INTEGRUM OUTSOURCE SOLUTIONS PVT LTD

14 Job openings at INTEGRUM OUTSOURCE SOLUTIONS PVT LTD
US Health Care (Voice Process) - Night Shift - Freshers Only Navi Mumbai, Maharashtra 0 years INR Not disclosed On-site Full Time

Job Title: Provider Support (Inbound Voice Process) Department: Operations Employment Type: Full-Time Reports To: Team Manager Company: Integrum Outsource Solutions Private Limited Work Shift: Night Shift Eligibility: Only Male Candidates (Boundaries: Thane to Panvel) Job Summary: We are seeking a skilled and experienced Provider Support (Associate/Specialist/Executive) for our Inbound Voice Process . The role involves providing eligibility, benefits, and claim status support via calls, ensuring high-quality service, and adhering to compliance standards. Key Responsibilities: Analyze, review, and adjudicate provider claims. Resolve medical claims by approving or denying documentation, calculating benefit amounts, and initiating payments/denials. Ensure compliance with company policies, state and federal regulations, and client guidelines. Review claims to verify cost reasonability and medical necessity. Identify and report overpayments, underpayments, and other discrepancies. Communicate with reinsurance brokers for claim processing information. Verify member eligibility, benefit coverage, and authorization requirements. Utilize domain knowledge to solve problems and improve workflows. Maintain HIPAA compliance and protect confidential claim information. Provide process improvement suggestions and update documentation accordingly. Perform administrative duties as assigned. Required Qualifications: Experience & Skills - Freshers with excellent communication skills with interest = in Medical Billing (RCM), International Calling, Claim Processing, or Denial Management (A.R) can apply. Typing speed of at least 30 WPM. Effective verbal and written communication skills. Active listening and ability to assess customer needs. Critical thinking and problem-solving skills. Work Environment & Benefits: Work from Office - Seawoods Darave, Navi Mumbai Drop Facility Available Competitive Salary - Rs. 20,000 to Rs. 25,000 Compliance & Adherence: Must comply with all company policies and procedures. Adherence to HIPAA regulations and healthcare compliance standards. If you meet the requirements and are looking for a challenging role in the healthcare industry, we invite you to apply and become part of our growing team! Job Type: Full-time Pay: ₹20,000.00 - ₹25,000.00 per month Schedule: Night shift Language: English (Required) Location: Navi Mumbai, Maharashtra (Required) Shift availability: Night Shift (Required) Work Location: In person

US Health Care (Voice Process) - Night Shift Navi Mumbai, Maharashtra 0 years INR 2.4 - 4.8 Lacs P.A. On-site Full Time

Job Title: Provider Support (Inbound Voice Process) Department: Operations Employment Type: Full-Time Reports To: Team Manager Company: Integrum Outsource Solutions Private Limited Work Shift: Night Shift Eligibility: Only Male Candidates (Boundaries: Thane to Panvel) Job Summary: We are seeking a skilled and experienced Provider Support (Associate/Specialist/Executive) for our Inbound Voice Process . The role involves providing eligibility, benefits, and claim status support via calls, ensuring high-quality service, and adhering to compliance standards. Key Responsibilities: Analyze, review, and adjudicate provider claims. Resolve medical claims by approving or denying documentation, calculating benefit amounts, and initiating payments/denials. Ensure compliance with company policies, state and federal regulations, and client guidelines. Review claims to verify cost reasonability and medical necessity. Identify and report overpayments, underpayments, and other discrepancies. Communicate with reinsurance brokers for claim processing information. Verify member eligibility, benefit coverage, and authorization requirements. Utilize domain knowledge to solve problems and improve workflows. Maintain HIPAA compliance and protect confidential claim information. Provide process improvement suggestions and update documentation accordingly. Perform administrative duties as assigned. Required Qualifications: Experience & Skills - Freshers with excellent communication skills with interest in Medical Billing (RCM), International Calling, Claim Processing, or Denial Management (A.R) can apply. Typing speed of at least 30 WPM. Effective verbal and written communication skills. Active listening and ability to assess customer needs. Critical thinking and problem-solving skills. Work Environment & Benefits: Work from Office - Seawoods Darave, Navi Mumbai Drop Facility Available Competitive Salary - Rs. 20,000 to Rs. 40,000 Compliance & Adherence: Must comply with all company policies and procedures. Adherence to HIPAA regulations and healthcare compliance standards. If you meet the requirements and are looking for a challenging role in the healthcare industry, we invite you to apply and become part of our growing team! Job Type: Full-time Pay: ₹20,000.00 - ₹40,000.00 per month Schedule: Night shift Language: English (Preferred) Location: Navi Mumbai, Maharashtra (Preferred) Shift availability: Night Shift (Required) Work Location: In person

