Mainframe +Claim Adjudication

Job Title Claims Adjudication - Non-Voice BPO Process Experience 3 to 7 Years Location Chennai Process Type Non-Voice Back Office Domain Healthcare Insurance Shift 5 30pm to 2 30pm or 6 30pm to 3 30pm Job Summary We are seeking a detail-oriented and experienced Claims Adjudicator to join our non-voice BPO team The ideal candidate will be responsible for...

Process all claims in each Level 1, 2 within 3 business day and maintain the turnaround time with in the specified global target - Discussed with market on age claims on weekly basis and take appropriate actions on the claims" - Claim Assessing based on Policy and provide suggestion to be implemented in policy - Do Claim Adjudication feedback analysis and...

**Job Summary** Join our dynamic team as a PE-Claims HC specialist where you will play a crucial role in processing and adjudicating claims with precision and efficiency. This hybrid role requires a keen understanding of Medicare and Medicaid claims ensuring compliance and accuracy. With a focus on night shifts you will contribute to our mission of...

About The client A Fortune 500 global leader in technology services and digital business solutions this company delivers comprehensive Business Process Services BPS and IT-enabled solutions With a worldwide presence it serves diverse industries including banking healthcare retail manufacturing and communications The firm s expertise spans a broad spectrum of...

**Designation: Quality Claims Executive** **Location: Neelankarai, ECR** **Job Roles & Responsiblities** Summary: As a Quality Executive specializing in Claims Analysis, you will play a pivotal role in ensuring the accuracy, efficiency, and compliance of claims processing within our organization. Leveraging your analytical skills and attention to detail,...

**Job Title: Claims Examiner II** **Do you see ? Are you passionate about?** **About us**: For over 20 years, Smart Data Solutions has been partnering with leading payer organizations to provide automation and technology solutions enabling data standardization and workflow automation. The company brings a comprehensive set of turn-key services to handle...

Roles and Responsibilities 2-3 years of experience in processing claims adjudication and adjustment process Experience in professional HCFA and institutional UB claims Knowledge in handling authorization COB duplicate and pricing process Knowledge of healthcare insurance policy concepts including in network out of network providers deductible coinsurance...

**Job Summary** healthcare **Responsibilities** Claims adjudication **Certifications Required** N / A

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 exclusions, state variations -...

**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...