Claims Specialist
2 days ago
Essential FunctionsReviewing and adjudicating medical claims for payment, determining coverage and appropriate coding and verifying information for accuracy. Evaluate and process claims in accordance with company policies and procedures, as well as to productivity and quality standards. Interprets and processes routine and claims including CMS 1500 and UB04. Reviews and analyzes Physician/Hospital contract for correct payment method in-process claims in order to identify and resolve errors prior to final adjudication. Analyzing historical claims for patient and provider for correct adjudication. Possess good Knowledge of medical terminology, coding and claims processing. Consistently maintains production and quality standards based on quality control expectations. Adaptability in cross training and multiple tasking. Assists claimants, providers, and clients with problems or questions regarding their claims and/or policies. Analyzing patient information in order to ensure payment accuracy. Prepares and prints drafts for payment of claims, refund requests and verifies that payments have been made. Consistently maintains production and quality standards based on quality control expectations.Primary Internal Interactions Actively participate in the team meetings, discussions and provide inputs Calibrate, Cooperate and support the team in pursuit of achieving and exceeding team goalsPrimary External Interactions Email Communication Verbal communication during Trainings or ON Query CallsSkills Technical Skills Working knowledge of MS office (Word, Excel and Power point) and Internet / OutlookProcess Specific Skills Minimum experience of 1 to 3 years in US Healthcare claims processing/adjudication or medical billing with good performance records.Soft skills (Desired) Good communication skills, both verbal and written Aptitude and keen eye for details
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Health Claim Specialist
4 weeks ago
New Delhi, India iAssist Innovations Labs Full timeJob Description:We are seeking a detail- oriented and experienced Health Claims Specialist to join our team. The ideal candidate will be responsible for accurately processing and adjudicating medical claims in accordance with company policies, industry regulation, and contractual agreements. The Health Claims Specialist will play a crucial role in ensuring...
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Carrier Claim Specialist
3 weeks ago
New Delhi, India BolsterBiz Full timeCompany DescriptionBolsterBiz is a leading provider of offshoring and outsourcing services based in New Delhi. We specialize in driving business growth, optimizing operational efficiency, and ensuring long-term success. With over 2,000 completed projects and more than 100 clients in the USA, we offer cost-effective solutions with access to expert...
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Claims Specialist
2 days ago
New Delhi, India Plum Full timeAbout PlumPlum is an employee insurance and health benefits platform focused on making health insurance simple, accessible and inclusive for modern organizations. Healthcare in India is seeing a phenomenal shift with inflation in healthcare costs 3x that of general inflation. A majority of Indians are unable to afford health insurance on their own; and so as...
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Claims Specialist
4 weeks ago
New Delhi, India Howden Full timeJob DescriptionIndustry: General Insurance / Insurance Broking / Insurance Surveyor Location: Mumbai Experience: 12+ years Reporting To: Business Head/Vertical HeadRole Summary The role holder will lead the claims function across all Specialty lines of business, ensuring efficient, compliant, and client-centric claims handling. The role involves strategic...
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Claims Specialist
4 weeks ago
New Delhi, India Howden Full timeJob DescriptionIndustry: General Insurance / Insurance Broking / Insurance SurveyorLocation: MumbaiExperience: 12+ yearsReporting To: Business Head/Vertical HeadRole SummaryThe role holder will lead the claims function across all Specialty lines of business, ensuring efficient, compliant, and client-centric claims handling. The role involves strategic...
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Claims Specialist
3 weeks ago
New Delhi, India GrayQuest Full timeAbout GrayQuestGrayQuest is India’s leading FinTech innovator in the education ecosystem, transforming the$100B+ education industry through its cutting-edge financial solutions. Our flagship offering—monthly EMI solutions for school and college fee payments—makes education more accessible,affordable, and rewarding for millions of Indian families.We...
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Claims Specialist
3 weeks ago
New Delhi, India Classic Search Private Limited Full timeRole - Research Sensory & Claims SubstantiationLocation - BangaloreIndustry - Personal Care / Consumer Care/ Household Products / Personal Hygiene/ Cosmetics and BeautyExperience – 4-5yrs in core domainKey Responsibility Areas :-The position will be responsible for the consumer testing program and substantiation/defense of big impact, consumer-relevant...
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Carrier Claim Specialist
3 weeks ago
Delhi, India BolsterBiz Full timeCompany DescriptionBolsterBiz is a leading provider of offshoring and outsourcing services based in New Delhi. We specialize in driving business growth, optimizing operational efficiency, and ensuring long-term success. With over 2,000 completed projects and more than 100 clients in the USA, we offer cost-effective solutions with access to expert...
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Claims Specialist
4 weeks ago
New Delhi, India Classic Search Private Limited Full timeRole - Research Sensory & Claims Substantiation Location - Bangalore Industry -Personal Care / Consumer Care/ Household Products / Personal Hygiene/ Cosmetics and BeautyExperience – 4-5yrs in core domainKey Responsibility Areas :-The position will be responsible for the c onsumer testing program and substantiation /defense of big impact,consumer-relevant...
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Carrier Claim Specialist
3 weeks ago
Delhi, India BolsterBiz Full timeCompany DescriptionBolsterBiz is a leading provider of offshoring and outsourcing services based in New Delhi. We specialize in driving business growth, optimizing operational efficiency, and ensuring long-term success. With over 2,000 completed projects and more than 100 clients in the USA, we offer cost-effective solutions with access to expert...
