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0.0 - 1.0 years
2 - 6 Lacs
Navi Mumbai
Work from Office
Skill required: Operations Support - Pharmacy Benefits Management (PBM) Designation: Health Operations New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years Language - Ability: English(International) - Intermediate About Accenture Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. Visit us at www.accenture.com 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.The business processes, operations and interactions of third party administrators of prescription drug programs, understanding of the processes used to manage programs for payers, process and pay prescription drug claims, develop and maintain the formulary, contract with pharmacies and negotiate discounts and rebates with drug manufacturers. What are we looking for Ability to perform under pressureAdaptable and flexibleAbility to establish strong client relationshipWritten and verbal communicationPrioritization of workload Roles and Responsibilities: In this role you are required to solve routine problems, largely through precedent and referral to general guidelines Your primary interaction is within your own team and your direct supervisor In this role you will be given detailed instructions on all tasks The decisions that you make impact your own work and are closely supervised You will be an individual contributor as a part of a team with a predetermined, narrow scope of work Please note that this role may require you to work in rotational shifts Qualification Any Graduation
Posted 4 days ago
8.0 - 11.0 years
8 - 15 Lacs
Hyderabad
Work from Office
Cognizant is hiring Encounter Submission Specialist (US Healthcare) for Hyderabad location. Job Title: Team Manager Experience - 8 - 11 Years Job Location: Hyderabad (relocation benefits available for other location candidates) Mode of Work - Work from Office Shifts - Mid Shift - (1 PM IST to 11 PM IST) Candidates with 8 - 11 years of experience particularly from Encounter submission background US Healthcare Knowledge. E.g. Encounter, EDI, HIPAA, 837 Layout, insights into Medicare and Medicaid , Markets etc. Facets/QNXT or any other healthcare adjudication system knowledge will be an added advantage. SQL Server - SSIS or SSRS plus any Microsoft cloud technologies will be an added advantage. Analytical and Query Writing Skills (SQL) - Joint query, structured query, creating tables, running reports in SQL etc SQL Procedure and Packages, Debugging skills. Knowledge on any reporting tools or software e.g. Tableau or Power BI etc. Should be good at communication skills Interested, kindly share your updated resume to the below email pragya.shrivastav@cognizant.com
Posted 1 week ago
5.0 - 8.0 years
7 - 11 Lacs
Hyderabad
Work from Office
Cognizant is hiring Encounter Submission Specialist (US Healthcare) for Hyderabad location. Job Title: Team Leader Experience - 5 - 8 Years Job Location: Hyderabad (relocation benefits available for other location candidates) Mode of Work - Work from Office Shifts - Mid Shift - (1 PM IST to 11 PM IST) Candidates with 5 - 8 years of experience particularly from Encounter submission background US Healthcare Knowledge. E.g. Encounter, EDI, HIPAA, 837 Layout, insights into Medicare and Medicaid , Markets etc. Facets/QNXT or any other healthcare adjudication system knowledge will be an added advantage. SQL Server - SSIS or SSRS plus any Microsoft cloud technologies will be an added advantage. Analytical and Query Writing Skills (SQL) - Joint query, structured query, creating tables, running reports in SQL etc SQL Procedure and Packages, Debugging skills. Knowledge on any reporting tools or software e.g. Tableau or Power BI etc. Should be good at communication skills Interested, kindly share your updated resume to the below email pragya.shrivastav@cognizant.com
Posted 1 week ago
0.0 - 5.0 years
3 - 7 Lacs
Pune, Bengaluru, Mumbai (All Areas)
Work from Office
Job Title : AR Caller & US Healthcare Medical Billing RCM Specialist Job Description : We are seeking a skilled AR Caller & US Healthcare Medical Billing RCM Specialist to manage and optimize revenue cycle processes for our healthcare clients. The ideal candidate will handle accounts receivables, follow up on denied or unpaid claims, and work directly with insurance companies to resolve outstanding issues. The role requires a deep understanding of medical billing, claims processing, and insurance follow-up within the US healthcare system. Key Responsibilities : Manage accounts receivable, including timely follow-up on unpaid claims Call insurance companies to resolve denied or delayed claims Investigate and address claim rejections or underpayments Review and submit appeals for denied claims Maintain accurate documentation and reporting on claim statuses Collaborate with billing teams to improve revenue cycle processes Stay updated on payer rules, regulations, and changes in billing practices Qualifications : 1+ years of experience in US healthcare billing and RCM processes Familiarity with EOBs, denials, and insurance payer policies Excellent communication and negotiation skills Proficiency in medical billing software and MS Office Hiring for freshers salary 10.7k to 25k ( Depends on last drawn salary) Location- Mumbai *FOR EXPERIENCE CANDIDATES IN MEDICAL BILLING (Voice Process)* Salary upto 50k open for right candidate/ decent hike on last drawn/ Home Pickup and Home Drop facility provided. If travelling not taken then 4000 allowance provided. Us shift/ 5:30pm-2:30am Monday-Friday working / Saturday & Sunday Fixed Off. Location :- Navi Mumbai, Mumbai, Hyderbad, Banglore, Pune, Andheri, Turbhe Extra Perks: - Incentives - up to 5500 Overtime - per hour 150rs & If working on Saturday - Double Salary Preferred : Certification in Medical Billing and Coding or equivalent Experience with Medicare/Medicaid billing Location: Pune / Navi Mumbai / Bangalore / Andheri / Ghansoli / Airoli /Hyderabad Job Type : Full-time Contact Details. SR.HR Shreya - 9136512502
