Job Overview: We are seeking a detail-oriented and experienced Medical Claims Auditor to join our team. In this role, you will be responsible for conducting audits on medical claims to ensure accuracy, compliance with plan provisions, and adherence to federal and state regulations. Your expertise will help maintain quality assurance within the claims process, reduce errors, and support the financial integrity of our TPA operations. ______________________________________________________________________________________ Key Responsibilities: ● Perform pre-payment and concurrent audits on medical claims for self-funded and level-funded health plans. ● Verify claims for accuracy in coding (ICD-10, CPT, HCPCS) for the application of plan benefits. ● Review plan documents alongside claim codes to determine the proper benefit assignments. ● Collaborate with claims examiners, supervisors, and compliance teams to resolve discrepancies. ● Document audit findings, prepare detailed reports, and present outcomes to internal stakeholders. ● Ensure claims adhere to regulatory guidelines including HIPAA, ERISA, and other applicable federal/state requirements. ● Participate in internal quality assurance initiatives and continuous improvement efforts. ● Maintain confidentiality of sensitive member and provider information. ______________________________________________________________________________________ Required Qualifications: ● 3 years of experience in medical claims auditing, preferably in a US healthcare TPA or insurance environment. ● Strong knowledge of medical terminology, coding systems (ICD-10, CPT, HCPCS), and claims forms (CMS-1500, UB-04). ● Familiarity with healthcare regulations including HIPAA, ERISA, and ACA. ● Proficiency in auditing tools, claim systems, and Microsoft Office Suite. ● Certifications such as CPC, CPMA, or CCS are mandatory. ● Excellent analytical, organizational, and communication skills. ______________________________________________________________________________________ Preferred Tools/Systems Experience: ● Claims adjudication platforms such as Trizetto, VBA, Plexis. ● EMR/EHR platforms and audit management systems. ______________________________________________________________________________________ Job Type: Full-time Pay: ₹700,000.00 - ₹1,000,000.00 per year Benefits: Health insurance Leave encashment Paid sick time Paid time off Provident Fund Schedule: Fixed shift Monday to Friday Night shift US shift Ability to commute/relocate: Mumbai Suburban, Maharashtra: Reliably commute or planning to relocate before starting work (Preferred) Education: Master's (Preferred) Experience: Medical coding: 5 years (Required) Medical Auditing: 3 years (Preferred) License/Certification: Medical Coding Certification (Preferred) Location: Mumbai Suburban, Maharashtra (Preferred) Shift availability: Night Shift (Required) Work Location: In person

Job Overview: We are hiring a skilled Customer Support Executive to join our international voice team. You will handle customer queries mainly through phone calls, and occasionally via email and chat. The role demands excellent English communication, a problem-solving mindset, and the ability to multitask in a fast-paced environment. Key Responsibilities: Interact with customers over inbound/outbound calls, email, and chat to resolve queries or issues. Maintain a professional tone, clear communication, and customer-friendly approach at all times. Document interactions accurately and follow the escalation process when required. Manage tasks efficiently and prioritize workload to meet service standards. Ensure customer satisfaction by delivering timely and effective solutions. Required Experience & Skills: Minimum 2 years of experience in an international voice process (BPO/KPO). Strong fluency in English (spoken and written). Comfortable working in US night shifts . Experience in managing both voice and written communication platforms. Preferred Skills: Background in insurance or related international support domains is a plus. Familiarity with tools like CRM or ticketing systems. Good analytical thinking and ability to handle pressure while multitasking. Job Type: Full-time Pay: Up to ₹500,000.00 per year Benefits: Health insurance Leave encashment Paid sick time Paid time off Provident Fund Schedule: Evening shift Fixed shift Monday to Friday Night shift US shift Ability to commute/relocate: Malad, Mumbai, Maharashtra: Reliably commute or planning to relocate before starting work (Preferred) Education: Bachelor's (Preferred) Experience: International voice process: 2 years (Preferred) Customer service/support: 2 years (Preferred) Location: Malad, Mumbai, Maharashtra (Preferred) Shift availability: Night Shift (Preferred) Overnight Shift (Preferred) Work Location: In person Speak with the employer +91 8210791433

