Analytical Claim Specialist

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 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...

Job Title:Claims Resolution Specialist">Description:The Claims Resolution Specialist will be responsible for receiving and answering emails and telephone calls related to claims. This role involves providing advice to policyholders on claim procedures, ensuring fair settlement of claims in a timely manner, and managing all administration aspects of the...

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,...

Intelligent Claims Resolution SpecialistWe are seeking a skilled professional to orchestrate Large Language Models (LLMs) and Small Language Models (SLMs) that optimize revenue cycle processes, minimize Accounts Receivable (AR) dollars, and improve claim resolution efficiency.About the Role:The ideal candidate will work closely with healthcare experts and...

Job Description:As a Trade Claims Specialist, you will be responsible for end-to-end trade claim calculation, verification and finalization. You will work closely with the team to ensure accurate and timely processing of trade claims.Your key responsibilities will include:Trade Claim calculation and verificationNMC claim verifications and DM difference...

The ideal candidate for this role will have 3-5 years of experience in a similar position, with a strong understanding of claim processes and procedures. This experience should be focused on reviewing distributor claim documents thoroughly, ensuring completeness according to a set checklist.Key Responsibilities:Claim Scrutiny: Detail-oriented review of...

Claims Specialist Job DescriptionAnalyze and advise on claims for various lines of businesses. Key responsibilities include reviewing claims, establishing coverage, maintaining records, and preparing documentation.Key Responsibilities:Ensure eligibility for claims is reasonable and correct by analyzing claims and supporting documentation.Adjudicate claims...

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...