Posted 1 week ago
1.0 - 4.0 years
2 - 5 Lacs
Noida, Gurugram
Work from Office
R1 RCM India is proud to be recognized amongst India's Top 50 Best Companies to Work Fo2023 by Great Place To Work Institute. We are committed to transform the healthcare industry with our innovative revenue cycle management services. Our goal is to make healthcare simpler and enable efficiency for healthcare systems, hospitals, and physician practices. With over 30,000 employees globally, we are about 14,000 strong in India with offices in Delhi NCR, Hyderabad, Bangalore, and Chennai. Our inclusive culture ensures that every employee feels valued, respected, and appreciated with a robust set of employee benefits and engagement activities. Responsibilities: Follow up with the payer to check on claim status. Responsible for calling insurance companies in USA on behalf of doctors/physicians and follow up on outstanding accounts receivables. Identify denial reason and work on resolution. Save claim from getting written off by timely following up. Candidates must be comfortable with calling on denied claims. Interview Details: Interview Mode: Face-to-Face Interview Walk-in Day : 07-Jun-2025 (Saturday) Walk in Timings :11 AM to 3 PM Walk in Address: Candor Tech Space Tower No. 3, 6th Floor, Plot 20 & 21, Sector 135, Noida, Uttar Pradesh 201304 Desired Candidate Profile: Candidate must possess good communication skills. Only Immediate Joiners can apply & Candidate must be confortable with Gurgaon Location. Provident Fund (PF) Deduction is mandatory from the organization worked. B.Tech/B.E/LLB/B.SC Biotech aren't eligible for the Interview. Candidates not having Healthcare experience shouldnt have more than 24 Months Exp. Undergraduate with Min. 12 Months Exp is mandatory. Benefits and Amenities: 5 days working. Both Side Transport Facility and Meal. Apart from development, and engagement programs, R1 offers transportation facility to all its employees. There is specific focus on female security who work round-the-clock, be it in office premises or transport/ cab services. There is 24x7 medical support available at all office locations and R1 provides Mediclaim insurance for you and your dependents. All R1 employees are covered under term-life insurance and personal accidental insurance.
Posted 1 week ago
1.0 - 4.0 years
2 - 5 Lacs
Hyderabad
Work from Office
The AR Associate is responsible for the accounts receivable aspects of the client-focused revenue cycle operations and must display in-depth knowledge of and execute all standard operating procedures (SOPs) as well as communicating issues, trends, concerns and suggestions to leadership. Eligibility: Graduate with Minimum 1- 4 Years experience in Hospital Billing-Denial Management (RCM/AR Domain) & EPIC platform experience is an added advantage! Primary Responsibilities: Review outstanding insurance balances to identify and resolve issues preventing finalization of claim payment, including coordinating with payers, patients and clients when appropriate Analyze and trend data, recommending solutions to improve first pass denial rates and reduce age of overall AR Accounts Receivable Specialist that has an "understanding" of the whole accounting cycle / claim life cycle Ensure all workflow items are completed within the set turn-around-time within quality expectations Able to analyze EOBs and denials at a claim level in addition they should find trends impacting dollar and leading to process improvements Perform other duties as assigned Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so Role & responsibilities Must be a Graduate (10+2+3) Minimum 1-4 Years experience in Healthcare accounts receivable with (Denial Management) -Hospital Billing UB04 Solid knowledge of medical insurance (HMO, PPO, Medicare, Medicaid, Private Payers) In-depth working knowledge of the various applications associated with the workflows Must possess proven experience in Hospital Billing-UB04 If you are passionate about healthcare and meet the required criteria, we encourage you to attend and share this opportunity with your friends or colleagues who might be interested. Knowledge / Skills / Abilities: Solid knowledge and use of the American English language skills with neutral accent Ability to communicate effectively with all internal and external clients Ability to use good judgment and critical thinking skills; ability to identify and resolve problems Proficient in MS Office software; particularly Excel and Outlook Efficient and accurate keyboard/typing skills Solid work ethic and a high level of professionalism with a commitment to client/patient satisfaction Functional knowledge of HIPAA rules and regulations and experience related to privacy laws, access and release of information Interview Venue: Optum (UnitedHealth Group) aVance; Phoenix Infocity Private Ltd, SEZ 3rd floor, Site-5; Building No. H06A HITEC City 2, Hyderabad-500081 Date: 10-June-2025 Time: 11:00 AM Point Of Contact: Lakshmi Deshapaka Email: deshapaka_vijayalakshmi1@optum.com Things to Carry: Updated resume Government-issued photo ID (e.g., Aadhaar, Passport, or Driver's License) Passport-size photographs (2) Looking forward to seeing you and your referrals at the drive! Please Note: Dress Code: Business Formals Entry will be allowed only after showing the physical copy of this interview invite Kindly Ignore if you have appeared for a walk-in drive with us in the last 30 Days & not open to night shifts If you have no experience in Hospital Billing-UB04