US Health Care (Voice Process) - Night Shift Kohima 0 years INR 2.4 - 4.8 Lacs P.A. On-site Full Time

Job Title: Provider Support (Inbound Voice Process) Department: Operations Employment Type: Full-Time Reports To: Team Manager Company: Integrum Outsource Solutions Private Limited Work Shift: Night Shift Eligibility: Only Male Candidates (Boundaries: Thane to Panvel) Job Summary: We are seeking a skilled and experienced Provider Support (Associate/Specialist/Executive) for our Inbound Voice Process . The role involves providing eligibility, benefits, and claim status support via calls, ensuring high-quality service, and adhering to compliance standards. Key Responsibilities: Analyze, review, and adjudicate provider claims. Resolve medical claims by approving or denying documentation, calculating benefit amounts, and initiating payments/denials. Ensure compliance with company policies, state and federal regulations, and client guidelines. Review claims to verify cost reasonability and medical necessity. Identify and report overpayments, underpayments, and other discrepancies. Communicate with reinsurance brokers for claim processing information. Verify member eligibility, benefit coverage, and authorization requirements. Utilize domain knowledge to solve problems and improve workflows. Maintain HIPAA compliance and protect confidential claim information. Provide process improvement suggestions and update documentation accordingly. Perform administrative duties as assigned. Required Qualifications: Experience & Skills - Freshers with excellent communication skills with interest in Medical Billing (RCM), International Calling, Claim Processing, or Denial Management (A.R) can apply. Typing speed of at least 30 WPM. Effective verbal and written communication skills. Active listening and ability to assess customer needs. Critical thinking and problem-solving skills. Work Environment & Benefits: Work from Office - Seawoods Darave, Navi Mumbai Drop Facility Available Competitive Salary - Rs. 20,000 to Rs. 40,000 Compliance & Adherence: Must comply with all company policies and procedures. Adherence to HIPAA regulations and healthcare compliance standards. If you meet the requirements and are looking for a challenging role in the healthcare industry, we invite you to apply and become part of our growing team! Job Type: Full-time Pay: ₹20,000.00 - ₹40,000.00 per month Schedule: Night shift Language: English (Preferred) Location: Navi Mumbai, Maharashtra (Preferred) Shift availability: Night Shift (Required) Work Location: In person

Tax Manager Navi Mumbai, Maharashtra 0 - 3 years INR 9.0 - 15.0 Lacs P.A. On-site Full Time

Experience: 2-3 years experience in US Accounting and Taxation Pay Scale: INR 9 lakhs to INR 15 lakhs Qualifications: CA or Equivalents About the Role: We are seeking a highly skilled and experienced Tax Manager to join our growing team. This role is crucial for tackling complex US tax issues, identifying strategic tax planning opportunities, and cultivating strong client relationships. You will be responsible for overseeing tax return preparation, tax planning, financial analysis, and other client services, working closely with our US counterparts. This position offers a significant opportunity to advance within the firm as we expand our specialized US taxation services. Key Responsibilities: Lead and manage the preparation and review of complex US business and individual income tax returns. Identify strategic tax planning and other consulting opportunities for clients. Cultivate and maintain strong client relationships, acting as a primary point of contact for tax-related queries. Perform in-depth financial analysis to support tax planning and compliance. Provide guidance and mentorship to junior tax professionals and Senior Accountants on tax-related matters. Collaborate across departments to deliver comprehensive solutions and a seamless client experience. Ensure strict adherence to all relevant US tax laws, regulations, and information security policies. Manage workload efficiently, including communication with multiple managers and clients. Requirements: Chartered Accountant (CA) or an equivalent professional qualification. 2-3 years of direct experience in US accounting and taxation, including experience with US tax return preparation (e.g., ProSeries, ProSystems, Lacerte software knowledge is a bonus). In-depth knowledge of US tax laws and regulations. Proven ability to manage and track complex tax workloads. Excellent communication skills, both written and verbal, for client interaction and internal collaboration. Strong analytical and problem-solving abilities. Ability to work independently and as a leader within a team. Proficiency in Microsoft Excel is a must Job Type: Full-time Pay: ₹900,000.00 - ₹1,500,000.00 per year Schedule: Day shift Monday to Friday Location: Navi Mumbai, Maharashtra (Preferred) Work Location: In person

