170 Medicare Jobs - Page 4

Dear Applicant, Hiring for US Healthcare (SQL) - TM Level : TM Location - Hyderabad Work mode : WFO Shift : US shift Years of exp : 7 yrs CTC - Up to 15lpa Qualification : any Graduate Notice period : Immediate , 30 days Skills : 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 skills. Interested candidates contact HR Hema@9136535233/ hemavathi@careerguideline.com

AR Calling - Mumbai (Navi Mumbai) - 40k Take Home Experience :- Min 1+ yrs exp in AR Calling in Physician Billing Package :- Max Upto 40K Take-home Work Location :- Mumbai Qualification :- Inter & Above Notice Period :- Preferred Immediate Joiners - 1 week of notice (serving) Relieving is not Mandate WFO Interview Mode :- Virtual & Walkin AR Callers - Hyderabad - 33k Take Home Experience : Minimum 1+ years in AR Calling Package : Max Upto 33K Take-home Qualification: Degree Mandate Notice Period : 0 to 25Days Location : Hyderabad WFO Interview Mode : Virtual Interviews Interested candidates can share your updated resume to HR Harshitha - 7207444236 (share resume via WhatsApp ) Refer your friend's / Colleagues

Healthcare KPO | Makarba, Ahmedabad We're hiring for: AR Caller Payment Posting Eligibility Verification Credentialing Dental Billing Min. 6 months experience required Fixed Night Shift Graduates only (No IT) Excellent English Communication must

Location: Bangalore (Work from Office) Grade: G Designation: Team Executive Shift: Night shift Number of Positions: 1 About the Role: We are seeking a dynamic and experienced Team Lead with a strong background in US Healthcare , specifically in Member Enrollment . The ideal candidate will have proven experience in managing teams, excellent communication skills, and a deep understanding of the healthcare domain. This is a Team Lead role and requires hands-on leadership experience in enrollment processes. Key Responsibilities: Lead and manage a team responsible for US healthcare member enrollment activities. Ensure compliance with CMS guidelines and support processes related to Medicare (preferred). Monitor team performance and provide regular coaching, feedback, and performance reviews. Prepare and maintain internal and client reports accurately and on time. Coordinate and conduct training sessions for new and existing team members. Act as a liaison between the team and upper management, ensuring seamless communication. Handle team escalations and resolve operational issues efficiently. Ensure adherence to quality, compliance, and productivity standards. Mandatory Skills: Proven Team Lead experience (on paper). Strong knowledge of the US Healthcare system . Hands-on experience in Member Enrollment processes. Willingness to work night shifts Preferred Skills: Exposure to Medicare processes and guidelines. Familiarity with CMS compliance standards. Disclaimer: Firstsource follows a fair, transparent, and merit-based hiring process. We never ask for money at any stage. Beware of fraudulent offers and always verify through our official channels or deepalakshmi@firstsource.com email addresses.

Dear All, Greetings from Flatworld Healthcare Services. WE ARE HIRING !! Job Title: Credentialing & Provider Enrollment Specialist Department: Revenue Cycle Management (RCM) Experience Required: 1 to 5 Years Location: Bangalore Employment Type: Full-time Interested candidates can share their CVs at pavan.v@finnastra.com or contact 9035473861 (Available between 1 PM - 10 PM ). Job Summary: We are seeking a detail-oriented and proactive Credentialing & Provider Enrollment Specialist with 12 years of experience in the healthcare RCM domain. The ideal candidate will be responsible for managing end-to-end provider credentialing, re-credentialing, and enrollment with insurance payers, ensuring compliance with regulatory standards and timelines. Key Responsibilities: Complete initial and re-credentialing applications for healthcare providers. Submit and track enrollment applications with Medicare, Medicaid, and commercial payers. Maintain and update provider information in internal databases and payer portals. Monitor expirables (licenses, certifications, etc.) and ensure timely renewals. Communicate with providers, payers, and internal teams to resolve enrollment issues. Ensure compliance with payer-specific and regulatory credentialing requirements. Follow up with insurance companies to check application status and resolve delays. Assist in audits and provide necessary documentation as required. Qualifications: 1 to 4 years of hands-on experience in provider credentialing and enrollment. Knowledge of payer requirements and CAQH, PECOS, NPPES, etc. Strong communication, organizational, and follow-up skills. Proficient in MS Office and credentialing software/tools. Preferred Skills: Experience working with U.S. healthcare providers. Familiarity with medical billing and insurance guidelines. Ability to manage multiple priorities in a deadline-driven environment. Perks & Benefits: 5 Days Working Provident Fund & Gratuity Medical Insurance Travel Allowance Fresher and non-relevant experience applicants, please ignore!

