646 Health Claims Jobs - Page 6

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 ...

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. Job Duties and Deliverables include, but are not limited to Constantly upgrading yourself on industry trends and claim procedures. Managing claim intimations and ensuring accurate registration of claims. Coordinating with AMCs for smooth claim processes and timely res...

4+ Years of Experience in US Healthcare Claims Adjudication Open Positions : Team Leader Operations Quality Specialist Subject Matter Expert (SME) Process Trainer Hari - 7618776218 Shiny -7022976218

HURRY UP !!! Urgent Hiring for US Healthcare Claims Adjudications. OPEN REQURIMENTS Team Leader Operations. Quality Specialist. Subject Matter Expert (SME). Process Trainer. International voice exp with 4+yrs Contact HR Maya 9880516218

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...

We are looking for Duty Medical Officer who has experince in Insurance Sector. Experience : Minimum of 1 year in Insurance Qualification : MBBS Interested kindly contact 7358189600

Role & responsibilities This role will need to partner with others inter-departmental teams in order to realize some of the outcomes About you: • The successful candidate should have excellent computer (PowerPoint, Excel and Word) skills, strong financial and analytic research skills, problem solving, and organizational skills as well as a commitment to quality, customer satisfaction and meeting of deadlines. • Previous experience in claims processing preferably in the Consumer Directed Health market with knowledge of HSA, FSA, HRA, DCA, and other Transit products. • Ability to work independently and collaboratively in a fast-paced environment. EDUCATION/EXPERIENCE • Bachelors/ master’s degr...

Role & responsibilities - Acts as an interface between the TPA, Insurance Company and the hospital. - Responsible for investigation of suspicious claims on calls & Emails. - 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) Preferred candidate profile Qualification - B Pharmacy / M Pharmacy Experience - 6 Months to 2 Years.

Role & responsibilities • Answer incoming customer calls in a professional and timely manner. • Assist customers with inquiries including medical claims and rejections. • Provide accurate and detailed information about claim procedures, documentation requirements, and coverage. • Investigate and resolve customer concerns, ensuring high levels of customer satisfaction. • Collaborate with internal departments, such as claims processing to address and resolve complex issues. • Maintain thorough and up-to-date knowledge of products, medical billing codes, and claim processes. • Document customer interactions and update customer records accurately in the system. • Identify and escalate critical o...

Role & responsibilities Coordinate with patients, TPAs, and insurance companies for pre-authorization, approval, and final claim settlements. Prepare and submit claim documents and bills to TPAs/insurance companies in the prescribed format. Follow up regularly with TPAs for claim status, pending queries, and settlement updates. Verify patient insurance details, coverage, and eligibility before admission and discharge. Maintain accurate and up-to-date records of all claims submitted and settled. Handle rejections, discrepancies, and short settlements by coordinating with relevant departments and TPAs. Ensure compliance with hospital policies and TPA/insurance requirements. Generate periodic r...

Role & responsibilities Asst. Billing Manager works under supervision of Head of Accounts & Finance Guide and mentor team Maintains billing controls by preparing and recommending policies and procedures. Maintains financial security by following internal controls. Prepares refunds by verifying documentation, and requesting refunds. Maintains customer confidence and protects operations by keeping financial information confidential. Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies. Accomplishes the result by performing the duty. Supervise, guide, train,...

Hiring Medical Officers - Doctors for non clinical profile. Must have experience in claims processing.

Role Summary: Responsible for end-to-end management of Group Personal Accident (GPA) claims within the health claims vertically. This is a non-medico role focused on operational excellence, stakeholder coordination. Please share resume at aparna@aceconsultants.in

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...

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...

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 ...

Will be responsible for leading & managing the overall operations & business development activities. This role requires strong leadership, operational excellence & client relationship skills to ensure smooth service delivery & business growth. Required Candidate profile Candidate MUST have experience in TPA *Operations Management *Business Development *Team Leadership *Compliance & Reporting *Client Relationship Management *Networking & Negotiation Skills

Key Responsibilities: 1. OPD & IPD Operations Management Supervise and streamline outpatient (OPD) and inpatient (IPD) services to ensure smooth patient flow and operational efficiency. Coordinate with clinical and non-clinical teams for timely and quality patient care. 2. Facility Management Oversee maintenance, cleanliness, safety, and functionality of all hospital facilities. Ensure availability of required medical and non-medical equipment. 3. Patient Satisfaction & Relations Monitor and improve patient satisfaction scores. Address and resolve patient complaints promptly and professionally. Implement patient feedback systems. 4. Hospital Operations & Administration Manage day-to-day hosp...

Hello Job Seekers, Greetings from ShiningstarsITPL !! We are hiring enthusiastic and detail-oriented professionals for our Claims Processing team in Bangalore. The role involves handling Property, Content Damage, Liability, and Injury claims with accuracy, compliance, and excellent customer service. Hiring for Claims Associate Location: Bangalore (Kundanhalli) Experience: Minimum 6 months (with all supporting documents) Qualification: Graduation Mandatory Salary: UPTO 4.2 LPA Shift: 9 Hours (5 Days Working) Cab Facility: Two-way cab available within 25 km radius Roles & Responsibilities Accurately capture and update claim files while maintaining compliance with company policies. Analyze fact...

1. General Insurance a Must. 2. Test Designing. 3. Test Execution. 4. Defect Management. 5. Understand client requirements, queries, issues and respond. 6. Providing Status as per set Governance to Lead &/or Client. 7. Raising Issues/Risks and providing Mitigation/Solution. 8. Candidate should have either Commercial (GC) or Health Claims Experience.

Medical Officer (MBBS/BAMS/BHMS) at Good Health Insurance TPA. Responsible for cashless request processing, claim review, ICD coding, and policy adherence. Freshers can apply. Strong medical knowledge and computer skills required. 91212 46809

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...

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 ...

HIRING FRESHERS ALSO Role & responsibilities Medical Adjudication of Health Claims Identifying Frauds Adhering to SLAs and processing the claims within the TAT as per policy Support CRM, provider, sales and grievance team QUALIFICATION - MBBS, BAMS AND BHMS ONLY. Rest won't be considered. Work from Office only. Candidate should be comfortable with Roaster timings.

Looking for fresh BAMS, BHMS graduates to join our Claims Processing team. This role involves reviewing medical documents and helping process health insurance claims (cashless/reimbursement) as per policy guidelines.