Mainframe +Claim Adjudication

HelloGreetings Calibrated Healthcare is hiring for Claims Examiner II.Job Description:1. Minimum 1+ years of experience in US Healthcare Claims Adjudication / Claims Processing that directly aligns with the specific responsibilities for this position.2. Well versed with HMO Plans & PPO Plans3. Understanding of Claims Operations / Claims...

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....

TagLynk Careers, hiring partner for a leading insurance organization, is looking for a senior leader to drive Accident & Health Claims Strategy & Operations . This role is ideal for seasoned professionals with deep expertise in health insurance claims, fraud mitigation, provider network management and regulatory compliance.Key ResponsibilitiesStrategic...

TagLynk Careers, hiring partner for a leading insurance organization, is looking for a senior leader to drive Accident & Health Claims Strategy & Operations. This role is ideal for seasoned professionals with deep expertise in health insurance claims, fraud mitigation, provider network management and regulatory compliance.Key ResponsibilitiesStrategic...

TagLynk Careers, hiring partner for a leading insurance organization, is looking for a senior leader to driveAccident & Health Claims Strategy & Operations . This role is ideal for seasoned professionals with deep expertise inhealth insurance claims, fraud mitigation, provider network management and regulatory compliance. Key Responsibilities Strategic...

**REQUIRED: Urgent Hiring for Insurance claim Executive Who handled Motor vehicle insurance claim and marine insurance claim.** We help insurers redefine their customer experience while accelerating their innovation agenda to drive sustainable growth by transforming to an intelligent operating model. Intelligent Insurance Operations combines our advisory,...

Business Analyst – Health Insurance Platform (Hong Kong)About UsMetaMorphoSys is a next-generation InsurTech product company transforming life and health insurance across Asia. We offer a unified platform across five core value streams: Claims, Underwriting, Provider Management, Benefit Configuration, and FWA. Our platform is live across multiple markets...

Experience: 1-3 YearsSkills Required: Claims Adjudication, Claims Processing, Health Insurance, Payment Processing.Roles and Responsibilities:Process Adjudication claims and resolve for payment and Denials • Knowledge in handling authorization, COB, duplicate, pricing and corrected claims processKnowledge of healthcare insurance policy concepts including...

**Role : Medical Officer - CLAIM PROCESSING** 1.Medical Scrutiny by thorough assessment of documents. 2.Provide Medical opinion on admissibility of Insurance Claims. 3.Proficient with medical terms & system. 4.Understanding of Policy terms & conditions with their practical applicability & Various Protocols / Guidelines. 5.Understanding of Claims...

**CLAIM PROCESSING-** 1.Medical Scrutiny by thorough assessment of documents. 2.Provide Medical opinion on admissibility of Insurance Claims. 3.Proficient with medical terms & system. 4.Understanding of Policy terms & conditions with their practical applicability & Various Protocols / Guidelines. 5.Understanding of Claims adjudication / Claims Processing...