Posted 1 week ago
2.0 - 7.0 years
3 - 6 Lacs
Bangalore Rural, Chennai, Bengaluru
Work from Office
* Minimum of 2 years of experience in inpatient coding Hospital Billing * Knowledge of ICD-10-CM/PCS coding guidelines, medical terminology, anatomy, and physiology. * Specialty: Multispecialty Must be Knowing Denial Management Required Candidate profile * Expertise in Hospital Billing (UB04) * Strong understanding of UB04 claim forms and related processes * Good communication skills * Open for Night Shift or rotational shift
Posted 1 week ago
1.0 - 6.0 years
1 - 4 Lacs
Chennai
Work from Office
Dear Aspirants, Warm Greetings!! We are hiring for the following details, Position: - AR Analyst - Charge Entry & Charge QC - Payment posting Salary: Based on Performance & Experienced Exp : Min 1 year Required Joining: Immediate Joiner / Maximum 10 days NB: Freshers do not apply Work from office only (Direct Walkins Only) Monday to Friday ( 10 am to 6 pm ) Everyday contact person VIBHA HR ( 9043585877 ) Interview time (10 am to 6 pm) Bring 2 updated resumes Refer( HR Name VIBHA ) Mail Id : vibha@novigoservices.com Call / Whatsapp (9043585877) Refer HR VIBHA Location : Chennai , Ekkattuthangal Warm Regards, HR Recruiter VIBHA Novigo Integrated Services Pvt Ltd,Sai Sadhan, 1st Floor, TS # 125, North Phase,SIDCOIndustrial Estate, Ekkattuthangal, Chennai 32 Contact details:- VIBHA HR vibha@novigoservices.com Call / Whatsapp ( 9043585877)
Posted 1 week ago
1.0 - 6.0 years
1 - 4 Lacs
Chennai
Work from Office
Dear Aspirants, Warm Greetings!! We are hiring for the following details, Position: - Payment - AR Analyst Salary: Based on Performance & Experienced Exp : Min 1 year Required Joining: Immediate Joiner / Maximum 10 days NB: Freshers do not apply Work from office only (Direct Walkins Only) Monday to Friday ( 11 am to 6 Pm ) Everyday contact person Vineetha HR ( 9600082835 ) Interview time (10 Am to 5 Pm) Bring 2 updated resumes Refer( HR Name Vineetha vs) Mail Id : vineetha@novigoservices.com Call / Whatsapp (9600082835) Refer HR Vineetha Location : Chennai , Ekkattuthangal Warm Regards, HR Recruiter Vineetha VS Novigo Integrated Services Pvt Ltd,Sai Sadhan, 1st Floor, TS # 125, North Phase,SIDCOIndustrial Estate, Ekkattuthangal, Chennai 32 Contact details:- HR Vineetha vineetha@novigoservices.com Call / Whatsapp ( 9600082835)
Posted 1 week ago
12.0 - 15.0 years
35 - 50 Lacs
Chennai
Work from Office
Job Summary We are seeking a Sr. Software Engineer with 12 to 15 years of experience in .NET + Entity Framework + Azure. The ideal candidate will have domain expertise in Medicare & Medicaid Claims Claims and Payer. This hybrid role requires a proactive individual who can contribute to our projects during day shifts. No travel is required. Responsibilities Develop and maintain software applications using .NET + Entity Framework + Azure to ensure high performance and reliability. Collaborate with cross-functional teams to design implement and test software solutions that meet business requirements. Provide technical guidance and mentorship to junior developers to foster a collaborative and productive work environment. Oversee the entire software development lifecycle from requirement analysis to deployment and maintenance. Ensure that all software solutions comply with industry standards and best practices particularly in the domain of Medicare & Medicaid Claims Claims and Payer. Troubleshoot and resolve complex technical issues to minimize downtime and ensure seamless user experience. Conduct code reviews to ensure code quality performance and security standards are met. Implement and maintain CI/CD pipelines to streamline the development and deployment process. Stay updated with the latest industry trends and technologies to continuously improve software solutions. Work closely with product managers and stakeholders to gather and understand requirements and translate them into technical specifications. Develop and execute unit tests to ensure code quality and functionality. Document software designs code and processes to ensure maintainability and knowledge sharing. Participate in agile development processes including sprint planning daily stand-ups and retrospectives. Qualifications Possess strong expertise in Azure and .Net Framework with a proven track record of successful project delivery. Have in-depth knowledge and experience in Medicare & Medicaid Claims Claims and Payer domains. Demonstrate excellent problem-solving skills and the ability to troubleshoot complex technical issues. Exhibit strong communication and collaboration skills to work effectively with cross-functional teams. Show proficiency in implementing and maintaining CI/CD pipelines. Have experience in conducting code reviews and ensuring adherence to coding standards. Display a proactive attitude towards learning and adopting new technologies and industry trends. Hold a Bachelors degree in Computer Science Engineering or a related field. Possess strong analytical skills and attention to detail. Demonstrate the ability to work independently and manage multiple tasks simultaneously. Show a commitment to delivering high-quality software solutions that meet business needs. Have experience in agile development methodologies. Exhibit strong documentation skills to ensure maintainability and knowledge sharing.
