SPE-Claims HC
24 hours ago
Job Description Job Summary We are seeking a skilled Claims Adjudication Specialist with 3 to 5 years of experience to join our team. The ideal candidate will have a strong background in claims adjudication processes and a keen eye for detail. This work-from-home position requires a proactive individual who can efficiently manage claims and contribute to our companys success in the healthcare sector. The role is crucial in ensuring accurate and timely claims processing ultimately benefiting our clients and the broader co Responsibilities - Review and analyze claims to ensure accuracy and compliance with established guidelines. - Process claims efficiently ensuring timely adjudication and resolution. - Collaborate with team members to identify and resolve discrepancies in claims data. - Utilize claims adjudication software to manage and track claims processing. - Communicate effectively with stakeholders to provide updates on claims status. - Identify trends and patterns in claims data to improve processing efficiency. - Ensure adherence to regulatory requirements and company policies in all claims activities. - Provide support and guidance to team members on complex claims issues. - Maintain accurate records of claims processing activities for audit purposes. - Contribute to the development of process improvements to enhance claims adjudication. - Participate in training sessions to stay updated on industry changes and best practices. - Engage in continuous learning to enhance skills and knowledge in claims adjudication. - Support the companys mission by ensuring high-quality claims processing that meets client needs. Qualifications - Possess strong analytical skills to evaluate and process claims accurately. - Demonstrate proficiency in using claims adjudication software and tools. - Exhibit excellent communication skills to interact with stakeholders effectively. - Have a keen attention to detail to identify and resolve claims discrepancies. - Show a proactive approach to problem-solving in claims processing. - Display a solid understanding of healthcare claims and related regulations. - Possess the ability to work independently in a remote work environment. Certifications Required Certified Professional Coder (CPC) or equivalent certification in claims adjudication.
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SPE-Claims HC
2 weeks ago
Bengaluru, India Cognizant Full timeJob Description Job Summary Join our team Clinical Claims Review Specialist where you will leverage your expertise in claims adjudication to ensure accurate and efficient processing of claims. With a focus on commercial claims and payer domain you will work remotely during night shifts contributing to our mission of providing exceptional service and support...
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TL-Claims HC
2 weeks ago
India, Cochin / Kochi / Ernakulam Cognizant Full timeJob Description Job Summary We are seeking a dedicated professional for the role of TL-Claims HC with 5 to 7 years of experience. The candidate will be responsible for overseeing claims adjudication processes ensuring accuracy and efficiency. This hybrid role requires expertise in MS Office and UiPath with a strong understanding of payer and provider...
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SPE-Customer Service HC
3 weeks ago
Pune, India Cognizant Full timeJob Description Job Summary Join our team as a Customer Service Specialist where you will leverage your expertise in customer service and claims to enhance client satisfaction and streamline processes. With a hybrid work model and night shifts you will play a crucial role in addressing customer inquiries and resolving claims efficiently contributing to our...
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HC and Insurance Operations Analyst
3 days ago
Chennai, India NTT DATA North America Full timeJob Description PROVIDER DATA MANAGEMENT - GRADE 6 HC & INSURANCE OPERATIONS ANALYST Position Overview: At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees have been key factors in our company's growth and market presence. By hiring the best people and helping them grow both...
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HC & Insurance Operations Senior Assoc.
24 hours ago
Chennai, India NTT Data Full timeJob Description PROVIDER DATA MANAGEMENT - GRADE 5 HC & Insurance Operations Senior Assoc. Position Overview: At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees have been key factors in our company's growth and market presence. By hiring the best people and helping them grow...
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SPE-AR Management HC
4 weeks ago
Noida, India Cognizant Full timeJob Description Job Summary Join our dynamic team as a Specialist in Accounts Receivable Management within the healthcare sector. This hybrid role requires expertise in healthcare products and revenue cycle management. With a focus on night shifts you will play a crucial role in optimizing financial operations ensuring timely collections and enhancing cash...
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SPE-Medical Coding HC
3 weeks ago
Hyderabad, India Cognizant Full timeJob Description Job Summary We are seeking a skilled Medical Coding Specialist with 2 to 3 years of experience in healthcare products and medical coding. The candidate will work in a hybrid model primarily during the day shift. This role involves ensuring accurate coding of medical records contributing to the efficiency and accuracy of healthcare data...
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SPE-AR Management HC
3 weeks ago
Hyderabad, India Cognizant Full timeJob Description Job Summary Join our team as a Specialist in Accounts Receivable Management within the healthcare sector. You will leverage your expertise in healthcare products and revenue cycle management to optimize financial processes. This hybrid role offers the flexibility of remote work with night shifts ensuring seamless operations without the need...
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SPE-Medical Coding HC
3 weeks ago
Hyderabad, India Cognizant Full timeJob Description Job Summary We are seeking a skilled Medical Coding Specialist with 2 to 4 years of experience to join our team in a hybrid work model. The ideal candidate will have expertise in healthcare products and medical coding. This role involves ensuring accurate coding of medical records contributing to the efficiency of healthcare services and...
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HC & Insurance Operations Associate
4 weeks ago
Chennai, India NTT Data Full timeJob Description 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...
