Claims Adjudication Profile Openings

Should possess U.S Health insurance claim processing experience - Knowledge of medical billing and coding terminologies - Ready to work in Night Shift as well as Day shift - Understanding of plan documents and general benefits - Familiarity with terms such as deductible, out of pocket, coinsurance, and copay - Strong attention to detail and accuracy -...

Dear All, Urgently hiring for a leading insurance company in Mumbai. Location : Mumbai. Role : Claims Assessor. Key Accountability - Managing Claims and to have strong eye on risk i.e. claims adjudication of Death/ Credit llife claims - To drive closure from team i.e. claim assessment of cases within TAT - Liaising with stakeholders and partners (MPH) -...

·Adjudicate each claim with available details of defect & estimates. Collect, verify and analyse information obtained during the claims process used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures ·Ensure Service partners work as per agreed SLA’s to meet service standards. ...

Conduct thorough reviews of claims to identify and rectify any discrepancies or errors. - Implement quality assurance measures to enhance the accuracy and efficiency of the claims process. - Accurately enter billing information for claim files into the system. - Ensure that all necessary documentation is recorded and maintained for auditing purposes. -...

**Job Profile** - Calls insurance to confirm receipt of claim - Calls insurance to request claim be adjudicated - Following up on the claims send for adjudication. - Gathers all required appeal information for denied cases to assist in drafting the appeal - Updates information in practice management software: Billing notes and status. - Request clients if...

Claims HandlerExperience: 0.6 months to 4 years (Entry Level position)Location: Whitefield, Bangalore ( WFO )Shift :RotationalShift Timing: 3.30pm-12am / 6am-3pmJob descriptionSutherland is seeking a motivated and passionate person to join us as a Claims Specialist. If you are looking to build a fulfilling career and are confident you have the skills...

**NAME **Open Position **DEPTARTMENT**:Administration **TITLE **Claims Examiner **STATUS**:Full-time **REPORTS TO**:Manager of TPA Operations **CLASSIFICATION **Non-Exempt **JOB SUMMARY/ORGANIZATIONAL IMPACT**:Serves self-insured clients by determining insurance coverage; examining and resolving medical claims; documenting actions; maintaining quality...

Claims Handler Experience: 0.6 months to 4 years (Entry Level position)Location: Whitefield, Bangalore (WFO)Shift :RotationalShift Timing: 3.30pm-12am / 6am-3pmJob descriptionSutherland is seeking a motivated and passionate person to join us as a Claims Specialist. If you are looking to build a fulfilling career and are confident you have the skills and...

Claims Handler Experience: 0.6 months to 4 years (Entry Level position)Location: Whitefield, Bangalore (WFO)Shift :RotationalShift Timing: 3.30pm-12am / 6am-3pmJob descriptionSutherland is seeking a motivated and passionate person to join us as a Claims Specialist. If you are looking to build a fulfilling career and are confident you have the skills and...

Claims Handler Experience: 0.6 months to 4 years (Entry Level position) Location: Whitefield, Bangalore (WFO ) Shift :Rotational Shift Timing: 3.30pm-12am / 6am-3pm Job description Sutherland is seeking a motivated and passionate person to join us as a Claims Specialist. If you are looking to build a fulfilling career and are confident you have...

Job opening for claim executive position in a reputed Insurance and Loss Assessor Location: Mumbai Job description: Documentation of all claims from different sites of all over India. Making Assessments of Thefts, Material Damage and Other claims as per the documents and as per the policy guidelines. Interacting with the Insurance Company for the Queries...

Claims HandlerExperience: 0.6 months to 4 years (Entry Level position)Location: Whitefield, Bangalore (WFO)Shift :RotationalShift Timing: 3.30pm-12am / 6am-3pmJob descriptionSutherland is seeking a motivated and passionate person to join us as a Claims Specialist. If you are looking to build a fulfilling career and are confident you have the skills and...

Project Name - E-Mahatma Jyotirao Phule Jan Arogya Yojana (MLPJAY) Designation - Medical Officer Location - Worli Qualification MBBS Job Description - Ensure using self login ID Verifies all necessary document and technical details mandatory for claims processing Verifies Previously Consumed amount Verifies enrollment details and Duration of patients...

Ensure using self login ID Verifies all necessary document and technical details mandatory for claims processing Verifies Previously Consumed amount Verifies enrollment details and Duration of patients Stay in Hospital Keeping claim pending if any document is missing and need to keep pending twice Ensure compliance all mandatory documents Ensure...

Processing of claims request received from the hospital Proper scrutiny of the medical documents received from the hospital/ patient and ask for relevant details to corroborate with the available diagnosis. Collate the medical details with the applicable policy terms to arrive at the final decision of claims adjudication. Coordination with the insurance...

Processing of claims request received from the hospital Proper scrutiny of the medical documents received from the hospital/ patient and ask for relevant details to corroborate with the available diagnosis. Collate the medical details with the applicable policy terms to arrive at the final decision of claims adjudication. Coordination with the insurance...

Processing of claims request received from the hospital Proper scrutiny of the medical documents received from the hospital/ patient and ask for relevant details to corroborate with the available diagnosis. Collate the medical details with the applicable policy terms to arrive at the final decision of claims adjudication. Coordination with the insurance...

Processing of claims request received from the hospital Proper scrutiny of the medical documents received from the hospital/ patient and ask for relevant details to corroborate with the available diagnosis. Collate the medical details with the applicable policy terms to arrive at the final decision of claims adjudication. Coordination with the insurance...

Opening with a leading TPA at **Vidhyavihar**for the position of Medical officer - Medical Scrutiny - Provide Medical opinion for Health Insurance Claims - Processing of Cashless Requests & Health Insurance Claim Documents - Proficient with medical terms & system. - Understanding of Policy terms & conditions & Various Protocols / Guidelines - Understanding...

This position is responsible for the delivery of exceptional customer service through claims review as per SLA. ·Adjudicate each claim with available details of defect & estimates. Collect, verify and analyse information obtained during the claims process used in settling claims to ensure that claims are valid and that settlements are made according...