Posted 1 week ago
1.0 - 3.0 years
3 - 5 Lacs
Navi Mumbai
Work from Office
Skill required: Operations Support - Pharmacy Benefits Management (PBM) Designation: Health Operations Associate Qualifications: Bachelor of Pharmacy Years of Experience: 1 to 3 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.In Pharmacy Benefits Management, you will be responsible for the business processes, operations and interactions of third party administrators of prescription drug programs, understanding of the processes used to manage programs for payers, process and pay prescription drug claims, develop and maintain the formulary, contract with pharmacies and negotiate discounts and rebates with drug manufacturers. What are we looking for? Adaptable and flexible Ability to perform under pressure Problem-solving skills Results orientation Prioritization of workload Roles and Responsibilities: In this role you are required to solve routine problems, largely through precedent and referral to general guidelines Your expected interactions are within your own team and direct supervisor You will be provided detailed to moderate level of instruction on daily work tasks and detailed instruction on new assignments The decisions that you make would impact your own work You will be an individual contributor as a part of a team, with a predetermined, focused scope of work Please note that this role may require you to work in rotational shifts Qualifications Bachelor of Pharmacy
Posted 1 week ago
1.0 - 4.0 years
3 - 5 Lacs
Mumbai, Hyderabad, Chennai
Work from Office
|| We Are Hiring || AR Callers || Locations :- Hyderabad, Chennai & Mumbai || PHYSICIAN BILLING : Experience :- Min 1 year of experience into AR Calling - Physician Billing Package :- Up to 40K Take home Locations :- Hyderabad , Mumbai , Chennai, Noida & Gurugram Qualification :- Inter & Above Notice Period :- 0 - 20 days WFO HOSPITAL BILLING : Experience :- Min 1 year of experience into AR Calling - Hospital Billing Package :- Up to 43K Take home Locations :- Hyderabad , Mumbai , Chennai, Noida & Gurugram Qualification :- Inter & Above Notice Period :- Preferred Immediate Joiners WFO Perks and benefits Incentives Allowances 2 way Cab Interested candidates can share your updated resume to HR Dharani - 8341558673 mail id : dharanipalle.axishr@gmail.com (share resume via WhatsApp ) Refer your friend's / Colleague
Posted 1 week ago
2.0 - 7.0 years
4 - 9 Lacs
Hyderabad, Bengaluru, Delhi / NCR
Work from Office
We are Conducting Mega Job fair for Top 10 Companies for AR calling. Job Title: AR Caller (Accounts Receivable Caller) Department: Revenue Cycle Management / Medical Billing Location: Bangalore / Hyderabad / Chennai / Noida Job Type: Full-Time. Experience: 0 to 10 years Job Summary: We are seeking an AR Caller to follow up on outstanding insurance claims and ensure timely reimbursement. The ideal candidate will be responsible for calling insurance companies (payers) to verify claim status, resolve denials, and secure payment for services rendered. Key Responsibilities: Call insurance companies and follow up on pending claims. Understand and interpret Explanation of Benefits (EOB) and denial codes. Identify reasons for claim denials or delays and take appropriate actions. Resubmit claims or file appeals when necessary. Document all call-related information accurately and clearly. Work with billing teams to resolve billing issues. Meet daily productivity and quality targets. Stay updated on payer policies and healthcare regulations. Required Skills: Excellent communication skills (verbal and written) in English. Basic knowledge of the US healthcare system and insurance claim process. Attention to detail and analytical thinking. Familiarity with denial management and RCM workflow is a plus. Experience using billing software like Athena, NextGen, eClinicalWorks, or similar is a bonus. Qualifications: Bachelors degree preferred, but not mandatory. Prior experience in AR calling/medical billing is an advantage. Willingness to work night shifts (for US clients). contact Hiring Manager : Aditya - 9900024811 / 7259027295 / 7760984460 / 7259027282 9900024951
Posted 1 week ago
1.0 - 3.0 years
2 - 3 Lacs
Thane
Work from Office
HEALTHCARE AR PROCESS Thane Location Blended process DOJ - 3rd week of May 24*7 rotational shifts 2 rotational week offs Hsc/Graduate with minimum 6 months experience as AR - Medical billing (mandatory) Required Candidate profile Salary - 25k in hand (based on qualification and/or experience) HR-amcat-ops Follow updated Thane IBU transport boundaries
Posted 1 week ago
1.0 - 3.0 years
2 - 3 Lacs
Thane
Work from Office