Senior Accountant Navi Mumbai, Maharashtra 0 - 10 years INR 4.0 - 5.0 Lacs P.A. On-site Full Time

Experience: 5-10 years experience Pay Scale: INR 4 lakhs to INR 7.5 lakhs Qualifications: B.Com, M.Com, MBA, CA Dropouts, or Equivalents About the Role: We are looking for an experienced and proactive Senior Accountant to play a pivotal role in our outsourced accounting and US taxation services. In this position, you will guide and manage the work of Junior Accountants, finalize accounting records, and perform basic tax preparation. This role offers a unique opportunity to grow and develop, building general accounting knowledge and gaining exposure to specialized industry taxation within our firm as we continue to expand. Key Responsibilities: Supervise and mentor Junior Accountants, ensuring accuracy and efficiency in their tasks. Review and finalize accounting entries and financial statements. Perform basic US tax preparation work for businesses and individuals. Manage and track workload efficiently, including communication with multiple managers. Communicate effectively with clients for information intake, follow-up on missing documentation, and general questions. Collaborate with other team members to deliver exceptional client service. Ensure adherence to all relevant information security policies and procedures, safeguarding sensitive data. Requirements : Bachelor's or Master's degree in Commerce (B.Com/M.Com), MBA, CA Dropout, or an equivalent qualification. 5-10 years of experience in accounting, with a focus on general ledger management and financial reporting. Working knowledge of Microsoft Excel is a must. Experience with accounting software. Strong understanding of accounting principles and practices. Excellent communication and interpersonal skills. Ability to work independently as a self-starter and collaboratively as part of a team. Prior experience with US accounting or taxation is a plus. Job Type: Full-time Pay: ₹400,000.00 - ₹500,000.00 per year Schedule: Day shift Monday to Friday Location: Navi Mumbai, Maharashtra (Preferred) Work Location: In person

Manager - U.S. Taxation Navi Mumbai, Maharashtra 0 - 3 years INR 18.0 - 25.0 Lacs P.A. On-site Full Time