Job Overview: We are hiring a skilled Customer Support Executive to join our international voice team. You will handle customer queries mainly through phone calls, and occasionally via email and chat. The role demands excellent English communication, a problem-solving mindset, and the ability to multitask in a fast-paced environment. Key Responsibilities: Interact with customers over inbound/outbound calls, email, and chat to resolve queries or issues. Maintain a professional tone, clear communication, and customer-friendly approach at all times. Document interactions accurately and follow the escalation process when required. Manage tasks efficiently and prioritize workload to meet service standards. Ensure customer satisfaction by delivering timely and effective solutions. Required Experience & Skills: Minimum 2 years of experience in an international voice process (BPO/KPO). Strong fluency in English (spoken and written). Comfortable working in US night shifts . Experience in managing both voice and written communication platforms. Preferred Skills: Background in insurance or related international support domains is a plus. Familiarity with tools like CRM or ticketing systems. Good analytical thinking and ability to handle pressure while multitasking. Job Type: Full-time Pay: Up to ₹500,000.00 per year Benefits: Health insurance Leave encashment Paid sick time Paid time off Provident Fund Schedule: Evening shift Fixed shift Monday to Friday Night shift US shift Ability to commute/relocate: Malad, Mumbai, Maharashtra: Reliably commute or planning to relocate before starting work (Preferred) Education: Bachelor's (Preferred) Experience: International voice process: 2 years (Preferred) Customer service/support: 2 years (Preferred) Location: Malad, Mumbai, Maharashtra (Preferred) Shift availability: Night Shift (Preferred) Overnight Shift (Preferred) Work Location: In person Speak with the employer +91 8210791433

Job Overview: We are seeking a detail-oriented and experienced Sr. Medical Coder/Auditor to join our team. In this role, you will be responsible for conducting audits on medical claims to ensure accuracy, compliance with plan provisions, and adherence to federal and state regulations. Your expertise will help maintain quality assurance within the claims process, reduce errors, and support the financial integrity of our TPA operations. ______________________________________________________________________________________ Key Responsibilities: ● Perform pre-payment and concurrent audits on medical claims for self-funded and level-funded health plans. ● Verify claims for accuracy in coding (ICD-10, CPT, HCPCS) for the application of plan benefits. ● Review plan documents alongside claim codes to determine the proper benefit assignments. ● Collaborate with claims examiners, supervisors, and compliance teams to resolve discrepancies. ● Document audit findings, prepare detailed reports, and present outcomes to internal stakeholders. ● Ensure claims adhere to regulatory guidelines including HIPAA, ERISA, and other applicable federal/state requirements. ● Participate in internal quality assurance initiatives and continuous improvement efforts. ● Maintain confidentiality of sensitive member and provider information. ______________________________________________________________________________________ Required Qualifications: ● 5 plus years of experience in medical claims auditing, preferably in a US healthcare TPA or insurance environment. ● Strong knowledge of medical terminology, coding systems (ICD-10, CPT, HCPCS), and claims forms (CMS-1500, UB-04). ● Familiarity with healthcare regulations including HIPAA, ERISA, and ACA. ● Proficiency in auditing tools, claim systems, and Microsoft Office Suite. ● Certifications such as CPC, CPMA, or CCS are mandatory. ● Excellent analytical, organizational, and communication skills. ______________________________________________________________________________________ Preferred Tools/Systems Experience: ● Claims adjudication platforms such as Trizetto, VBA, Plexis. ● EMR/EHR platforms and audit management systems. ______________________________________________________________________________________ Job Type: Full-time Pay: ₹700,000.00 - ₹1,000,000.00 per year Benefits: Health insurance Leave encashment Paid sick time Paid time off Provident Fund Schedule: Evening shift Fixed shift Monday to Friday Night shift US shift Ability to commute/relocate: Mumbai Suburban, Maharashtra: Reliably commute or planning to relocate before starting work (Preferred) Education: Bachelor's (Required) Experience: Medical coding: 5 years (Required) Medical Auditing: 5 years (Preferred) License/Certification: Medical Coding Certification (Required) Location: Mumbai Suburban, Maharashtra (Preferred) Shift availability: Night Shift (Preferred) Overnight Shift (Preferred) Work Location: In person