HEALTHCARE AR PROCESS Thane Location Blended process DOJ - 3rd week of May 24*7 rotational shifts 2 rotational week offs Hsc/Graduate with minimum 6 months experience as AR - Medical billing (mandatory) Required Candidate profile Salary - 25k in hand (based on qualification and/or experience) HR-amcat-ops Follow updated Thane IBU transport boundaries
Posted 1 week ago
1.0 - 6.0 years
3 - 8 Lacs
Hyderabad, Bengaluru, Delhi / NCR
Work from Office
We are Conducting Mega Job fair for Top 10 Companies for AR calling. Job Title: AR Caller (Accounts Receivable Caller) Department: Revenue Cycle Management / Medical Billing Location: Bangalore / Hyderabad / Chennai / Noida Job Type: Full-Time / Part-Time Experience: 110 years. Job Summary: We are seeking an AR Caller to follow up on outstanding insurance claims and ensure timely reimbursement. The ideal candidate will be responsible for calling insurance companies (payers) to verify claim status, resolve denials, and secure payment for services rendered. Key Responsibilities: Call insurance companies and follow up on pending claims. Understand and interpret Explanation of Benefits (EOB) and denial codes. Identify reasons for claim denials or delays and take appropriate actions. Resubmit claims or file appeals when necessary. Document all call-related information accurately and clearly. Work with billing teams to resolve billing issues. Meet daily productivity and quality targets. Stay updated on payer policies and healthcare regulations. Required Skills: Excellent communication skills (verbal and written) in English. Basic knowledge of the US healthcare system and insurance claim process. Attention to detail and analytical thinking. Familiarity with denial management and RCM workflow is a plus. Experience using billing software like Athena, NextGen, eClinicalWorks, or similar is a bonus. Qualifications: Bachelors degree preferred, but not mandatory. Prior experience in AR calling/medical billing is an advantage. Willingness to work night shifts (for US clients). contact Hiring Manager : Aditya - 7259027282 / 7259027295 / 7760984460 / 9900024811 / 9686682465
Posted 1 week ago
0.0 - 5.0 years
3 - 7 Lacs
Pune, Chennai, Mumbai (All Areas)
Work from Office
AR Caller, Denial Management, Senior AR, Full-time, Permanent Candidates, Perks and Benefits Required Candidate profile Ub04, CMS1500, Epic, Cerner, Sorian, Athena. ***Candidates with minimum 6 months+ Experience with Hospital or Physician Billing into AR Calling is Preffered*** Perks and benefits Salary + Bonus, Cab pick and drop
Posted 1 week ago
1.0 - 6.0 years
1 - 4 Lacs
Chennai
Work from Office
Dear Aspirants, Warm Greetings!! We are hiring for the following details, Position: - AR Analyst - Charge Entry & Charge QC - Payment Posting Salary: Based on Performance & Experienced Exp : Min 1 year Required Joining: Immediate Joiner / Maximum 10 days NB: Freshers do not apply Work from office only (Direct Walkins Only) Monday to Friday ( 11 am to 5 Pm ) Everyday Contact person Nausheen HR( 9043004655) Interview time (11Am to 5 Pm) Bring 2 updated resumes Refer( HR Name - Nausheen Begum HR) Mail Id : nausheen@novigoservices.com Call / Whatsapp (9043004655) Refer HR Nausheen Location : Chennai , Ekkattuthangal Warm Regards, HR Recruiter Nausheen HR Novigo Integrated Services Pvt Ltd,Sai Sadhan, 1st Floor, TS # 125, North Phase,SIDCOIndustrial Estate, Ekkattuthangal, Chennai 32 Contact details:- HR Nausheen nausheen@novigoservices.com Call / Whatsapp ( 9043004655)
Posted 2 weeks ago
1.0 - 6.0 years
1 - 4 Lacs
Chennai
Work from Office
Dear Aspirants, Warm Greetings!! We are hiring for the following details, Position: - AR Analyst - Charge Entry & QC - Payment Salary: Based on Performance & Experienced Exp : Min 1 year Required Joining: Immediate Joiner / Maximum 10 days NB: Freshers do not apply Work from office only (Direct Walkins Only) Monday to Friday ( 11 am to 6 Pm ) Everyday contact person Vineetha HR ( 9600082835 ) Interview time (10 Am to 5 Pm) Bring 2 updated resumes Refer( HR Name Vineetha vs) Mail Id : vineetha@novigoservices.com Call / Whatsapp (9600082835) Refer HR Vineetha Location : Chennai , Ekkattuthangal Warm Regards, HR Recruiter Vineetha VS Novigo Integrated Services Pvt Ltd,Sai Sadhan, 1st Floor, TS # 125, North Phase,SIDCOIndustrial Estate, Ekkattuthangal, Chennai 32 Contact details:- HR Vineetha vineetha@novigoservices.com Call / Whatsapp ( 9600082835)
Posted 2 weeks ago
9.0 - 14.0 years
9 - 18 Lacs
Chennai
Work from Office
