774 Claims Processing Jobs - Page 19

Accountable to manage daily activities of coding Patients chart, Diagnosis report Coding/ Auditing charts Updating the production/pending reports Participate in client calls, understand the quality requirements both from process prospect & targets Required Candidate profile Extensive Quality experience Audits, Coaching & training as per process defined.Sound knowledge in Medical Coding concept. Sound knowledge in Healthcare concept. Must have Good Product Knowledge

Job Description: • Complete the full cycle of Identification, Validation, Enrollment and Billing procedures related to members • Work on the customers applications, eligibility and fallouts arising out of discrepancies in the systems • Ensure the accuracy and completeness of applications taken • Billing activity includes monthly generation of member premium bills and payments received to fulfill those bills • Correct all Billing discrepancies in a way that member no longer owes money • Changes in Payment types as requested by Member • Complete Account reconciliation of members post terminating the member from Services • Works flexibly and cooperatively under supervision with all team members • Completes all responsibilities according to established protocols, policies and standard practices plus adhere to regulatory compliance programs such as HIPPA Skills Required • Good verbal and written communication skills, • Ability to multi-task, Critical thinking abilities, open and ready to work on feedback • Quality focused, Good Analytical skills. • Proficiency with Windows, MS Office and basis computer skills • Demonstrate skills necessary to interpret regulations and guidelines • Ability to interact positively with internal and external customers Eligibility Criteria • At least 6 months of experience in preferably in health care domain and preferably with experience of working in night shift • Proficiency in Microsoft Office Suite • Must be an Graduate from an recognized university (No B.Tech, MCA or IT related degree) • Should be willing to work from Office • Typing - 20 WFM with 90% Accuracy • Should have the ability/resources to WFH if required

Role & responsibilities Excellent MS Office knowledge, Good Typing speed (35 words per minute). Candidate should be open to work in 24X7X365 environment. Preferred candidate profile Reimbursement billing & Registration, data handling, Error resolve, working on mail and condonation with RM Team. Knowledge of Indian Health Care and prior experience in Health Insurance Claim Processing, Good Clinical Acumen Preferred Industry Health Insurance/TPA/Hospital / Clinical Practice/heath care/ wellness etc.. Preferred Location Ahmedabad, Bangaluru Chandigarh, Chennai Dehradun, Hyderabad Indore, Kochin Kolkata, Mumbai Nagpur, Noida Surat, Vadodara

Role & responsibilities Excellent MS Office knowledge, Good Typing speed (35 words per minute). Candidate should be open to work in 24X7X365 environment. Preferred candidate profile Reimbursement billing & Registration, data handling, Error resolve, working on mail and condonation with RM Team. Knowledge of Indian Health Care and prior experience in Health Insurance Claim Processing, Good Clinical Acumen Preferred Industry Health Insurance/TPA/Hospital / Clinical Practice/heath care/ wellness etc.. Preferred Location Ahmedabad, Bangaluru Chandigarh, Chennai Dehradun, Hyderabad Indore, Kochin Kolkata, Mumbai Nagpur, Noida Surat, Vadodara

Role & responsibilities Excellent MS Office knowledge, Good Typing speed (35 words per minute). Candidate should be open to work in 24X7X365 environment. Preferred candidate profile Reimbursement billing & Registration, data handling, Error resolve, working on mail and condonation with RM Team. Knowledge of Indian Health Care and prior experience in Health Insurance Claim Processing, Good Clinical Acumen Preferred Industry Health Insurance/TPA/Hospital / Clinical Practice/heath care/ wellness etc.. Preferred Location Ahmedabad, Bangaluru Chandigarh, Chennai Dehradun, Hyderabad Indore, Kochin Kolkata, Mumbai Nagpur, Noida Surat, Vadodara

Role & responsibilities Excellent MS Office knowledge, Good Typing speed (35 words per minute). Candidate should be open to work in 24X7X365 environment. Preferred candidate profile Reimbursement billing & Registration, data handling, Error resolve, working on mail and condonation with RM Team. Knowledge of Indian Health Care and prior experience in Health Insurance Claim Processing, Good Clinical Acumen Preferred Industry Health Insurance/TPA/Hospital / Clinical Practice/heath care/ wellness etc.. Preferred Location Ahmedabad, Bangaluru Chandigarh, Chennai Dehradun, Hyderabad Indore, Kochin Kolkata, Mumbai Nagpur, Noida Surat, Vadodara