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)

Hiring: Team Lead Revenue Cycle Management (RCM) Location: Kothrud, Pune Shift: Day/Night | Work Mode: Work from Office Salary: As per experience and industry standards We are looking for a Team Lead with 35 years of experience in Revenue Cycle Management, including claim submission, denial management, AR follow-up, and team handling. Key Responsibilities: Lead and manage a team of RCM specialists Handle claim submissions, payment posting, and denial resolutions Work on AR reports and improve cash flow Ensure compliance with payer and healthcare regulations Generate reports and drive process improvements Requirements: 35 years of RCM/medical billing experience Strong knowledge of CPT, ICD-10, HCPCS, and insurance guidelines Good communication and leadership skills Graduation or diploma preferred Apply now and grow your career in RCM with us. CONTACT: Sanjana- 9251688426

Hiring: AR Caller (Denial Management) Location : Pune CTC : Up to 5.5 LPA Shift : US Shift (Night) | 5 Days Working | 2 Days Rotational Off Notice Period : Immediate to 30 Days About the Role We are looking for experienced AR Calling professionals (Provider Side) to join our growing US Healthcare RCM team. Eligibility: Experience: Minimum 1 year in AR Calling (Provider Side) Qualification: Any Key Skills: Revenue Cycle Management (RCM) Denial Management & Resolution AR Follow-up / Collections Physician / Provider Billing Prior Authorization HIPAA Compliance How to Apply? Contact: Sanjana 9251688426

Hiring: AR Caller (Denial Management) Location : Pune CTC : Up to 5.5 LPA Shift : US Shift (Night) | 5 Days Working | 2 Days Rotational Off Notice Period : Immediate to 30 Days About the Role We are looking for experienced AR Calling professionals (Provider Side) to join our growing US Healthcare RCM team. Eligibility: Experience: Minimum 1 year in AR Calling (Provider Side) Qualification: Any Key Skills: Revenue Cycle Management (RCM) Denial Management & Resolution AR Follow-up / Collections Physician / Provider Billing Prior Authorization HIPAA Compliance How to Apply? Contact: Sanjana 9251688426

Requirements: • 3+ Years of experience in Health and Welfare benefit administration. • Experience in delivering results across Medicare, COBRA, Workday, FSA, HSA, DVS, DBP Medicare, should be specialize in resolving complex insurance and payroll issues, managing client escalations and improving operational accuracy. • Should have experience in Annual enrollment, Life Events, Vendors Files, Payroll and Premium, Life Insurance, Medicare Benefits, Claim, Billing, etc., • Must be proficient in using Microsoft Office applications (Microsoft Word, Excel, and PowerPoint). • Ability to work towards deadlines. • Positive attitude and solution-oriented thinking. Requirement Excellent communication skills and Interpersonal skill. Candidates willing to work in US Shift (night shift) may apply. . Perks and Benefits Cab facility. Monthly meal vouchers. 5 days working a week. Interested candidates can share their resume at Sakshi.srivastava@conduent.com with below details : Total Experience- Open to work in night shifts- Yes/No Notice Period- Current Location- Current CTC- Expected CTC- Kindly mention Analyst and your name in subject line