HCLTech Walk-in Drive for- 2nd &3rd of June 25 Timings: 11:00AM- 2:00PM Venue: 138, 602/3, Medavakkam High Road, Elcot Sez, Sholinganallur, Chennai, Tamil Nadu 600119. JOB SUMMARY We are seeking a highly skilled and detail-oriented Medical Coding Specialist with expertise in Durable Medical Equipment (DME) and Cardiology coding for the US healthcare market. This is an individual contributor role that demands precision, deep domain knowledge, and a commitment to compliance and quality. The ideal candidate will play a critical role in ensuring accurate coding, minimizing denials, and supporting revenue cycle integrity. KEY WORDS US Medical Coder, Certified Professional Coder (CPC), Certified Coding Specialist (CCS), AAPC / AHIMA certified, Individual Contributor, Specialist Coder, Remote Medical Coding, ICD-10-CM, CPT Coding, HCPCS Level II, EMR / EHR systems, Revenue Cycle Management, Medical Necessity Documentation, Coding Compliance, HIPAA Compliance, Denial Management, Coding Audits, Risk Adjustment Coding, Cardiology Coding, DME Coding (Durable Medical Equipment), Medicare & Commercial Insurance, US Healthcare Reimbursement. ESSENTIAL RESPONSIBILITIES : Perform accurate and timely coding of DME and Cardiology-related medical records using ICD-10-CM, CPT, and HCPCS Level II codes. Review clinical documentation to ensure coding reflects the services provided and supports medical necessity. Collaborate with physicians, billing teams, and auditors to resolve coding discrepancies and improve documentation quality. Stay updated with the latest coding guidelines, payer policies, and regulatory changes. Ensure compliance with HIPAA, CMS, and other applicable regulations. Participate in internal audits and contribute to continuous improvement initiatives. SKILLS AND COMPETENCIES Certification: CPC, CCS, or equivalent AAPC/AHIMA certification is mandatory. Experience: Minimum 35 years of hands-on coding experience in DME and Cardiology. Strong understanding of US healthcare reimbursement systems and payer-specific requirements. Proficiency in using EMR/EHR systems and coding software. Excellent analytical, communication, and problem-solving skills. Ability to work independently with minimal supervision. Expertise on coding guidelines and good knowledge on billing guidelines. FORMAL EDUCATION AND EXPERIENCE Graduation in any stream Experience with denial management and appeals. Exposure to coding audits and compliance reviews. Familiarity with Medicare and commercial insurance guidelines. Experience in managing customer relationship
Posted 2 weeks ago
1.0 - 6.0 years
2 - 6 Lacs
Pune
Work from Office
Walk-In Drive on 7th June 2025 at Cotiviti -Pune for Healthcare Audit Walk-In Date: 7-June-2025 (Saturday) Time 9:00 Am 1:00 Pm Venue: Cotiviti India Pvt Ltd Plot C, Podium Floor, Binarius/Deepak Complex, Opposite Golf Course, Yerwada, Pune- 411006. We are hiring for the Healthcare Data Audit process at Cotiviti. Please refer to the information below and required skill set for the same. POSITION SUMMARY: Specialist Payment Accuracy position is an entry level position responsible for auditing client data and validating claim accuracy. Communicates audit recommendations and outcomes to supervisory auditor for evaluation, verification and continuous learning. POSITION REQUIREMENTS: Graduation mandatory. Excellent communication skills. US Healthcare experience is preferred. Computer proficiency in Microsoft Office (Word, Excel, Outlook); Access preferred Strong interest in working with large data sets and various databases Must be flexible working in fixed/rotational shifts Immediate joiners preferred Good energy and Positive attitude Long Term Career Orientation If the above profile interests you then please walk-in for the interview. Please refer to the above mentioned walk-in details. Please bring your updated Resume along with an ID Proof. Best regards, Atish Chintalwar Senior Executive Human Resource COTIVITI About Cotiviti: Cotiviti is a leading healthcare solutions and analytics company headquartered in the United States, with more than 10000 employees in offices across the U U.S., Canada, Australia, India, Nepal, Philippines & Mexico. Cotiviti has been in business for more than two decades (including predecessor companies), and our solutions have been well proven and tested. Our clients are primarily health insurance companies, including U.S. government payers, although healthcare providers, employers, and insurance brokers also use our solutions. In fact, we support almost every major health plan in the U.S. and more than 180 healthcare payers in total. We focus on improving the financial and quality performance of our clients. In healthcare, this means taking in billions of clinical and financial data points, analyzing them, and helping our clients discover ways they can improve efficiency and quality. In addition to healthcare, we support the largest and most influential retailers in the industry, including mass merchandisers, across the U.S., Canada, United Kingdom, Europe and Latin America. Our data management recovery audit services have helped them save hundreds of millions of dollars.
