23 Medical Claims Jobs

Greetings...!! We have the requirement for Client: I Space Software India Pvt Ltd Location: Madhapur ,Hyderabad Working Mode : WFO Time : 7:00 PM - 4:00 AM ( US Shifts ) Working Days : 5 Days ( Sat & Sun fixed Weekoff) F2F Interview JD: Experience in interacting with international US customers / Clients Experience on eligibility verification ( EBV) Awarenesson us health insuranceguidelinesthe claims submission process and procedures Analysisexplanation of benefits(EOB) forms toensure insurance companieshave paid for charges Followingup with the appropriateparties( insurancecompanies and patients ) to ensurebills are paid Understandand Analyzethe patient's records interacting the Physicians a...

The Accounts Receivable Caller, also known as AR Caller, is a crucial team member in the healthcare revenue cycle. Your primary responsibility will involve communicating with insurance companies and patients to effectively follow up on unresolved medical claims. You will need to navigate through intricate billing and coding procedures to guarantee accurate reimbursement for the healthcare services provided. As an AR Caller, you will be expected to initiate calls to insurance companies to resolve claims and conduct necessary follow-ups. You must also address any inquiries from patients regarding billing matters, ensuring that you provide them with clear and concise explanations. Collaborating...

You are a Senior Data Analyst in the Professional Services team at Analytical Wizards, located in Bangalore. Your role involves developing custom reports, conducting complex data analysis, and catering to client-specific data requirements. Your expertise in SQL, data manipulation, and healthcare analytics will be invaluable in delivering actionable insights and solutions. You will collaborate with internal teams and clients, ensuring data integrity, accuracy, and quality across all deliverables. Your responsibilities include developing and delivering custom data extracts and reports using SQL, Excel, and Python. You will analyze large-scale healthcare datasets to derive valuable insights and...

Role:AR Analyst( Medical Billing background) Exp: 0.6-1 year Salary: 18 - 20k Must Have : Denial management, Resolve issues related to unpaid medical claims. Shift:General Direct Walk-in NP: Immediate Location: Chennai Regards Sowmiya 8870213772

You will be joining our team as a Medical Claims Call Center Representative, bringing your highly motivated and experienced background in the medical field. Your main responsibility will involve handling inbound customer calls regarding claims and claim rejections. Providing exceptional customer service by effectively resolving customer inquiries and concerns will be your primary focus. Your duties will include answering incoming customer calls in a professional and timely manner, assisting customers with inquiries related to medical claims, and providing accurate information on claim procedures, documentation requirements, and coverage. You will investigate and resolve customer concerns, en...

Urgent Job Opening Quality Assurance, Quality Control, Clinical Research , Regulatory Affairs, Medical Record Summarization , Medical Claims , Medical Officer, Medical Billing , Pharmacist, ADL, ARD, FRD, CDM, Production, R&D , Lab Technician

Involved in Analyzing Medical Reports to Process Medical Claims. Processing/Approving Medical claim Scrutinizing medical documents Providing Medical opinions Medical Audit Checking the validation of Hospitalization.

Contact insurance companies in the US to follow up on unpaid or denied medical claims Review patient account information resolve denials or rejections Work on hospital billing claims Analyze denial codes, understand reason for denials Required Candidate profile Document update the system with call outcomes and next steps Ensure adherence to HIPAA guidelines internal quality std Meet daily and weekly targets for call volume resolution Communicate effectively Perks and benefits Perks and Benefits

Role:AR Analyst( Medical Billing background) Exp: 0.6-1 year Salary: 21k Must Have : Resolve issues related to unpaid medical claims, denied claims Review and appeal unpaid and denied claims. Shift:General Location: Chennai Regards Sowmiya 9600445623

Urgent Job Opening Quality Assurance, Quality Control, Clinical Research , Regulatory Affairs, Medical Record Summarization , Medical Claims , Medical Officer, Medical Billing , Pharmacist, ADL, ARD, FRD, CDM, Production, R&D , Lab Technician

Experience: 0-12 months Qualification: BDS, BHMS, BAMS Key Responsibilities: Good communication skill. Knowledge in computers like MS office. Good medical knowledge. Independently process Post hospitalization claims; process complex claims with minimal assistance Needs to validate the information on all medical claims received. Claims must be thoroughly reviewed and ensure that there is no missing or incomplete information Suggest operational policies, workflows and process improvement initiatives Proactive approach by informing Providers regarding missing or repetitive errors by various hospital departments and improvisation of the same. Applying medical and surgical aspects to scrutinize t...

Urgent Job Opening Clinical Research Associate , Quality Assurance, Quality Control, Regulatory Affairs, Medical Record Summarization , Medical Claims , Medical Officer, Medical Billing , Pharmacist, ADL, ARD,FRD, CDM, Production ,R&D ,Lab Technician

Urgent Job Opening Quality Assurance, Quality Control, Clinical Research , Regulatory Affairs, Medical Record Summarization , Medical Claims , Medical Officer, Medical Billing , Pharmacist, ADL, ARD, FRD, CDM, Production, R&D , Lab Technician

Hiring for UHG Process International BPO ???? Location: Andheri & Malad Process: UHG (Voice as applicable) Shift: US Shift / Night Shift Salary: Up to ?42,000 in-hand (depending on last drawn salary) Eligibility: Graduate Freshers & Experienced candidates can apply Excellent communication skills (written & verbal) Comfortable with night shifts Job Highlights: 5 days working, 2 days rotational week off Attractive salary with performance-based incentives Excellent work environment with growth opportunities Additional Information: Immediate joiners preferred Candidates must be comfortable working from office Benefits: Attractive salary package + incentives. 5-day work week with 2 rotational off...