Job description Eligibility and Criteria 1. Good Knowledge about RCM industry is required 2. Accounts Receivable (AR) Knowledge - min 1.5 yrs is must 3. Provider Side experience is required, not payer side 4. Good Communication skills is needed 5. Relieving letter is mandatory 6. Immediate joiners are preferred 7. No Female Candidates

Role & responsibilities Excellent MS Office knowledge, Good Typing speed (35 words per minute). Candidate should be open to work in 24X7X365 environment. Preferred candidate profile Reimbursement billing & Registration, data handling, Error resolve, working on mail and condonation with RM Team. Knowledge of Indian Health Care and prior experience in Health Insurance Claim Processing, Good Clinical Acumen Preferred Industry Health Insurance/TPA/Hospital / Clinical Practice/heath care/ wellness etc.. Preferred Location Ahmedabad, Bangaluru Chandigarh, Chennai Dehradun, Hyderabad Indore, Kochin Kolkata, Mumbai Nagpur, Noida Surat, Vadodara

Role & responsibilities Claims adjudication, claims approval, TAT, accuracy, productivity, claims cost, fraud and leakage control, client/provider feedback, team training and retention Preferred candidate profile Processing claims, quality check and adherence to TAT, fraud triggers, fraud risk assessment, computer skills. Candidate should be open to work in 24X7X365 environment Microsoft office proficiency Knowledge of Indian Health Care and prior experience in Health Insurance Claim Processing, Good Clinical Acumen Minimum 1-3 Years Preferred Industry Health Insurance/TPA/Hospital / Clinical Practice/heath care/ wellness etc.. Minimum- Medical Graduate (BDS/BAMS/ BHMS/BPT/ BUMS) Preferred Location Indore Surat Mumbai Nagpur Chennai Bangalore Kochi Kolkata Noida Hyderabad Vishakapatnam Chandigarh Vadodara

Role & responsibilities Claims adjudication, claims approval, TAT, accuracy, productivity, claims cost, fraud and leakage control, client/provider feedback, team training and retention Preferred candidate profile Processing claims, quality check and adherence to TAT, fraud triggers, fraud risk assessment, computer skills. Candidate should be open to work in 24X7X365 environment Microsoft office proficiency Knowledge of Indian Health Care and prior experience in Health Insurance Claim Processing, Good Clinical Acumen Minimum 1-3 Years Preferred Industry Health Insurance/TPA/Hospital / Clinical Practice/heath care/ wellness etc.. Minimum- Medical Graduate (BDS/BAMS/ BHMS/BPT/ BUMS) Preferred Location Indore Surat Mumbai Nagpur Chennai Bangalore Kochi Kolkata Noida Hyderabad Vishakapatnam Chandigarh Vadodara

Role & responsibilities Claims adjudication, claims approval, TAT, accuracy, productivity, claims cost, fraud and leakage control, client/provider feedback, team training and retention Preferred candidate profile Processing claims, quality check and adherence to TAT, fraud triggers, fraud risk assessment, computer skills. Candidate should be open to work in 24X7X365 environment Microsoft office proficiency Knowledge of Indian Health Care and prior experience in Health Insurance Claim Processing, Good Clinical Acumen Minimum 1-3 Years Preferred Industry Health Insurance/TPA/Hospital / Clinical Practice/heath care/ wellness etc.. Minimum- Medical Graduate (BDS/BAMS/ BHMS/BPT/ BUMS) Preferred Location Indore Surat Mumbai Nagpur Chennai Bangalore Kochi Kolkata Noida Hyderabad Vishakapatnam Chandigarh Vadodara

Role & responsibilities Claims adjudication, claims approval, TAT, accuracy, productivity, claims cost, fraud and leakage control, client/provider feedback, team training and retention Preferred candidate profile Processing claims, quality check and adherence to TAT, fraud triggers, fraud risk assessment, computer skills. Candidate should be open to work in 24X7X365 environment Microsoft office proficiency Knowledge of Indian Health Care and prior experience in Health Insurance Claim Processing, Good Clinical Acumen Minimum 1-3 Years Preferred Industry Health Insurance/TPA/Hospital / Clinical Practice/heath care/ wellness etc.. Minimum- Medical Graduate (BDS/BAMS/ BHMS/BPT/ BUMS) Preferred Location Indore Surat Mumbai Nagpur Chennai Bangalore Kochi Kolkata Noida Hyderabad Vishakapatnam Chandigarh Vadodara

