US Healthcare Claims Operations Specialist

Claims Adjudication SpecialistWe are seeking a skilled Claims Adjudication Specialist to lead the claims processing function in the US healthcare sector.Responsibilities:Manage claims adjustments and coding (ICD, CPT, HCPCS)Lead NSA project experience with expertise in claims processingCollaborate with cross-functional teams to resolve complex claims...

Job Title:Medical Billing SpecialistJob Type: Full-time (work from home)Work Days: Monday to Friday Work Hours: 8:30 am to 5 pm [as per MT timezone]; Nightshift in IndiaHolidays: as per the US CalendarExperience: 1+ year in US healthcare industryResponsibilities:Submit and follow up on claims with insurance companies to receive payment for services rendered...

Hiring Company:Bombe.Design(India's leading design-led digital solutions partner)Client:AUS-based medical organizationdelivering advanced, tech-enabled healthcare services.Work Location & Model:Hybrid (India-based):Work from Home most daysMandatory 2 days/week in-office during Indian business hours for team collaborationWork Timings:6:00 PM to 2:30 AM IST6...

Job Title:Claims ManagementJob Overview:The Claims Management Specialist is responsible for efficiently and accurately processing cashless insurance claims.Key responsibilities include verifying policy coverage, providing customer service, coordinating with healthcare providers, resolving issues, maintaining records, adhering to service level agreements, and...

JOB TITLE: Claims SpecialistWe are seeking an experienced and skilled Claims Specialist to join our team. This role is responsible for monitoring and handling all legal issues regarding claims matters, as well as recovering costs and expenses incurred by our company from third parties.Key Responsibilities:Maintain up-to-date knowledge of relevant laws and...

Job Role: Healthcare Revenue Cycle ProfessionalAbout the Position:We are seeking a skilled and experienced individual to join our healthcare revenue cycle team. As an AR Caller, you will be responsible for making outbound calls to US healthcare insurance companies, resolving outstanding claims, and ensuring timely reimbursement for healthcare providers.Key...

Health Insurance Claims ProfessionalOur organization seeks a highly skilled and empathetic Health Insurance Claims Professional to handle claims with accuracy, fairness, and efficiency.This role requires strong analytical skills to evaluate health insurance claims, as well as excellent communication skills to coordinate with hospitals, TPAs, and...

Insurance Claims Settlement SpecialistThis role involves overseeing the entire insurance claims settlement process from submission to final resolution. The ideal candidate will assess claims, investigate their validity, coordinate with adjusters, and ensure timely and fair settlements.The Insurance Claims Settlement Specialist is responsible for handling the...

Job Opportunity: Billing & Claims SpecialistWe are seeking a highly organized and detail-oriented individual to fill the role of Billing & Claims Specialist.Prepare and submit dental insurance claims accurately and on time.Post insurance and patient payments in practice management systems.Follow up on unpaid or denied claims to ensure resolution.Communicate...

Job Role: Data Mapping SpecialistKey Responsibilities:Support the migration of claims data from legacy systems to Guidewire Claim Center by analyzing and mapping system tables to the target structures.Develop and validate SQL queries for efficient data extraction and transformation.Collaborate with cross-functional teams to ensure accurate data mapping and...