438 Medicare Jobs - Page 16

Role Title: IT Project Management Senior Analyst - Integrated Solution Manager Position Summary: The Integrated Solution Manager Senior 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 del...

Role TitleIT Project Management Advisor - Integrated Solution Manager Position Summary: The Integrated Solutions Manager 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, ...

Job Summary We are seeking an experienced Architect with 12 to 16 years of experience to join our team. The ideal candidate will have strong technical skills in Spring Boot Microservices and Java along with domain expertise in Medicare & Medicaid Claims Claims and Payer. This hybrid role requires a deep understanding of the healthcare industry and the ability to design and implement robust solutions. Responsibilities Lead the design and development of scalable and efficient software solutions using Spring Boot and Microservices. Oversee the implementation of Java-based applications to ensure high performance and responsiveness. Provide technical guidance and mentorship to the development tea...

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- 3 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 sol...

Job Summary We are seeking a dedicated Senior Process Executive - HC with 1 to 3 years of experience in Claims Adjudication. The ideal candidate will have expertise in Medicare and Medicaid Claims and it is advantageous if they also have experience in Commercial Claims. This is a work-from-home position with night shifts. Responsibilities Process and adjudicate Medicare and Medicaid claims efficiently and accurately. Ensure compliance with all relevant regulations and guidelines. Analyze and resolve claim discrepancies and issues promptly. Collaborate with team members to improve claim processing workflows. Maintain up-to-date knowledge of industry standards and changes. Provide exceptional ...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together Primary Responsibilities The coder will evaluate medical records to verify the plan of care for chronic medi...

Immediate Requirement Hospital Billing AR Caller / Sr. AR Caller Exp: 1 to 7yrs Salary: 42k Location: Bangalore Interested Candidate Plz Drop Updated CV to gayathri.srinivasan@geniehr.com or Ping me 7339094334

Role & responsibilities Accurately post all payments (electronic, checks, credit cards, etc.) to patient accounts in the billing system. Ensure all payments are applied to the correct accounts and invoices. Identify and resolve discrepancies between posted payments and actual deposits. Post adjustments, write-offs, and denials as per payer contracts and company policies. Identify trends in denials and underpayments and communicate findings to management. Identify billing errors and make necessary corrections to avoid claim denials. Ensure timely and accurate submission of claims to payers. Manage the resolution of denied claims by identifying root causes and correcting errors. Resubmit corre...

Follow up with payers to obtain claim status updates Identify reasons for denials and work towards resolution Must have Voice Experience Work on billing scrubbers and make necessary edits Handle contractual WhatsApp cv 7696517849 Required Candidate profile AR Caller With Experience for Hyderabad, Bangalore Night Shifts Cab Yes Excellent English Speaking WhatsApp cv 7696517849 Register For Call Back https://callcenterjobs.anejabusinessgroup.com/ Perks and benefits https://callcenterjobs.anejabusinessgroup.com/

HIRING - AR Callers ( PB & HB ) || Hyderabad, Chennai & Mumbai || Up to 40K Take home Experience :- Min 1 year of experience into AR Calling Package :- Up to 40K Take home Locations :- Hyderabad , Chennai & Mumbai Qualification :- Inter & Above Notice Period :- Preferred Immediate Joiners WFO HIRING - Payment Posting || Hyderabad || Up to 5 lpa Experience - Minimum 1.7 year (19 months ) of experience into Payment Posting Package - Upto 5lpa Location - Hyderabad Qualification: Graduation Notice Period - Preferred Immediate Joiners WFO HIRING - Pre Auth || Location :- Mumbai || Up to 4.6 LPA Experience :- Min 1 year of experience into Pre Auth Package :- Up to 4.6 LPA Locations :- Mumbai Quali...

