Career Opportunities: Claims Resolution Specialist

Job Summary:The primary role of the Claims Resolution Specialist is to facilitate a seamless claims process by scrutinizing claim documents, collaborating with internal stakeholders, and ensuring timely receipt of all required documentation.Key Responsibilities:Review and verify claim documents against established proceduresIdentify discrepancies between...

Claims Handling SpecialistThe Claims Handling Specialist is responsible for managing all aspects of claims, ensuring fair settlement and adherence to legal requirements.Key responsibilities include receiving and answering emails and telephone calls related to claims, advising policyholders on claim procedures, and ensuring timely resolution of...

About Prisha Insurance Brokers Pvt. Ltd.Prisha Insurance Brokers Pvt. Ltd. is a leading insurance brokerage firm dedicated to providing comprehensive insurance solutions to individuals and businesses. With a focus on customer satisfaction and personalized service, we strive to offer the best insurance products tailored to our clients' needs.Job Description:...

Job DescriptionWe seek an expert to manage denied claims and identify revenue gain opportunities. The successful candidate will review open AR claims, identify trends through data analysis, and coordinate with stakeholders to address issues.Key Responsibilities:Conduct thorough reviews of denied claims and account-level dataAnalyze data to identify process...

Investigations and Dispute Resolution Manager">We are seeking an experienced Investigations and Dispute Resolution Manager to join our team. As part of our Investigations and Fact Finding practice within Fraud Investigations and Regulatory Enforcement services, you will have the opportunity to help our clients understand where they might have vulnerabilities...

Job OverviewWe are seeking a highly skilled and detail-oriented Financial Claims Specialist to join our team. This role is responsible for managing and resolving insurance and patient payment collections to ensure timely revenue realization.Key Responsibilities:Proactively follow up with insurance companies (Medicare, Medicaid, Commercial) via phone, portal,...

Claims SpecialistAs a Claims Specialist, you will be responsible for analyzing and managing claims for various lines of business.Key Responsibilities:Examine claims and supporting documentation to verify eligibility and accuracy.Process claims activities such as establishing new claims, making payments, refunds, updating reserves, and adding vendor details...

Lead Denial Management SpecialistJob DescriptionWe are seeking a seasoned professional to oversee the Claims Denial Management Process within our Revenue Cycle Management department. As a Lead Denial Management Specialist, you will be responsible for leading a team of denial management specialists in analyzing and resolving claim denials to maximize revenue...

Role & responsibilitiesVerify the accuracy and completeness of claim documents, including medical records and billing informationHandle customer inquiries related to claims status and provide resolution.Maintain and update claim records in the system.Identify discrepancies, fraudulent claims, and escalate cases as necessary.

Job Description:The global claims quality assurance function is responsible for supporting claims audit activities by providing expertise to internal and external stakeholders. The aim of the QA framework is to enhance claims outcomes through a structured review process.Key Skills and Qualifications:Claims handling and analysisProcess improvement...