DesignationAssistant Operations ManagerReports to (level of category)Manager - Operations Role ObjectiveFollow 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 management Must operate utilizing aggressive operating metrics.Qualifications:Graduate in any discipline from a recognized educational institute (Except B.Pharma, M.Pharma, Regular MBA, MCA B.Tech Freshers')Good analytical skills and proficiency with MS Word, Excel and Powerpoint (Typing speed of 30 WPM)Good communication Skills (both written & verbal) Skill Set:Candidate should be good in Denial ManagementCandidate should have knowledge of Medicare, Medicaid & ICD & CPT codes used on DenialsAbility to interact positively with team members, peer group and seniors.Subject matter expert in AR follow upDemonstrated ability to exceed performance targetsAbility to effectively prioritize individual and team responsibilitiesCommunicates well in front of groups, both large and small. Working in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast-growing team has opportunities to learn and grow through rewarding interactions, collaboration and the freedom to explore professional interests. Our associates are given valuable opportunities to contribute, to innovate and create meaningful work that makes an impact in the communities we serve around the world. We also offer a culture of excellence that drives customer success and improves patient care. We believe in giving back to the community and offer a competitive benefits package. To learn more, visitr1rcm.com Visit us on Facebook

DesignationAssistant Operations ManagerReports to (level of category)Manager - Operations Role ObjectiveFollow 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 management Must operate utilizing aggressive operating metrics.Qualifications:Graduate in any discipline from a recognized educational institute (Except B.Pharma, M.Pharma, Regular MBA, MCA B.Tech Freshers')Good analytical skills and proficiency with MS Word, Excel and Powerpoint (Typing speed of 30 WPM)Good communication Skills (both written & verbal) Skill Set:Candidate should be good in Denial ManagementCandidate should have knowledge of Medicare, Medicaid & ICD & CPT codes used on DenialsAbility to interact positively with team members, peer group and seniors.Subject matter expert in AR follow upDemonstrated ability to exceed performance targetsAbility to effectively prioritize individual and team responsibilitiesCommunicates well in front of groups, both large and small. Working in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast-growing team has opportunities to learn and grow through rewarding interactions, collaboration and the freedom to explore professional interests. Our associates are given valuable opportunities to contribute, to innovate and create meaningful work that makes an impact in the communities we serve around the world. We also offer a culture of excellence that drives customer success and improves patient care. We believe in giving back to the community and offer a competitive benefits package. To learn more, visitr1rcm.com Visit us on Facebook

DesignationAssistant Operations ManagerReports to (level of category)Manager - Operations Role ObjectiveFollow 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 management Must operate utilizing aggressive operating metrics.Qualifications:Graduate in any discipline from a recognized educational institute (Except B.Pharma, M.Pharma, Regular MBA, MCA B.Tech Freshers')Good analytical skills and proficiency with MS Word, Excel and Powerpoint (Typing speed of 30 WPM)Good communication Skills (both written & verbal) Skill Set:Candidate should be good in Denial ManagementCandidate should have knowledge of Medicare, Medicaid & ICD & CPT codes used on DenialsAbility to interact positively with team members, peer group and seniors.Subject matter expert in AR follow upDemonstrated ability to exceed performance targetsAbility to effectively prioritize individual and team responsibilitiesCommunicates well in front of groups, both large and small. Working in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast-growing team has opportunities to learn and grow through rewarding interactions, collaboration and the freedom to explore professional interests. Our associates are given valuable opportunities to contribute, to innovate and create meaningful work that makes an impact in the communities we serve around the world. We also offer a culture of excellence that drives customer success and improves patient care. We believe in giving back to the community and offer a competitive benefits package. To learn more, visitr1rcm.com Visit us on Facebook

SME Responsibilities: 1. Provide expert knowledge and guidance in medical billing procedures, coding, and compliance standards. 2. Process Improvement: Analyze existing billing processes and systems to identify opportunities for improvement in efficiency and accuracy. 3. Training and Development: Develop training materials and conduct training sessions for staff on medical billing best practices, new regulations, and software updates. 4. Audit and Compliance: Conduct regular audits to ensure billing practices comply with regulatory requirements and internal policies. 5. Quality Assurance: Implement quality assurance measures to maintain high standards of accuracy and completeness in billing documentation and submissions. 6. Research and Resolution: Research complex billing issues and provide timely resolutions to ensure prompt reimbursement and customer satisfaction. 7. Documentation and Reporting: Maintain detailed documentation of billing processes, audits, and resolutions. Prepare reports for management on key metrics and performance indicators. 8. Customer Support: Provide support to internal teams and external clients regarding billing inquiries, discrepancies, and issues. 9. Stay Updated: Stay informed about changes in medical billing regulations, coding guidelines, and industry trends to ensure compliance and best practices. 10. Collaboration: Collaborate with cross-functional teams including healthcare providers, IT professionals, and legal experts to address billing challenges and implement solutions. ** Hand on experience in ECW software preferrable**