Minimum Mandatory Skill Set Computer Operations, Computer proficiency, MS Excel, Communication in English & Hindi, Open to work in shifts. Brief Job Profile Generic job profile includes document processing, Data entry process, Maintaining trackers, Escalate issues as required within organization and follow up to ensure timely resolution. Desired Competencies/ Skill Set Working knowledge of MS Excel with data entry speed and accuracy, ability to communicate in English and Hindi effectively, Insurance / Health Insurance Knowledge. Should be open to shift duties. Preferred Industry Health Insurance, TPA, BFSI, Healthcare

Minimum Mandatory Skill Set Computer Operations, Computer proficiency, MS Excel, Communication in English & Hindi, Open to work in shifts. Brief Job Profile Generic job profile includes document processing, Data entry process, Maintaining trackers, Escalate issues as required within organization and follow up to ensure timely resolution. Desired Competencies/ Skill Set Working knowledge of MS Excel with data entry speed and accuracy, ability to communicate in English and Hindi effectively, Insurance / Health Insurance Knowledge. Should be open to shift duties. Preferred Industry Health Insurance, TPA, BFSI, Healthcare

Minimum Mandatory Skill Set Computer Operations, Computer proficiency, MS Excel, Communication in English & Hindi, Open to work in shifts. Brief Job Profile Generic job profile includes document processing, Data entry process, Maintaining trackers, Escalate issues as required within organization and follow up to ensure timely resolution. Desired Competencies/ Skill Set Working knowledge of MS Excel with data entry speed and accuracy, ability to communicate in English and Hindi effectively, Insurance / Health Insurance Knowledge. Should be open to shift duties. Preferred Industry Health Insurance, TPA, BFSI, Healthcare

Minimum Mandatory Skill Set Computer Operations, Computer proficiency, MS Excel, Communication in English & Hindi, Open to work in shifts. Brief Job Profile Generic job profile includes document processing, Data entry process, Maintaining trackers, Escalate issues as required within organization and follow up to ensure timely resolution. Desired Competencies/ Skill Set Working knowledge of MS Excel with data entry speed and accuracy, ability to communicate in English and Hindi effectively, Insurance / Health Insurance Knowledge. Should be open to shift duties. Preferred Industry Health Insurance, TPA, BFSI, Healthcare

Minimum Mandatory Skill Set Computer Operations, Computer proficiency, MS Excel, Communication in English & Hindi, Open to work in shifts. Brief Job Profile Generic job profile includes document processing, Data entry process, Maintaining trackers, Escalate issues as required within organization and follow up to ensure timely resolution. Desired Competencies/ Skill Set Working knowledge of MS Excel with data entry speed and accuracy, ability to communicate in English and Hindi effectively, Insurance / Health Insurance Knowledge. Should be open to shift duties. Preferred Industry Health Insurance, TPA, BFSI, Healthcare

Job Track Description: Requires experience in a professional, sales, or technical area through formal education. Performs technical-based activities. Contributes to and manages projects. Uses deductive reasoning to solve problems and make recommendations. Interfaces with and influences key stakeholders. Leverages previous knowledge and expertise to achieve results with teams and can complete work self-guided. A college or university degree required. General Profile Requires in-depth knowledge and experience. Uses best practices and understanding of business issues to improve products and services. Solves complex problems. Takes a new perspective using existing solutions. Works unaided and receives minimal guidance. Acts as a resource for colleagues with less experience. Functional Knowledge Understands and applies concepts in the field of expertise. Basic knowledge of related disciplines. Business Expertise Has knowledge of best practices and team integration. Is aware of the competition and what makes them different in the market. Impact Impacts a range of customer, operational, project, or service activities in teams. Works within broad guidelines and policies. Leadership Acts as a resource for colleagues with less experience. May guide small projects with manageable risks and resource requirements. Problem Solving Solves complex problems. Takes a new perspective on existing solutions. Exercises judgment based on reviewing many sources of information. Interpersonal Skills Explains difficult or sensitive information. Works to build consensus within a team. Responsibility Statements Serves as liaison between end-users and product development teams. Manages and communicates deliverable status to development teams. Reviews, defines, and documents project requirements. Examines requirements and defines technology solutions. Defines a go-to approach for system construction. Produces component specifications and translates these into detailed designs for implementation. Directs a small project team of business analysts across client portfolio projects. Helps prepare technical plans to ensure resources are available. Provides advice on technical aspects of system development and integration. Applies relevant technical strategies, policies, standards, and practices. Performs other duties as assigned. Complies with all policies and standards. Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law. People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by submitting their request through this form that must be downloaded:click here to access or download the form. Complete the form and then email it as an attachment toFTADAAA@conduent.com.You may alsoclick here to access Conduent's ADAAA Accommodation Policy. At Conduent we value the health and safety of our associates, their families and our community. For US applicants while we DO NOT require vaccination for most of our jobs, we DO require that you provide us with your vaccination status, where legally permissible. Providing this information is a requirement of your employment at Conduent.