Posted 2 weeks ago
6.0 - 11.0 years
6 - 13 Lacs
Hyderabad
Work from Office
Preferred candidate profile Strong Knowledge in US Health Care domain in all lines of business especially Encounters, EDI, HIPAA compliance, 837 layout, CMS Medicare and Medicaid guidelines Knowledge of QNXT or other healthcare claims adjudication systems SQL Server SSIS and SSRS plus any Microsoft cloud technologies will be added advantage Analytical and query writing ability (SQL is a MUST) SQL procedure and packages debugging skills Knowledge on any reporting tools or software e.g. Tableau or Power BI etc US Night shifts WFO Team management required on papers TL-Upto 11 LPA TM- Upto 15 LPA For more details please connect on below Chhavi Bhatt 8955611211 Chhavi.bhatt@manningconsulting.in
Posted 2 weeks ago
0.0 - 1.0 years
1 - 3 Lacs
Coimbatore
Work from Office
Job Summary Join our dynamic team as a Claims Processing Executive where you will play a crucial role in managing and processing Medicare Medicaid and Commercial claims. With a focus on accuracy and efficiency you will utilize your expertise in MS Excel to ensure seamless operations. This hybrid role offers night shifts providing flexibility and the opportunity to contribute to impactful healthcare solutions. Responsibilities Process Medicare Medicaid and Commercial claims with precision to ensure timely and accurate payments Utilize MS Excel to analyze and manage claim data enhancing operational efficiency Collaborate with team members to resolve claim discrepancies and improve processing workflows Maintain up-to-date knowledge of healthcare regulations and policies to ensure compliance Communicate effectively with stakeholders to provide updates and resolve issues related to claims Monitor claim processing metrics to identify areas for improvement and implement solutions Support the team in achieving departmental goals by contributing to process optimization initiatives Provide detailed reports on claim status and outcomes to management for strategic decision-making Assist in the development and implementation of best practices for claims processing Ensure high-quality service delivery by adhering to established protocols and guidelines Participate in training sessions to enhance skills and stay informed about industry changes Contribute to the companys mission by ensuring accurate and efficient claim processing impacting patient care positively Foster a collaborative work environment to achieve collective goals and enhance team performance Qualifications Demonstrate proficiency in MS Excel for data analysis and reporting Possess knowledge of Medicare Medicaid and Commercial claims processes Exhibit strong communication skills in English for effective stakeholder interaction Show attention to detail and problem-solving skills to manage claim discrepancies Display adaptability to work in a hybrid model with night shifts Have a proactive approach to learning and implementing industry best practices. Certifications Required Certified Professional Coder (CPC) or equivalent certification in healthcare claims processing.
Posted 2 weeks ago
3.0 - 6.0 years
8 - 12 Lacs
Hyderabad
Work from Office
Role Title: IT Project Management Associate Advisor - Integrated Solution Manager Position Summary: The Integrated Solutions Manager Associate Advisor will work with business, technology, and solution teams to develop artifacts that support the program’s overall long-term business objectives. This individual must possess a strong understanding of Cigna processes and capabilities across all integrated application/business work streams. & Responsibilities : Provides counsel and advice to top management on significant Integrated Solution matters, often requiring coordination between organizations. Responsible for managing, directing, and planning multiple complex projects, or occasionally one highly complex project, consisting of one or more project teams. Responsible for coordinating, scheduling, and assigning project tasks, team building, maintaining working relationships with client functional areas outside of IT. Applies project development methodologies and reporting techniques to indicate project status. May manage and direct one or more project teams of project managers, specialists, analysts, and programmers to meet complex project objectives. Reviews, evaluates, and formulates project plans, schedules, and budgets. Allocates staff and budget resources to meet changing corporate needs. Identifies and negotiates schedules, milestones and resources required to meet project objectives. Organizes and guides project operations using methodologies accepted by the industry. Evaluates and reports progress in terms of quality and performance metrics common to IT projects. Modifies schedules as required. Works with client departments to coordinate systems testing, installation, training, and support. Keeps informed of technical and managerial advances in IT. Focuses on providing thought leadership and technical expertise across multiple disciplines. Recognized internally as “the go-to person” for the most complex IT Project Management assignments. Work with the ISMs and system teams to plan technical Integrated, End-to-End and Regression Testing that aligns with the portfolio and program level epics. Participate in agile development and collaborate with developers and product managers to plan for testing. Leverage test management and execution tools including Jira and Zephyr. Oversee ISM work throughout test plan development and test execution to ensure that testing is on time and within budget. Measure and monitor progress and results during each test to ensure that the product is tested, validated, and demoed on time and within budget, and that it meets or exceeds expectations, including taking necessary corrective actions as needed. Ensure that the team follows the testing standards, guidelines, and testing methodology as agreed upon. Develop reusable automated test scripts and maintain their compatibility. Facilitate continuous improvement including identification and implementation of test automation. Be the first escalation point when issues arise within the integrated testing phase. Escalate to the Integration Solution Manager Practice Lead as necessary and appropriate if issues are unresolvable at their level. Ensure appropriate resources are assigned to projects with the right skillset and experience. Review test strategies for programs/projects to ensure they achieve the quality objectives that are defined. Serve as a subject matter expert in test management regardless of what methodology is used to execute. Communicate importance of and drive team’s compliance with Cigna policies and procedures. Manage oversight of ISM’s work activities and assignments throughout the integrated testing life cycle. Competencies / Skills: Strong technical test experience The ability to write a Program/Project Test Strategy and Program/Project Level Test Plan Deep understanding of technical requirements, portfolio, and program epics Ability to develop and manage all aspects of the technical testing effort, including plans, interdependencies, schedule, budget, tools, and required personnel. Good understanding of best testing practices and ability to provide feedback at technical reviews. Ability to document and communicate the status of testing progress against plans, taking corrective action as necessary. Ability to provide technical leadership to meet testing deadlines and objectives. Ability to review deliverables for completeness, quality, and compliance with established project standards. Expert level of Healthcare products, Commercial, Medicare/Medicaid Team Leadership & Development including ability to mentor, coach, and effectively transfer expertise to others. Ability to resolve conflict (striving for win-win outcomes); ability to execute with limited information and ambiguity. Ability to deal with organizational politics including ability to navigate a highly matrixed organization effectively. Strong Influencing skills (sound business and technical acumen as well as skilled at achieving buy-in for delivery strategies) Stakeholder management (setting and managing expectations) Strong business acumen including ability to effectively articulate business objectives. Analytical skills, Highly Focused, Team player, Versatile, Resourceful Ability to learn and apply quickly including ability to effectively impart knowledge to others. Effective under pressure Precise communication skills, including an ability to project clarity and precision in verbal and written communication and strong presentation skills. Strong problem-solving and critical thinking skills Experience Required: Experience providing mentoring/coaching to several individuals. Experience with managing vendor relationships. Experience with Agile delivery methodology. Qualified candidates will typically have 8 - 11 years of professional IT work experience and managing projects/initiatives. Experience Desired: Demonstrated experience establishing and delivering complex projects/initiatives within agreed upon parameters while achieving the benefits and/or value-added results. Demonstrated core project management skills including project planning, scope management, issue and risk management, resource planning, financial management, etc. Competencies: Manages Ambiguity Manages Conflict Collaborates Manages Complexity Resourcefulness Nimble Learning About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.