Job Title : Manager - U.S. Taxation Company :Dectree Infotech Pvt Ltd (DTC India) Location : Navi Mumbai Job Type : Full-time and In-Office Experience : 5–10 years Salary: Commensurate Work Hours : 9:00 AM – 6:00 PM IST Work Days : Monday to Friday About the Company: Dectree Infotech Pvt Ltd (DTC India) is a subsidiary and offshore development center of DTC LLC, USA. We are launching a new venture in U.S. Taxation and Accounting , and are currently in the startup phase. As we build our team from the ground up, we are looking for multiple skilled professionals who are ready to embrace the dynamics of a startup culture and contribute meaningfully to the Company. Job Overview: The role requires deep experience in the preparation and review of individual and business U.S. income tax returns, along with providing tax planning and compliance support while ensuring adherence to U.S. tax laws and regulations. The candidate will be primarily responsible for managing client accounts, gathering, validating, and evaluating client information, generating tax compliance deliverables, and ensuring quality control. The candidate will also serve as a key point of contact for the U.S. team. Key Responsibilities: · Prepare and review U.S. Federal, State, and Local income tax returns, including but not limited to individuals (Form 1040), partnerships (Form 1065), C corporations (Form 1120), and S corporations (Form 1120S) . · Handle end-to-end tax compliance and ensure alignment with IRS regulations and state tax codes. · Meet the client deliverables as per the scope of the work and deadlines set and maintain quality of all deliverables. · Prepare detailed workpapers and maintain comprehensive documentation supporting all returns filed. · Provide review and quality checks of returns prepared by junior staff. · Maintain updated knowledge of U.S. tax laws and changes impacting compliance. · Strong written / verbal communication skills, analytical, interpersonal, problem -solving ability and attention to detail. · Strong proficiency and high level of comfort working with new and emerging technologies Qualifications: · A Bachelor’s or Master’s degree in commerce / MBA in Accounting, Finance, or related discipline. · CA, Certified Enrolled Agent (EA), or CPA (U.S.) would be preferred but not required · Experience in U.S. Tax Accounting is essential and Exposure to Federal, State, and International tax compliance. · Minimum of 5–10 years of hands-on experience in U.S. Corporate and Partnership Income Tax · Familiarity with ProSeries , ProSystem tax and Lacerte software would be an added advantage. Skills & Attributes: · Strong written / verbal communication skills is a must. · Ability to read, interpret and apply the tax legislation. · Successfully delegate work to all levels of staff. · Help the team to meet the goals as set as per dashboard. · Maintain an educational program to continually develop skills. · Ability to support recruitment activity and train new joiners on key concepts and technologies · People management skills with demonstrated ability to build a transparent and cohesive teamwork. · Team player with leadership qualities and a proactive work ethic. · Ability to work independently in a startup environment, manage multiple projects, and meet deadlines. Why Join Us: · Be part of an exciting new venture with direct exposure to U.S. clients. · Opportunity to work in a startup environment with high learning and growth potential. · Collaborative work culture with long-term career progression opportunities. Job Types: Full-time, Permanent Pay: ₹1,800,000.00 - ₹2,500,000.00 per year Experience: US Taxation: 3 years (Preferred) Location: Navi Mumbai, Maharashtra (Preferred) Work Location: In person

US Health Care (Voice Process) - Night Shift navi mumbai, maharashtra 0 years INR 2.4 - 4.8 Lacs P.A. On-site Full Time

Job Title: Provider Support (Inbound Voice Process) Department: Operations Employment Type: Full-Time Reports To: Team Manager Company: Integrum Outsource Solutions Private Limited Work Shift: Night Shift Eligibility: Only Male Candidates (Boundaries: Thane to Panvel) Job Summary: We are seeking a skilled and experienced Provider Support (Associate/Specialist/Executive) for our Inbound Voice Process . The role involves providing eligibility, benefits, and claim status support via calls, ensuring high-quality service, and adhering to compliance standards. Key Responsibilities: Analyze, review, and adjudicate provider claims. Resolve medical claims by approving or denying documentation, calculating benefit amounts, and initiating payments/denials. Ensure compliance with company policies, state and federal regulations, and client guidelines. Review claims to verify cost reasonability and medical necessity. Identify and report overpayments, underpayments, and other discrepancies. Communicate with reinsurance brokers for claim processing information. Verify member eligibility, benefit coverage, and authorization requirements. Utilize domain knowledge to solve problems and improve workflows. Maintain HIPAA compliance and protect confidential claim information. Provide process improvement suggestions and update documentation accordingly. Perform administrative duties as assigned. Required Qualifications: Experience & Skills - Freshers with excellent communication skills with interest in Medical Billing (RCM), International Calling, Claim Processing, or Denial Management (A.R) can apply. Typing speed of at least 30 WPM. Effective verbal and written communication skills. Active listening and ability to assess customer needs. Critical thinking and problem-solving skills. Work Environment & Benefits: Work from Office - Seawoods Darave, Navi Mumbai Drop Facility Available Competitive Salary - Rs. 20,000 to Rs. 40,000 Compliance & Adherence: Must comply with all company policies and procedures. Adherence to HIPAA regulations and healthcare compliance standards. If you meet the requirements and are looking for a challenging role in the healthcare industry, we invite you to apply and become part of our growing team! Job Type: Full-time Pay: ₹20,000.00 - ₹40,000.00 per month Language: English (Preferred) Location: Navi Mumbai, Maharashtra (Preferred) Shift availability: Night Shift (Required) Work Location: In person