Job Track Description Requires relevant expertise through formal education in a professional, sales, or technical area. Performs technical-based activities. Contributes to and manages projects. Uses deductive reasoning to solve problems and make recommendations. Interfaces with and influences key stakeholders. Leverages previous knowledge and expertise to achieve results. Able to complete work self-guided. College or university degree required or equivalent work experience. General Profile Performs routine assignments. Exposure to fundamental theories and concepts. Develops skills by performing structured work assignments. Uses existing procedures to solve routine or standard problems. Receives instruction, guidance, and direction from others. Functional Knowledge Requires a conceptual understanding of theories, practices, and procedures. Business Expertise Applies general knowledge of business developed through education or experience. Impact Works self-guided with no supervisory responsibilities. Follows standardized procedures and practices to achieve objectives and meet deadlines. Leadership No supervisory responsibilities. Responsible for developing technical contributions. Problem Solving Uses existing procedures to solve standard problems. Examines information and standard practices to make judgments. Interpersonal Skills Exchanges information and ideas effectively. Asks questions and checks for understanding. Responsibility Statements Serves as liaison between end-users and product development teams. Partners with senior BA's to examine, define, and document project requirements. Communicates project requirements to development teams. Supports analyzing requirements and defines tech solutions. Defines a go-to approach for system construction. Performs other duties as assigned. Complies with all policies and standards. Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law. People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by submitting their request through this form that must be downloaded:click here to access or download the form. Complete the form and then email it as an attachment toFTADAAA@conduent.com.You may alsoclick here to access Conduent's ADAAA Accommodation Policy. At Conduent we value the health and safety of our associates, their families and our community. For US applicants while we DO NOT require vaccination for most of our jobs, we DO require that you provide us with your vaccination status, where legally permissible. Providing this information is a requirement of your employment at Conduent.

Minimum Mandatory Skill Set Knowledge of Processing of claims, quality check and adherence to TAT, computer skills, excel. Candidate should be open to work in 24X7X365 shifts Brief Job Profile Claims adjudication, Fraud and leakage control, Client/provider feedback, Team training and retention, Investigation Desired Competencies/ Skill Set MS Excel and MIS skills, Candidate having work experience of claim processing, Investigation, computer skills. Preferred Industry Health Insurance, TPA, Hospitals, Healthcare

Payroll Company: Teamlease Digital Role & responsibilities: Accurately enter insurance data into the database Maintain Insurance Company database Maintain quality score Perform other duties as assigned Observe professional standards of conduct, including attendance, professional behaviour, and dress code. Required Candidate Profile: - Adaptable and flexible -Knowledge of excel basics - Ability to perform under pressure - Problem-solving skills - Detail orientation - Ability to establish strong client relationship -Comfortable with Night Shifts -Good Communication Skills -Stability Shifts- Night Shifts Mode of work- Work from Office Perks and benefits: -5 days working. -Apart from development, and engagement programs, we offer transportation facility to all its employees. (Subject to hiring zone) -There is specific focus on female security who work round-the-clock, be it in office premises or transport/ cab services. -All employees are covered under insurance program. Interested candidates can share their resumes via whatsapp on 9773714088

Minimum Mandatory Skill Set Knowledge of Processing of claims, quality check and adherence to TAT, computer skills, excel. Candidate should be open to work in 24X7X365 shifts Brief Job Profile Claims adjudication, Fraud and leakage control, Client/provider feedback, Team training and retention, Investigation Desired Competencies/ Skill Set MS Excel and MIS skills, Candidate having work experience of claim processing, Investigation, computer skills. Preferred Industry Health Insurance, TPA, Hospitals, Healthcare

Looking after all insurance matters of Mfg. & EPC Cos of group . Profile includes –Record of all Ongoing Policy, Renewal, Dealing with insurance Co for new Coverage ,Premium Negotiations. Claims settlement, insurance of Group, Individual & family etc Required Candidate profile Profile includes – Record of all Ongoing Policy, Renewal, Dealing with insurance Co for new Coverage , Premium Negotiations. Claims settlement, insurance Management of Group, Individual & family etc

