Claims Process

**Requirements**: - 1-3 years of experience in processing claims adjudication and adjustment process - Experience in professional (HCFA), institutional (UB) claims (optional) - Both under graduates and post graduates can apply - Good communication (Demonstrate strong reading comprehension and writing skills) - Able to work independently, strong analytic...

**CLAIM EXAMINER ADJUDICATION** Claims examiners are confident decision-makers playing an important oversight role in the claims process. The role comes with the responsibility of overseeing the work of their colleagues and ensuring that high standards are always met. - Responsible for the coordination and resolution of the administrative denials and...

**Adjudication - Claim Examiner "Fresher or Experience"** - Responsible for the coordination and resolution of the administrative denials and appeals. - Ability to understand logic of standard medical coding (i.e., CPT, ICD-10, HCPCS, etc.). - Ability to resolve claims that require adjustments and adjustment projects, Identify claim(s) with inaccurate data...

Experience: 1-3 Years Notice Period: Immediate - 15 Days Joiners Location: Chennai,Coimbatore **Skills**: - 1-3 years of experience in processing claims adjudication and adjustment process - Experience of Facets is an added advantage. - Experience in professional (HCFA), institutional (UB) claims (optional) - Both under graduates and post graduates can...

Claims Processing Representative (US Night Shift) Includes insurance verification and retrieval of medical records and documents from various systems for the timely filing or re-adjudication of Workers compensation claims by the Revenue Specialists. Primarily interacts by phone with outside parties. **Responsibilities**: - Contacting Employers, Insurers...

Roles and Responsibilities: Process Adjudication claims and resolve for payment and Denials Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process Knowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of pocket, maximum inside limits and...

Roles and Responsibilities:Process Adjudication claims and resolve for payment and DenialsKnowledge in handling authorization, COB, duplicate, pricing and corrected claims processKnowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of pocket, maximum inside limits and...

Process Adjudication claims and resolve for payment and Denials - Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process - Knowledge of healthcare insurance policy concepts including in-network, of network providers, deductible, coinsurance, co-pay, out of pocket, maximum inside limits and exclusions, state variations -...

Location : Chennai (Remote) Experience: 1-3 years. Package: 3 LPA **Requirements**: **- 1-3 years of experience in processing claims adjudication and adjustment process** **- Experience of Facets is an added advantage.** **- Experience in professional (HCFA), institutional (UB) claims (optional)** **- Both under graduates and post graduates can...

**Job Title**: Claims Executive **Location**: Chennai **Responsibilities**: - Process claims accurately and efficiently, verifying policy coverage and calculating payable amounts. - Complete training in claims software and understand system features. - Ensure accurate data entry of bills and verification of details. - Adhere to Standard Operating...

**Job description**: **Sr Claim processor/Sr Claim adjudicator**Do quality check on the claims processed by Analysts/TraineesTrack the errors and provide feedback to the erring Analysts/traineesEnsure process guidelines are followed and met as documentedRaise process related issues / concerns on time with process and team leadsStay updated with the process...

: - Claim registration - On Daily Basis need to register the claims which has been assigned for processing, Scrutiny of the documents Reserve Setting: - Need to do the proper reserve setting on system based on the claim documents Technical processing claims which has been assigned for processing for health/ personal accident etc claims and deductions of...

Hi We are looking for a Sr. Claim Processor & Quality Analyst for one of our US-based client for their offshore office in Chennai. Job type: ONSITE, NIGHT SHIFT **Position : Claim Adjudication Executive** **Job Description**: Do quality check on the claims processed by Analysts/TraineesTrack the errors and provide feedback to the erring...

Hi, Position: Health Care & Insurance Operations Associate Experience: 1 to 4 Years Location: Chennai& Coimbatore Currently WFH Notice Period: Immediate to 15 days Roles and Responsibilities: - Process Adjudication claims and resolve for payment and Denials - Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process -...

Claims Business Analyst - Thryve Digital Health LLP is an emerging global healthcare partner that delivers strategic innovation, expertise, and flexibility to its healthcare partners. Being a US healthcare conglomerate captive, we have direct access to deeper insights that help us accelerate our learning process and keeps us ahead of the curve. Thryve...

**Roles and Responsibilities**: - Process Adjudication claims and resolve for payment and Denials. - Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process. - Knowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of pocket, maximum inside...

**Healthcare (Medical) Claims Examiner** Smart Data Solutions (SDS) is a technology leader in healthcare process automation and interoperability. We are seeking to add an experienced Claims Examiner to our rapidly growing organization! A career at SDS is both challenging and rewarding. With over 500 colleagues across the globe, we've created an open and...

Work From Office - AR Associate (Account Receivable) The USA Process - Shift Timings: Night Shift (Both way cab) - Salary: 18K-23K - Weekly 2 Days Fixed-Off (Sat & Sun) Roles And Responsibilities - Initiate Calls Requesting Status Of Claims In Queue. - Contact Insurance Companies For Further Explanation Of Denials And Underpayments - Take Appropriate Action...

Work From Office - AR Associate (Account Receivable) The USA Process - Shift Timings: Night Shift ( Both way cab) - Salary: 16K-21K - Weekly 2 Days Fixed-Off (Sat & Sun) **Roles And Responsibilities** - Initiate Calls Requesting Status Of Claims In Queue. - Contact Insurance Companies For Further Explanation Of Denials And Underpayments - Take Appropriate...

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