Claims Excellence

Job DescriptionWe are seeking a highly skilled Insurance Operations Senior Representative to join our team. The ideal candidate will possess excellent analytical and problem-solving skills, with the ability to review and process insurance claims efficiently and accurately.Responsibilities include validating member, provider, and other claims information,...

Guidewire Claim Center Developer RoleWe are seeking an accomplished Guidewire Claim Center Developer to spearhead our team's technical advancements.Essential expertise in GW Claims Configuration and Integration is required.GW Cloud certification holds significant value for the ideal candidate.Guidewire Certified professionals possess a considerable...

About this roleOur client is a family-owned business that has been a leader in the automotive warranty industry since 1966. We provide stability, growth, and career development opportunities.Job SummaryThe Warranty Administrator will be responsible for accurate and timely processing of warranty claims. This role requires strong attention to detail, effective...

Job Title: Operations Leader - Enrollment and Claims Management The role of the Operations Leader is to oversee the entire lifecycle of member enrollments and claims adjudication, ensuring compliance with US healthcare regulations, client-specific guidelines, and quality standards. This involves managing a team of professionals responsible for processing...

Job Title: Dental Insurance Verification AgentWe are seeking a detail-oriented and organized professional to join our dental practice team as a Dental Insurance Verification Agent. This role is responsible for the timely submission of dental insurance claims, tracking payments, following up on outstanding balances, and ensuring the accuracy of accounts...

Job Opportunity:We are seeking an experienced professional to fill the position of AR Caller with a strong background in Oncology billing and collections.About the Position:The ideal candidate will have at least 3 years of experience in AR calling specifically in oncology, excellent communication skills, and the ability to handle complex claim resolutions...

We are looking for an experienced Assistant Manager to oversee the Enrollment and Claims Adjudication process in US Healthcare. This role involves managing a team of healthcare professionals who process member enrollments and adjudicate claims in compliance with US healthcare regulations, client-specific guidelines, and quality standards.Key...

Main Accountabilities:Assess the documentation received for a claim in order to reach a decisionDetermine how the contract applies to each claimCommunicate clearly and proactively with clients, advisors and various professionals and effectively manage their expectationsMaintain established service standardsEvaluate opportunities for process improvements and...

Job Title: Auditing and Reimbursement ProfessionalRole Overview:This role is accountable for managing day-to-day activities of Denials Processing/ Claims follow-up/ Customer Service. The incumbent will be responsible for reviewing emails for updates, communicating with insurance carriers, documenting notes in software and spreadsheets, and taking necessary...

Job DescriptionWe are seeking a talented Business Tester to join our team, who will be accountable for developing test strategies and plans based on project requirements. They will execute functional and regression testing, report defects in a tracking tool, and ensure their closure through the Software Testing Life Cycle (STLC) process.The ideal candidate...