Greetings from Synthesis Healthcare!!! We are hiring Hospital Billing (Charge Entry) Executive at Chennai location. Required Skills: Extensive hands-on experience in claims editing and billing within a hospital setting. Comprehensive knowledge of UB-04 (CMS-1450) billing practices and requirements. Thorough understanding of Medicare billing guidelines , with particular emphasis on the 72-hour rule and its impact on billing accuracy. Ability to review and interpret medical records and support documentation for billing purposes. Familiarity with accurate assignment and billing of occurrence codes and value codes. Good communication skills, both written and verbal Preferred Skills: Experience with Medicare DDE (Direct Data Entry). At least 2-4 Years of experience in medical billing, specializing in Medicare billing (Charge Entry). Immediate Joiners Preferred. Perks & Benefits 5 Days of working Saturday & Sunday fixed off Double Wages ( If working on Saturday) Interested candidates can send their updated resumes to: hr@shai.health (Mail subject line: " Applying for Experienced Hospital Billing Executive for any queries call to this number 78457 77499).

Genpact (NYSE: G) is a global professional services and solutions firm delivering outcomes that shape the future. Our 125,000+ people across 30+ countries are driven by our innate curiosity, entrepreneurial agility, and desire to create lasting value for clients. Powered by our purpose - the relentless pursuit of a world that works better for people - we serve and transform leading enterprises, including the Fortune Global 500, with our deep business and industry knowledge, digital operations services, and expertise in data, technology, and AI. We are inviting applications for the role of Domain Trainee / Management Trainee, HRO Responsibilities . Expert in the entire domain of HRO like Travel, Insurance, Health & Welfare, COBRA, Medicare, HIPPA, 401K, Payroll, Visa & Immigrations, Onboarding & assimilation, Employees onboarding, Recruitment, different types of visa & process, concierge service, US HR Policies, Severance pay, mass termination, US taxes, W2, W4, F&F settlements to provide first level support to the employees . Performing day-to-day work in HR operations & manage helpdesk calls for the same . Managing international transfers, temp conversions and internal transfer . Employees personal information change citizenship, marital status, preferred name, legal name, educational qualification etc. . Manage/ process organizational changes for employees like Manager change, position change, job title, shift change, cost code/ center etc . Assisting the Managers to initiate the transactions for the employee life cycle . Coordinating with the staffing team for any new hire discrepancies . Termination processing for RFT, interns, temp, consultants and contractors Qualifications we seek in you Minimum qualification . Any Graduate . Excellent soft skills to deal with the sensitive employee grievances or relations . Excellent verbal, written, presentation and interpersonal skills in English Preferred qualifications . PGDBM HR will be preferred . Relevant experience in US HRO domain Genpact is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, religion or belief, sex, age, national origin, citizenship status, marital status, military/veteran status, genetic information, sexual orientation, gender identity, physical or mental disability or any other characteristic protected by applicable laws. Genpact is committed to creating a dynamic work environment that values diversity and inclusion, respect and integrity, customer focus, and innovation. Get to know us at www.genpact.com and on X, Facebook, LinkedIn, and YouTube. Furthermore, please do note that Genpact does not charge fees to process job applications and applicants are not required to pay to participate in our hiring process in any other way. Examples of such scams include purchasing a %27starter kit,%27 paying to apply, or purchasing equipment or training.