US Health Care (Voice Process) - Night Shift navi mumbai, maharashtra 0 years INR 0.2 - 0.4 Lacs P.A. On-site Full Time

Job Title: Provider Support (Inbound Voice Process) Department: Operations Employment Type: Full-Time Reports To: Team Manager Company: Integrum Outsource Solutions Private Limited Work Shift: Night Shift Eligibility: Only Male Candidates (Boundaries: Thane to Panvel) Job Summary: We are seeking a skilled and experienced Provider Support (Associate/Specialist/Executive) for our Inbound Voice Process . The role involves providing eligibility, benefits, and claim status support via calls, ensuring high-quality service, and adhering to compliance standards. Key Responsibilities: Analyze, review, and adjudicate provider claims. Resolve medical claims by approving or denying documentation, calculating benefit amounts, and initiating payments/denials. Ensure compliance with company policies, state and federal regulations, and client guidelines. Review claims to verify cost reasonability and medical necessity. Identify and report overpayments, underpayments, and other discrepancies. Communicate with reinsurance brokers for claim processing information. Verify member eligibility, benefit coverage, and authorization requirements. Utilize domain knowledge to solve problems and improve workflows. Maintain HIPAA compliance and protect confidential claim information. Provide process improvement suggestions and update documentation accordingly. Perform administrative duties as assigned. Required Qualifications: Experience & Skills - Freshers with excellent communication skills with interest in Medical Billing (RCM), International Calling, Claim Processing, or Denial Management (A.R) can apply. Typing speed of at least 30 WPM. Effective verbal and written communication skills. Active listening and ability to assess customer needs. Critical thinking and problem-solving skills. Work Environment & Benefits: Work from Office - Seawoods Darave, Navi Mumbai Drop Facility Available Competitive Salary - Rs. 20,000 to Rs. 40,000 Compliance & Adherence: Must comply with all company policies and procedures. Adherence to HIPAA regulations and healthcare compliance standards. If you meet the requirements and are looking for a challenging role in the healthcare industry, we invite you to apply and become part of our growing team! Job Type: Full-time Pay: ₹20,000.00 - ₹40,000.00 per month Language: English (Preferred) Location: Navi Mumbai, Maharashtra (Preferred) Shift availability: Night Shift (Required) Work Location: In person

US Health Care (Voice Process) - Night Shift navi mumbai, maharashtra 0 years INR 0.2 - 0.4 Lacs P.A. On-site Full Time

Job Title: Provider Support (Inbound Voice Process) Department: Operations Employment Type: Full-Time Company: Integrum Outsource Solutions Private Limited Work Shift: Night Shift Eligibility: Only Male Candidates Job Summary: We are seeking a skilled and experienced Provider Support (Associate/Specialist/Executive) for our Inbound Voice Process . The role involves providing eligibility, benefits, and claim status support via calls, ensuring high-quality service, and adhering to compliance standards. Key Responsibilities: Handle inbound calls from healthcare providers regarding claims, eligibility, andbenefits. Verify member eligibility, benefit coverage, and authorization requirements. Maintain HIPAA compliance and protect confidential claim information. Perform administrative duties as assigned. Experience & Skills - Freshers with excellent communication skills with interest in Medical Billing (RCM), International Calling, Claim Processing, or Denial Management (A.R) can apply. Typing speed of at least 30 WPM. Effective verbal and written communication skills. Active listening and ability to assess customer needs. Critical thinking and problem-solving skills. Work Environment & Benefits: Work from Office - Seawoods Darave, Navi Mumbai Drop Facility Available Compliance & Adherence: Must comply with all company policies and procedures. Adherence to HIPAA regulations and healthcare compliance standards. If you meet the requirements and are looking for a challenging role in the healthcare industry, we invite you to apply and become part of our growing team! Job Type: Full-time Pay: ₹20,000.00 - ₹40,000.00 per month Language: English (Preferred) Location: Navi Mumbai, Maharashtra (Preferred) Shift availability: Night Shift (Required) Work Location: In person

