Claims Examiner

**Healthcare (Medical) Claims Examiner** Smart Data Solutions (SDS) is a technology leader in healthcare process automation and interoperability. We are seeking to add an experienced Claims Examiner to our rapidly growing organization! A career at SDS is both challenging and rewarding. With over 500 colleagues across the globe, we've created an open and...

Claim Review & Investigation: Examine incoming claims to verify their accuracy, completeness, and legitimacy. Policy Verification: Confirm that claims fall under the terms and conditions of the relevant insurance policy or contract. Compliance: Ensure all claims processing and settlements comply with company policies, industry standards, and legal...

**Adjudication - Claim Examiner** **Job Title**: Claim Examiner "Adjudication" **Location**: Chennai **Job Type**: Full-Time **Shift**: Day Shift “Based on the Client Requirement” **Gender**: Male/ Female **Experience**: Fresher - Responsible for the coordination and resolution of the administrative denials and appeals. - Ability to understand logic of...

**In this role you will be responsible for**: Life Claims: - Processing Death Claims and identifying the right beneficiary(s) to provide the Claims benefit - Setting up a claim and then following up for pending requirements (if any) - Examining the received documents, payment calculation and settlement - Perform additional review before cutting the check...

**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,...

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...

**Greeting From Link K Insurance TPA Pvt Ltd** We are hiring **Medical Officer** for our **Claims Team**at our **Chennai Corporate office.** **Job Role: Medical Officer** **Industry: TPA Health Insurance** **Location: Anna Nagar, Chennai** **Experience: 3 to 5 Years** **Qualification: BAMS (**Bachelor of Ayurvedic Medicine and Surgery)...

**Executive should be aware of Hospital Billing and Front office work.**: - **Should be willing to work in Night Shift.**: - **This 30 bedded Hospital is located in Chromepet.** **Also will be engaged in** - Preparing and submitting billing data and medical claims to insurance companies. - Ensuring the patient’s medical information is accurate and up to...

**Job Summary**:A claims examiner needs to analyse multiple documents / contracts and decide to pay / deny the claim submitted by member or providers with respect to client specifications. The claims examiner should also route the claim to different department or provider / member for any missing information that required for claims adjudication. The claims...

**Job Summary**:A claims examiner needs to analyse multiple documents / contracts and decide to pay / deny the claim submitted by member or providers with respect to client specifications. The claims examiner should also route the claim to different department or provider / member for any missing information that required for claims adjudication. The claims...