Interested Candidates may connect with Ms.Zoya Shamsi +91 7251000195 (11am-5pm) About the Role: We are seeking a highly motivated and experienced individual with a medical background to join our dynamic team as a Medical Claims Call Center Representative. In this role, you will be the frontline of our customer service, handling inbound calls related to medical claims and rejections. Your primary focus will be to provide exceptional customer service while resolving inquiries and concerns effectively, ensuring a positive experience for every Niva Bupa member. Key Responsibilities: Answer incoming customer calls promptly and professionally. Assist customers with navigating medical claims, including inquiries about submissions, rejections, and procedures. Provide accurate and detailed information about claim processes, documentation requirements, and insurance coverage. Investigate and resolve customer concerns with a focus on high satisfaction and clear communication. Collaborate with internal departments like claims processing to address complex issues and expedite resolutions. Maintain extensive knowledge of Niva Bupa products, medical billing codes, and claim procedures. Document customer interactions and update records accurately in our system. Identify and escalate critical or unresolved issues to the appropriate supervisor. Adhere to company policies, procedures, and compliance guidelines. Key Requirements: Education & Certificates: B.Pharm & M.Pharm. Minimum 1-3 years of call center experience, preferably in healthcare or medical insurance. Strong knowledge of medical terminology, insurance claim procedures, and billing codes. Excellent verbal and written communication skills. Ability to handle high call volumes and prioritize customer needs effectively. Strong problem-solving and decision-making abilities. Attention to detail and accuracy in data entry and documentation. Exceptional customer service skills with a friendly and professional demeanor. Proficiency in computer systems, including CRM software and Microsoft Office Suite. Ability to work effectively in a team-oriented environment. Flexibility to work various shifts as per business requirements. What you'll gain? A competitive salary package of up to Rs. 3.5 LPA, based on your experience and Interview performance. Be part of a growing and respected healthcare company. Make a real difference in the lives of our members by providing exceptional customer service. Work in a dynamic and supportive environment with opportunities for growth and development. Competitive salary and benefits package. Ready to join Niva Bupa and contribute to a team dedicated to improving lives? Apply today!

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 corrected claims to payers for reimbursement. Track and report on claim correction activities and outcomes. Ensure all billing and charge correction activities comply with relevant laws, regulations, and internal policies. Stay updated on changes in billing regulations and payer requirements. Preferred candidate profile Bachelors degree in business or accounting major is preferred. 1 to 6 years experience in healthcare insurance collections, accounts receivable management, billing and claims processing, and insurance payor contracts. Advanced knowledge of insurance contracting, payor regulations, insurance benefits, coordination of benefits, managed care, and healthcare compliance, rules, and regulations. Advanced experience with reading, and understanding medical policy information, and utilizing insurance benefit and coverage information to recovery denied claims. Experience with medical billing and collections terminology CPT, HCPCS, ICD-10 and NDC coding, HIPAA guidelines and healthcare compliance.

Responsibilities may include the following and other duties may be assigned: As a Team Lead Billing for Patient Financial Services, the role involves the specialist to work closely with various departments to ensure accurate coding, compliance with payer requirements, and maximization of reimbursement on Patient Financial Service accounts receivable metrics. Review and analyze charge capture data for accuracy and completeness. Identify and correct charge errors and discrepancies. Collaborate with clinical and coding staff to resolve charge-related issues. Monitor and review billing processes to ensure compliance with payer guidelines. 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 corrected claims to payers for reimbursement. Track and report on claim correction activities and outcomes. Ensure all billing and charge correction activities comply with relevant laws, regulations, and internal policies. Stay updated on changes in billing regulations and payer requirements. Experience with various insurance plans offered by both government and commercial insurances (i.e., PPO, HMO, EPO, POS, Medicare, Medicaid, HRAs) and coordination of healthcare benefits, including requirements for referral, authorization, and pre-determination. Required Knowledge and Experience: Bachelors degree in business or accounting major is preferred. 8+ years experience in healthcare insurance collections, accounts receivable management, billing and claims processing, and insurance payor contracts. Advanced knowledge of insurance contracting, payor regulations, insurance benefits, coordination of benefits, managed care, and healthcare compliance, rules, and regulations. Advanced experience with reading, and understanding medical policy information, and utilizing insurance benefit and coverage information to recovery denied claims. Advanced experience with various insurance plans offered by both government and commercial insurances. Experience with medical billing and collections terminology CPT, HCPCS, ICD-10 and NDC coding, HIPAA guidelines and healthcare compliance.