CLAIM ADJUDICATION navi mumbai, maharashtra 1 years INR 2.16 - 3.0 Lacs P.A. On-site Full Time

Should possess U.S Health insurance claim processing experience Knowledge of medical billing and coding terminologies Ready to work in Night Shift as well as Day shift Understanding of plan documents and general benefits Familiarity with terms such as deductible, out of pocket, coinsurance, and copay Strong attention to detail and accuracy Ability to work in Microsoft word, Excel Process claims and ensure accuracy during testing of plan build Understand and analyze plan documents to determine benefits and coverage Ability to analyze, review and adjudicate provider claims Resolves medical claims by approving or denying documentation; calculates benefit amounts due; initiates payment and/or composes denial letter. Ensures the legal compliance of client policies, procedures, and guidelines, as well as legal compliance with state and federal regulations during the claim process. Review claims to determine if costs were reasonable and/ or medically necessary. Able to identify over-payments, underpayments and other irregularities in Processed claims. Verifying member eligibility, benefit coverage and researching or applying authorizations. Be able to integrate knowledge as a skilled specialist to solve problems and find new efficient workflows. Protects operations by keeping claims information confidential; must be HIPPAA compliant. Recognize areas of weakness, provide suggestions, and update documentation for process improvement. Perform general and administrative duties as assigned. Job Type: Full-time Pay: ₹18,000.00 - ₹25,000.00 per month Experience: US Health Insurance: 1 year (Required) Location: Navi Mumbai, Maharashtra (Required) Shift availability: Night Shift (Required) Day Shift (Required) Work Location: In person

CLAIM ADJUDICATION navi mumbai, maharashtra 0 - 1 years INR 0.18 - 0.25 Lacs P.A. On-site Full Time

Should possess U.S Health insurance claim processing experience Knowledge of medical billing and coding terminologies Ready to work in Night Shift as well as Day shift Understanding of plan documents and general benefits Familiarity with terms such as deductible, out of pocket, coinsurance, and copay Strong attention to detail and accuracy Ability to work in Microsoft word, Excel Process claims and ensure accuracy during testing of plan build Understand and analyze plan documents to determine benefits and coverage Ability to analyze, review and adjudicate provider claims Resolves medical claims by approving or denying documentation; calculates benefit amounts due; initiates payment and/or composes denial letter. Ensures the legal compliance of client policies, procedures, and guidelines, as well as legal compliance with state and federal regulations during the claim process. Review claims to determine if costs were reasonable and/ or medically necessary. Able to identify over-payments, underpayments and other irregularities in Processed claims. Verifying member eligibility, benefit coverage and researching or applying authorizations. Be able to integrate knowledge as a skilled specialist to solve problems and find new efficient workflows. Protects operations by keeping claims information confidential; must be HIPPAA compliant. Recognize areas of weakness, provide suggestions, and update documentation for process improvement. Perform general and administrative duties as assigned. Job Type: Full-time Pay: ₹18,000.00 - ₹25,000.00 per month Experience: US Health Insurance: 1 year (Required) Location: Navi Mumbai, Maharashtra (Required) Shift availability: Night Shift (Required) Day Shift (Required) Work Location: In person

US Health Care (Voice Process) - Night Shift navi mumbai,maharashtra 0 - 4 years INR Not disclosed On-site Full Time

