Nikitha - 8977261411 or drop your cv to pushpa.sabari@mrtinfotech.com

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 ...

TATA AIG General Insurance Company Limited is looking for Senior Manager - Health Claims to join our dynamic team and embark on a rewarding career journey Analysis for the current business practice. Find out the different operational strategies. Work on developing the current operational strategy applied to the company with the most recent technology. Coordinate with the operations manager to take the required steps after brainstorming and research. Optimize the operations in the company. Put the suitable operational strategy to fit with the company€™s culture. Implement the operational strategy in the different departments of the company. Supervise the strategy, and make sure that all the e...

Hiring For US Healthcare Voice Any graduate 3+ Yrs exp in CTC: Upto 10 LPA Location: Pune. (hybrid) NP: 0-30 Days 9049866622 | shweta@talentams.com Required Candidate profile 3 + yrs exp in healthcare voice P&C Voice EXCELLENT COMMUNICATIONS ONLY Perks and benefits Both way cabs Hybrid after 6 months Joining.

Greetings from Sagility . Sagility has huge openings for BDS/ MDS graduates in US healthcare organization Job Description: Interpret all types of Medical records Must have worked in Health care TPA/ must have worked a medical officer in any recognized TPA CPT & ICD 9 & 10 Coding Interpret medical necessity in contrast to clinical policies / guidelines Interpret medical data and provide accurate clinical review Identify Cost Savings within Medical Claims Itemized bill review (IBR) for Institutional claims Qualification & Skills: BDS/ MDS Graduation with Internship Interested Candidates can share the CV's to Yuva Indira. K @ 7200012804/ Share their CV's through mail yuvaindira.k@sagilityhealth...

Role & responsibilities Perform audit reviews of adjudicated health / hospital / medical claims to verify correctness, completeness, and adherence to policy guidelines, contractual terms, and regulatory norms. Use sampling and systematic review techniques (random audits, targeted audits, high-value claims audits) to ensure quality coverage across volumes. Check for proper documentation, coding (ICD / CPT / procedure / diagnosis codes), member eligibility, policy coverage, benefit limits, copayments, exclusions, etc. Validate whether preauthorization, referrals, or supporting documentation was appropriately obtained / processed. Identify and flag discrepancies, overpayments, underpayments, du...

Job Description: 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 IRs raised. Ensure that the claims are approved or denied as per the terms and conditions within the TAT. Provide supportive and positive experience to the new joiners and train them. Gather inputs from various sources and keep up-to-date on the new policies or changes in existing policies and intimate the Configuration team and the CRM team Manage a group of claim processors, guide and coach them...

HELLO JOB SEEKERS!! GREETINGS FROM SHININGSTARS!! ONLY GRADUATE FRESHERS AND GRADUATE EXPERIENCED CAN APPLY IMMEDIATE JOINERS ONLY. Are you ready to kickstart an exciting career with a dynamic multinational BPO in BANGALORE ? ShiningStars is on the lookout for enthusiastic individuals to join our team, and it could be YOU! PROFILE- CLAIMS ASSOCIATE PROCESS- BLENDED PROCESS LOCATION- BANGALORE ( KUNDANHALLI ). ROLES AND RESPONSIBILITIES- ELIGIBILITY- *Graduate Freshers / Experienced can only apply. *Minimum 2 years of experience is mandatory in Claims. *Freshers Must be from Commerce background. *Experience in voice or blended process is mandatory. *Communication Skills: Brilliant presentatio...

About The Role 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.Business solutions that...

About The Role 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.Business solutions that...

About The Role 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.Business solutions that...

About The Role 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.Business solutions that...

Role & responsibilities Claims Processing & Coordination Facilitate the Green Channel process to ensure zero waiting time for patient admissions and discharges. Support the end-to-end processing of cashless and reimbursement claims efficiently. Liaise with the Head Office to resolve claim-related issues promptly. Address and resolve patient grievances related to claims processing, escalating unresolved issues when necessary Collaborate with hospital staff to ensure seamless admission and discharge procedures for insured patients. Adhere to strict protocols to prevent fraudulent activities in claims processing. Enhance customer satisfaction by reducing waiting time for admissions, claims, and...

Greetings from NTT DATA, Clients business problem to resolve : At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees are key factors in our companys growth, market presence and our ability to help our clients stay a step ahead of the competition. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here.Clients Business problem to solve?Our Client is one of Leading Health Plan in US providing services in Florida state , NTT are getting into contract with Client to manage End to End Claims Administration services. O...

Mysore Shift: US Shift / Night Shift-Work from Office CTC: Up to 4 LPA Notice Period: 0–15 Days Min. 1 year in US Healthcare Claims B.Sc. (Science) background preferred Based in or willing to relocate to *Mysore* sravani.asarla@liveconnections.in

Position Summary The incumbent will be required to be a part of Operations function responsible for MetLife Global Capability Center and will be required to report to the Manager Operations of the MetLife Global Capability Center Job Responsibilities Essential Functions The key deliverables of the role will include but will not be restricted to the details below: Type of activities Work allocation Processing Reporting Meeting SLA including Performance guarantees Staffing Management Maintain regulatory compliance Customer interactions Basic Function Update & maintain day to day Workforce Management while ensuring decisional timeliness standards are met within the regulations Preparing, Report...

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 ...

Job Summary: We are seeking a qualified and experienced medical professional with a strong background in health insurance claim settlement and customer service . The ideal candidate will leverage their clinical knowledge to evaluate and process health insurance claims efficiently while ensuring a high level of customer satisfaction. This hybrid role bridges the gap between medical accuracy , regulatory compliance , and empathetic customer support . Key Responsibilities: Medical Review & Claims Adjudication: Assess and validate medical claims based on clinical documentation and policy coverage. Interpret diagnostic reports, treatment plans, and prescriptions to determine claim eligibility. Co...

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...

Role & responsibilities Handle claim submission, follow-up, and settlement with TPAs and government panels. Track outstanding payments and prepare periodic reconciliation reports. Coordinate with TPAs, insurance companies, and internal departments for claim clarifications. Maintain records of claims, payments, and rejections in both Excel and Tally. Post settlement entries, adjustments, and payment receipts in Tally. Prepare monthly outstanding and collection status reports for management review. Ensure timely submission of required documents for pending claims. Follow up on delayed or short payments and resolve discrepancies. Maintain communication logs and documentation for all settlement ...

Health Claims, Mass Claims & Provider Management, tpa Experience in HCP