MEDICAL CODER / MEDICAL BILLER Job Description We are looking for a detail-oriented and proactive Eligibility Executive to manage insurance verification and benefits validation for patients in the revenue cycle process. The ideal candidate will have experience working with U.S. healthcare insurance systems, payer portals, and EHR platforms to ensure accurate eligibility checks and timely updates for claims processing. Key Responsibilities Verify patient insurance coverage and benefits through payer portals, IVR, or direct calls to insurance companies. Update and confirm insurance details in the practice management system or EHR platforms accurately and in a timely manner. Identify policy lim...

Job Summary We are seeking an experienced Architect with 12 to 15 years of experience to join our team. The ideal candidate will have strong technical skills in React JS and Java along with domain expertise in Medicare and Medicaid Claims Claims and Payer. This hybrid role requires a proactive individual who can drive technical solutions and contribute to the companys mission of improving healthcare systems. Responsibilities Lead the design and development of scalable and efficient software solutions using React JS and Java Oversee the implementation of technical solutions that align with business requirements and industry standards Provide technical guidance and mentorship to the developmen...

Job Location : Hyderabad Qualification - Graduate Work mode Work from office Shift timing 1:00 PM IST to 12:00 AM IST Team leader - 12 lpa Team Manager - 15 lpa Notice 0-60 days US Health Care Domain Knowledge. E.g. Encounters, EDI, HIPAA, 837 Layout, insights into Medicare and Medicaid Markets etc. Facets or any other healthcare adjudication system knowledge will be added advantage. SQL Server SSIS and SSRS plus any Microsoft cloud technologies will be added advantage. Analytical and Query Writing Skills(SQL) SQL Procedure and Packages Debugging skills. Knowledge on any reporting tools or software e.g. Tableau or Power BI etc. PPT Presentations with client. Should be good at communication s...

We are seeking a Lead Business Analyst / Product Manager (Director of Execution) to define, drive, and deliver product innovation across our AI-driven analytics and risk adjustment platform. This is a high-impact hybrid role combining business analysis, product strategy, and project execution, ideal for a results-oriented professional with deep experience in US healthcare technology, product lifecycle management, and stakeholder engagement. You will act as the strategic link between engineering, clinical, and client teams, ensuring timely execution of product roadmaps and aligning delivery with market needs, client feedback, and organizational priorities. This position is critical in transla...

Roles & Responsibilities: Follow up with the payer to check on claim status. Identify denial reason and work on resolution. Save claim from getting written off by timely following up. Should have sound knowledge of working on Billing scrubbers and making edits. Work on Contractual adjustments & write off projects. Should have good Cash collected/Resolution Rate. Should have calling skills, probing skills and denials understanding. Work in all shifts on a rotational basis. No Planned leaves for next 6 months Requirements: Graduate in any discipline from a recognized educational institute. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Good communication Skills (bo...

Essential Duties and Responsibilities: Must be on current role of team handling for minimum 1.5 years Great knowledge AR/Credit up or end-to-end knowledge Should be aware of all type of payers. Must have good understanding of payer portal for benefits & denials. Should have great verbal and written communication skills, probing skills and denials understanding Open for night shift and WFO No Planned leaves for next 6 months. Qualifications: Graduate in any discipline from a recognized educational institute. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Good communication Skills (both written & verbal) . Skill Set: Candidate should be good Healthcare knowledge. C...

Roles & Responsibilities: Follow up with the payer to check on claim status. Identify denial reason and work on resolution. Save claim from getting written off by timely following up. Should have sound knowledge of working on Billing scrubbers and making edits. Work on Contractual adjustments & write off projects. Should have good Cash collected/Resolution Rate. Should have calling skills, probing skills and denials understanding. Work in all shifts on a rotational basis. No Planned leaves for next 6 months Requirements: Graduate in any discipline from a recognized educational institute. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Good communication Skills (bo...

Role Objective: To bill out medical accounts with accuracy within defined timelines and reduce rejections for payers. Essential Duties and Responsibilities: Process Accounts accurately basis US medical billing within defined TAT Able to process payer rejection with accuracy within defined TAT. 24*7 Environment, Open for night shifts Good analytical skills and proficiency with MS Word, Excel, and PowerPoint Qualifications: Graduate in any discipline from a recognized educational institute. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Good communication Skills (both written & verbal) Skill Set: Candidate should have good healthcare knowledge. Candidate should hav...