You are applying for the position of Provider Support (Inbound Voice Process) at Integrum Outsource Solutions Private Limited. As a Provider Support Associate/Specialist/Executive, your role will involve handling inbound calls from healthcare providers regarding claims, eligibility, and benefits. You will be responsible for verifying member eligibility, benefit coverage, and authorization requirements, while maintaining HIPAA compliance and protecting confidential claim information. Additionally, performing administrative duties as assigned will be part of your responsibilities. Key Responsibilities: - Handle inbound calls from healthcare providers regarding claims, eligibility, and benefits. - Verify member eligibility, benefit coverage, and authorization requirements. - Maintain HIPAA compliance and protect confidential claim information. - Perform administrative duties as assigned. Qualifications Required: - Freshers with excellent communication skills with an interest in Medical Billing (RCM), International Calling, Claim Processing, or Denial Management (A.R) can apply. - Typing speed of at least 30 WPM. - Effective verbal and written communication skills. - Active listening and ability to assess customer needs. - Critical thinking and problem-solving skills. If you meet the requirements and are looking for a challenging role in the healthcare industry, we invite you to apply and become part of our growing team! Please note that the work location is in Seawoods Darave, Navi Mumbai, and a drop facility is available. You must comply with all company policies and procedures, as well as adhere to HIPAA regulations and healthcare compliance standards. The preferred language for this position is English, and night shift availability is required. Join us and be a part of our dedicated team providing exceptional support to healthcare providers.,

CLAIM ADJUDICATION maharashtra 1 - 5 years INR Not disclosed On-site Full Time

As a candidate for this position, you should possess U.S. health insurance claim processing experience and have knowledge of medical billing and coding terminologies. You should be willing to work in both night shifts and day shifts with a strong attention to detail and accuracy. Additionally, you should have the ability to work in Microsoft Word and Excel. Key Responsibilities: - Process claims and ensure accuracy during testing of plan build - Understand and analyze plan documents to determine benefits and coverage - Analyze, review, and adjudicate provider claims - Ensure legal compliance with client policies, procedures, and guidelines, as well as state and federal regulations during the claim process - Review claims to determine the reasonableness of costs and medical necessity - Verify member eligibility, benefit coverage, and research or apply authorizations - Integrate knowledge as a skilled specialist to solve problems and find new efficient workflows - Maintain confidentiality of claims information and ensure HIPAA compliance - Identify areas of weakness, provide suggestions, and update documentation for process improvement - Perform general administrative duties as assigned Qualifications Required: - 1 year of experience in U.S. Health Insurance - Location: Navi Mumbai, Maharashtra - Shift availability: Night Shift and Day Shift - Work Location: In person Please note that this is a full-time position that requires the ability to work in both night and day shifts at the specified location.,

US Health Care (Voice Process) - Night Shift - Freshers Only navi mumbai,maharashtra 0 - 4 years INR 6e-05 - 7e-05 Lacs P.A. On-site Full Time

As a Provider Support (Associate/Specialist/Executive) at Integrum Outsource Solutions Private Limited, you will be responsible for handling the Inbound Voice Process, specifically providing eligibility, benefits, and claim status support through calls. Your role involves ensuring high-quality service delivery and adherence to compliance standards. Key Responsibilities: - Analyze, review, and adjudicate provider claims. - Ensure compliance with company policies, state and federal regulations, and client guidelines. - Review claims for cost reasonability and medical necessity. - Communicate with reinsurance brokers for claim processing information. - Verify member eligibility, benefit coverage, and authorization requirements. - Utilize domain knowledge to solve problems and enhance workflows. - Maintain HIPAA compliance and safeguard confidential claim information. - Offer suggestions for process improvements and update documentation accordingly. - Perform assigned administrative duties. Required Qualifications: - Freshers with excellent communication skills and interest in Medical Billing (RCM), International Calling, Claim Processing, or Denial Management (A.R) are encouraged to apply. - Typing speed of at least 30 WPM. - Effective verbal and written communication skills. - Active listening and ability to assess customer needs. - Critical thinking and problem-solving skills. If you meet the above requirements and seek a challenging role in the healthcare industry, we welcome you to apply and join our expanding team. Work Environment & Benefits: - Work Location: Seawoods Darave, Navi Mumbai - Drop Facility Available - Competitive Salary Range: Rs. 20,000 to Rs. 25,000 Compliance & Adherence: - Must comply with all company policies and procedures. - Adherence to HIPAA regulations and healthcare compliance standards. Please note: This job requires full-time availability, night shift schedule, proficiency in English, and the ability to work in person at the Navi Mumbai, Maharashtra location.,