Posted 2 weeks ago
5.0 - 9.0 years
12 - 16 Lacs
Hyderabad
Work from Office
Role Title: IT Project Management Lead Analyst - Integrated Solution Manager Position Summary: The Integrated Solution Manager Lead Analyst is responsible for defining and supporting the building of the integrated test strategies and test plans those alignments with the portfolio and program epic needs over the product lifecycle. This individual will work with business, technology, and solution teams to develop artifacts that supports the program overall long-term business objective. This individual must possess a strong understanding of Cigna processes and capabilities across all integrated application/business work streams. & Responsibilities : The ISM drives the testing phases and delivers artifacts in conjunction with the test execution phases. Collaborates with project team during the Project Kickoff, PI Prep, Execution Sync and Test evidence reviews. Leads Test Execution phases. Test Execution is a phase of Integration testing which is coordinated by the ISM in conjunction with other QE test teams in order to prove that the proposed technical solution for the business need has been met. The activities handled during this timeframe are: Work with system teams to plan technical Integrated, End-to-End and Regression Testing that aligns with the portfolio and program level epics. Participate in agile development and collaborate with developers and product managers to plan for testing. Leverage test management and execution tools including Jira and Zephyr. Measure and monitor progress and results during each test to ensure that the product is tested, validated, and demoed on time and within budget, and that it meets or exceeds expectations, including taking necessary corrective actions as needed. Ensure that the team follows the testing standards, guidelines, and testing methodology as agreed upon. Develop reusable automated test scripts and maintain their compatibility. Facilitate continuous improvement including identification and implementation of test automation. Be the first escalation point when issues arise within the integrated testing phase. Escalate to the Integration Solution Manager Practice Lead as necessary and appropriate if issues are unresolvable at their level. Create test strategies for programs/projects to ensure they achieve the quality objectives that are defined. Serve as a subject matter expert in test management regardless of what methodology is used to execute. Communicate importance of and drive team’s compliance with Cigna policies and procedures. Competencies / Skills: Strong technical test experience The ability to write a Program/Project Test Strategy and Program/Project Level Test Plan Deep understanding of technical requirements, portfolio, and program epics Ability to develop and manage all aspects of the technical testing effort, including plans, interdependencies, schedule, budget, tools, and required personnel. Good understanding of best testing practices and ability to provide feedback at technical reviews. Ability to document and communicate the status of testing progress against plans, taking corrective action as necessary. Ability to provide technical leadership to meet testing deadlines and objectives. Ability to review deliverables for completeness, quality, and compliance with established project standards. Expert level of Healthcare products, Commercial, Medicare/Medicaid Ability to resolve conflict (striving for win-win outcomes); ability to execute with limited information and ambiguity Ability to deal with organizational politics including ability to navigate a highly matrixed organization effectively. Strong Influencing skills (sound business and technical acumen as well as skilled at achieving buy-in for delivery strategies) Stakeholder management (setting and managing expectations) Strong business acumen including ability to effectively articulate business objectives. Analytical skills, Highly Focused, Team player, Versatile, Resourceful Ability to learn and apply quickly including ability to effectively impart knowledge to others. Effective under pressure Precise communication skills, including an ability to project clarity and precision in verbal and written communication and strong presentation skills. Strong problem-solving and critical thinking skills Experience Required: Qualified candidates will typically have 5 - 8 years of professional IT work experience and managing projects/initiatives. Experience Desired: Demonstrated experience establishing and delivering complex projects/initiatives within agreed upon parameters while achieving the benefits and/or value-added results. Demonstrated core project management skills including project planning, scope management, issue and risk management, resource planning, financial management, etc. Experience with Agile delivery methodology. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.
Posted 2 weeks ago
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