Role & responsibilities As the Delivery Lead of Insurance Collections for Patient Financial Services, the role involves working in conjunction with Senior Leadership to identify unit, department, and business priorities to successfully deliver on Patient Financial Service accounts receivable metrics. Responsibilities include accounts receivable management, including recovery and reconciliation of denial, and no activity insurance claims. The individual will interact and collaborate with various departments, lead payer issue denial trending, research and recovery of payer issues, system updates, data analytics, strategic work plans, and execution of plans and directives. Preferred candidate profile Bachelors degree in business or accounting major is preferred. 10+ 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

Role : Senior Analyst-Claims Adjusting Work Mode : Hybrid Experience : 3+ Yrs Location : Pune, Mumbai, Bangalore, Kochi ******************************************************************************************* *IMMEDIATE JOINERS ALERT!* We're looking for candidates who can *join immediately*. If you're available, please *send your CV via WhatsApp only* to: * 9152808909* Please note: *No calls* will be entertained. ******************************************************************************************* Must Have : End to End Marine Claims Position Summary: Our company is seeking to hire a Senior Analyst-Claims Adjusting for Claims vertical. As the Senior Analyst - Claims Adjusting, you will be responsible for handling and execute all allocated claims in accordance with the company's documented service standards. Your role will involve investigation, evaluation, processing, disposition and settlement of claims. You will be responsible for fostering a culture of collaboration, continuous improvement, and customer focus within the shared services team. You will be interacting with the team who are present in any of the onshore locations. Exposure to Insurance regulations and laws, claims handling procedures and Risk management principles is a definite plus. ESSENTIAL RESPONSIBILITIES: Importance Major Action and Support Actions Investigate the circumstances surrounding marine incidents, such as collisions, groundings , or cargo damage. Assess the extent of damage to vessels, cargo, or freight, and estimate the cost of repairs or replacement. Appropriately document information on claim file Maintain effective and ongoing communication with various internal and external contact. Learn and follow best practices of clients as well as claims requirements, standards and practices as required by applicable state statutes. Ensure compliance with relevant maritime law and regulations Ensure adherence to regulatory requirements, industry standards, and company policies. Mitigate organizational risk, maintaining compliance and reputation Competency Description Technical 1. Insurance regulations and laws 2. Claims handling procedures 3. Risk management principles 4. Industry standards 5. Maritime law and regulations Soft Skills 1.Communication (verbal and written) 2. Negotiation and conflict resolution 3. Analytical and problem-solving 4. Planning & Prioritizing 5. Customer service and relationship-building 6. Collaboration and teamwork 7. Adaptability and flexibility Behavioral 1. Integrity and ethics 2. Results-driven and accountable 3. Customer-focused and empathetic 4. Competitive 5. Patient 6. Innovative Collaboration 1. Collaborative mindset 2. Effective communication 3. Adaptability and flexibility 4. Constructive feedback and conflict resolution 5. Commitment to team success EDUCATION AND EXPERIENCE Minimum Required Degree: Bachelor Preferred Degree: Bachelors degree in insurance or related field Certificate(s)/Special Training: Insurance industry certifications AIC, AINS, Cert CII or any other relevant Insurance certification Experience ( Career Level Guide) Minimum 2-3 years of experience in insurance claims handling Proven track record of successful claim resolutions and customer satisfaction. Strong knowledge of insurance regulations, policies, and procedures. KNOWLEDGE, SKILLS AND ABILITY: Knowledge, Claims Handling Ability: Investigate and analyze claims documentation Determine coverage and liability Negotiate settlements and resolve disputes Communicate effectively with insureds, claimants, suppliers and brokers Apply industry-standard claims handling procedures. Skills Claims investigation and analysis Effective communication and interpersonal skills Time management and organization Customer service and relationship-building Collaboration and teamwork Remarks This position is in a temperature-controlled office environment. The noise level in the work environment is usually light to moderate. This position is to work in a Hybrid model and depending on the need must be flexible to work from office/home/shift timings as required to accomplish their role. This job description is not intended to be an exhaustive list of the duties and responsibilities of this position. Additional duties not included on this job description may be assigned by management at any time, based upon the business needs of the Company. Employees must perform all such duties assigned to them as a condition of employment. Likewise, this job description does not alter the at-will nature of employment at the Company. The Company may review and update this job description from time to time, as deemed necessary or appropriate in its sole discretion.