Job description URGENT OPENING FOR MEDICAL OFFICER Workings Hours: 9 Hrs Work Mode : Office Key Responsibilities: Review and assess medical claims submitted by corporate clients against policy terms and medical guidelines. Analyze clinical documents such as medical reports, diagnostic tests, prescriptions, discharge summaries, and other relevant medical records. Verify the authenticity, appropriateness, and completeness of medical documentation related to claims. Provide medical expertise to determine the validity and admissibility of claims. Collaborate with claims processing and underwriting teams to resolve discrepancies or clarifications related to medical information. Identify potential...

Our reputed MNC Client is hiring for Nurse Reviewer role: Shift: 11:30 AM - 8:30 PM Work Mode: Work From Office (5 days) Location: Hyderabad Job Summary: We are seeking an experienced Nurse Reviewer to conduct in-depth claim reviews based on medical guidelines, clinical criteria, and billing rules. The ideal candidate will have a strong understanding of medical coding, clinical experience, and excellent communication skills. Key Responsibilities: - Conduct claim reviews to identify areas with savings potential - Review and validate charges against medical documentation - Contact medical providers to resolve billing inconsistencies - Manage claims reports and prioritize according to client st...

Immediate Job Openings for our Pharma Clients Job Profile Quality Assurance, Quality Control , CRA , R & D , Pharmacist , Medical Claims , Medical Record summarization , Medical Billing , Medical Writer , BDM , CDM , RA Production ,

Review and analyze insurance claims for accurate submission. Follow up with insurance companies via phone calls Resolve denied or unpaid claims Document call details Understand and interpret EOBs, denial codes, and claim adjustments. Required Candidate profile Excellent spoken English Knowledge of medical billing terminology (CPT, ICD-10, modifiers). Familiarity with US healthcare RCM cycle. Strong understanding of denial management and claim reprocessing. Perks and benefits Perks and Benefits

Provides clinical review expertise for high dollar and complex claims, including facility and professional bills. Provides cost containment services by identifying coding and billing errors and insuring application of Medical and Reimbursement Policies. Additionally identifies cases for potential fraud and abuse and makes referrals. Major Job Responsibilities Evaluates medical information against criteria, benefit plan, coverage policies and determines necessity for procedure and refers to Medical Director if criteria are not met Evaluate itemized bills against reimbursement policies Adheres to quality assurance standards Serves as a resource to facilitate understanding of products Handles s...

Medical Claims Review Senior Analyst/Clinical supervisor Complex Claim Unit Provides clinical review expertise for high dollar and complex claims, including facility and professional bills. Provides cost containment services by identifying coding and billing errors and insuring application of Medical and Reimbursement Policies. Additionally identifies cases for potential fraud and abuse and makes referrals. Major Job Responsibilities Evaluates medical information against criteria, benefit plan, coverage policies and determines necessity for procedure and refers to Medical Director if criteria are not met Evaluate itemized bills against reimbursement policies Adheres to quality assurance stan...

*Verify patient eligibility and ensure accurate documentation. *Process medical claims and coordinate with hospital billing. *Provide patient support and resolve queries related to the scheme. *Keep track of the number of patients enrolled in the scheme and monitor the status of their claims. *Report any issues or discrepancies regarding claims or registrations to the relevant authorities. *Collect all the documents of ECHS OPD Patients. *Prepare their Bills. *Upload all OPD documents on UTI. *Taking care of all ECHS OPD queries. *Taking all reception responsibilities in evening shift, on regular basis. *Co-ordinate with Visiting Consultants and Patients. *Fix the appointment with consultant...

Department: Revenue Cycle Management/Billing Reports To: Billing Manager/Director Summary: The Senior Claims Processing Specialist is responsible for the accurate and timely processing of healthcare claims, with a primary focus on resolving clearinghouse rejections and claim edits within the core billing system. This role requires in-depth knowledge of medical billing, coding, payer regulations, and electronic claims submission processes. The Senior Specialist identifies and resolves complex claim issues, provides guidance to junior team members, and ensures claims are submitted cleanly and efficiently to maximize reimbursement. Key Responsibilities: Claims Processing: Review and process hea...

Experience: 0-12 months Qualification: BDS, BHMS, BAMS Key Responsibilities: -Good communication skill. -Knowledge in computers like MS office. -Good medical knowledge. -Independently process Post hospitalization claims; process complex claims with minimal assistance -Needs to validate the information on all medical claims received. Claims must be thoroughly reviewed and ensure that there is no missing or incomplete information -Suggest operational policies, workflows and process improvement initiatives -Proactive approach by informing Providers regarding missing or repetitive errors by various hospital departments and improvisation of the same. -Applying medical and surgical aspects to scru...