We are looking for candidates with experience in AR Calling, Eligibility and Verification, and initiating Authorizations in the US Healthcare industry. Perks and benefits Cab facility, PF, Health insurance

Dear Candidate, Greetings from AGS Health.! Job Title: AR CALLER Eligibility: Candidate holding 1-2 years of experience into Medical Billing (Denial Management) can only apply for this position. Working Days - 5 Days (Fixed weekend off) Location: Chennai Interested candidates can WhatsApp their updated resume to 9384898239 Sai Subhiksha HR-Talent Acquisition AGS Health

Hiring: AR Caller/Senior AR Caller Experience in Physician Billing or Hospital Billing Location: Chennai, Bangalore, Pune & Trichy Experience: 1 to 4 Years Salary:Up to 40,000 per month Relieving letter is not mandatory Contact: Suvetha D-9043426511 Required Candidate profile Strong understanding of denial management Work with multiple denial types and take appropriate actions for claim Handle appeals and denial management processes.

Firstsource HIRING for Claims Adjudication !! HR SPOC: Aiswarya HR / 8072289336 Job Title: CSA & Senior CSA Grade: H1/H2 Job Category: Associate Function/Department : Operations Reporting to: Team Lead Roles & Responsibilities (Indicative not exhaustive) A claims examiner needs to analyse multiple documents / contracts and decide to pay / deny the claim submitted by member or providers with respect to client specifications. The claims examiner should also route the claim to different department or provider / member for any missing information that required for claims adjudication. The claims needs to be completed adhering to required TAT and quality SLA. Key Results : Production, Quality Shift and Schedule adherence Process Knowledge Minimum Eligibility: Preferred educational qualifications: Graduation (Any discipline - 3 years) without arrears. Preferred work experience: Minimum 1 year of experience in Claims processing Skills and Competencies: Good Communication Skills Listening & Comprehension About Firstsource Firstsource Solutions is a leading provider of customized Business Process Management (BPM) services. Firstsource specialises in helping customers stay ahead of the curve through transformational solutions to reimagine business processes and deliver increased efficiency, deeper insights, and superior outcomes. We are trusted brand custodians and long-term partners to 100+ leading brands with presence in the US, UK, Philippines, and India. Our rightshore delivery model offers solutions covering complete customer lifecycle across Healthcare, Telecommunications & Media and Banking, Financial Services & Insurance verticals. Our clientele includes Fortune 500 and FTSE 100 companies Disclaimer: Firstsource follows a fair, transparent, and merit-based hiring process. We never ask for money at any stage. Beware of fraudulent offers and always verify through our official channels or Aiswarya.Mmm@firstsource.com.

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

Primary Responsibilities: The coder will evaluate medical records to verify the plan of care for chronic medical conditions The coder will perform accurate and timely coding review and validation of Hierarchical Condition Categories (HCCs) and Diagnoses through medical records. The coder will document ICD-10-CM codes to verify that coding meets both established coding standards as well as CMS Risk Adjustment Guidelines The coder will assist the project teams by completing review of all charts in line with Medicare & Medicaid Risk Adjustment criteria Apply understanding of anatomy and physiology to interpret clinical documentation and identify applicable medical codes Verify and ensure the accuracy, completeness, specificity and appropriateness of diagnosis codes based on services rendered Evaluate medical record documentation to ensure coding accurately reflects and supports relevant coding based on the ICD-10 code submitted to CMS for reimbursement and interpretation of medical documentation to ensure capture of all relevant coding based on CMS Hierarchical Condition Categories (HCC)conditions that are applicable to Medicare Risk Adjustment reimbursement initiatives Demonstrate analytical and problem-solving ability regarding barriers to receiving and validating accurate HCC information Meet the production targets Meet the Quality parameters as defined by the Client SLA Other duties as assigned by supervisors. 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 Full-time: Yes Work from office: Yes Travelling Onsite / Offsite: No Required Qualifications: Any graduate experience Graduates in Medical, Paramedical or Life Science disciplines are preferred. Graduates from other disciplines may be considered subject to their ability to demonstrate technical competence in ICD-10 CM and risk adjustment guidelines and standards AAPC/AHIMA Certification is mandatory (CRC is most preferred followed by CPC, CIC or COC) or AHIMA-CCS certified Work experience of 1+ years Medical coding work experience of a minimum of 1 year is required. HCC coding work experience is highly preferred. Experience in other medical coding work experience can be considered provided they demonstrate technical competence in ICD-10 CM and risk adjustment guidelines and standards Good knowledge in Anatomy, Physiology & Medical terminology At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone of every race, gender, sexuality, age, location and income deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes an enterprise priority reflected in our mission.