40 Medical Claims Jobs - Page 2

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...