Role Objective: To bill out medical accounts with accuracy within defined timelines and reduce rejections for payers. Essential Duties and Responsibilities: Process Accounts accurately basis US medical billing within defined TAT Able to process payer rejection with accuracy within defined TAT. 24*7 Environment, Open for night shifts Good analytical skills and proficiency with MS Word, Excel, and PowerPoint Qualifications: Graduate in any discipline from a recognized educational institute. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Good communication Skills (both written & verbal) Skill Set: Candidate should have good healthcare knowledge. Candidate should hav...

Role Objective : Authorization Creation is a process where we need to coordinate with the nurses for decrypting the medical records & reports. Essential Duties and Responsibilities Interact with the US health insurance companies (Insurance Customer Care/Nurses/UM Team) Quality of Notation, Ability to read clinical documentation and data enter for payer requirements. 80%+ Calling will be involved (may vary site to site), should be open to Voice based work Would secure relevant information of Health Insurance of the patient. Work on Websites/Applications to perform the activity as per the SOP. Would be working in 6pm to 3 am & 9pm to 6am, Supporting US operations (in EST Zone) Should be Open t...

Role Objective Follow up is the most essential part in the RCM cycle. It is usually the last step in the cycle after cashposting. After Denial management (AR Follow up), again the cycle starts till the payment is made by the insurance company. Essential Duties and Responsibilities: Establishes and assures compliance with departmental policies and procedures in conformance with corporate policies and procedures. Manages people and drives retention Analysis data to identify process gaps, prepare reports Performance management First level of escalation Work in all shifts on a rotational basis Need to be cost efficient with regards to processes, resource utilization and overall constant cost man...

Role Objective: To bill out medical accounts with accuracy within defined timelines and reduce rejections for payers. Essential Duties and Responsibilities: Process Accounts accurately basis US medical billing within defined TAT Able to process payer rejection with accuracy within defined TAT. 24*7 Environment, Open for night shifts Good analytical skills and proficiency with MS Word, Excel, and PowerPoint Qualifications: Graduate in any discipline from a recognized educational institute. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Good communication Skills (both written & verbal) Skill Set: Candidate should have good healthcare knowledge. Candidate should hav...

Role Objective: To bill out medical accounts with accuracy within defined timelines and reduce rejections for payers. Essential Duties and Responsibilities: Process Accounts accurately basis US medical billing within defined TAT Able to process payer rejection with accuracy within defined TAT. 24*7 Environment, Open for night shifts Good analytical skills and proficiency with MS Word, Excel, and PowerPoint Qualifications: Graduate in any discipline from a recognized educational institute. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Good communication Skills (both written & verbal) Skill Set: Candidate should have good healthcare knowledge. Candidate should hav...

Role Objective: To bill out medical accounts with accuracy within defined timelines and reduce rejections for payers. Essential Duties and Responsibilities: Process Accounts accurately basis US medical billing within defined TAT Able to process payer rejection with accuracy within defined TAT. 24*7 Environment, Open for night shifts Good analytical skills and proficiency with MS Word, Excel, and PowerPoint Qualifications: Graduate in any discipline from a recognized educational institute. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Good communication Skills (both written & verbal) Skill Set: Candidate should have good healthcare knowledge. Candidate should hav...

Role Objective: To bill out medical accounts with accuracy within defined timelines and reduce rejections for payers. Essential Duties and Responsibilities: Process Accounts accurately basis US medical billing within defined TAT Able to process payer rejection with accuracy within defined TAT. 24*7 Environment, Open for night shifts Good analytical skills and proficiency with MS Word, Excel, and PowerPoint Qualifications: Graduate in any discipline from a recognized educational institute. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Good communication Skills (both written & verbal)Skill Set: Candidate should have good healthcare knowledge. Candidate should have...