Claim 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 Examiner - Adjudication** **JOB SUMMARY**: - 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...

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...

**Roles & Responsibilities of Cashless / Claims - Medical Officer / Doctor**: - Processing of health insurance claims submitted by policyholders, hospitals, or healthcare providers. - Get fully trained and understand claims software, functionality and validations. - Verify whether the claim falls within the coverage/ scope of the health insurance policy. -...

m **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...

**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...

**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...

**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...

HC & Insurance Operations Senior Rep. Position's General Duties and Tasks: 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...

JOB DESCRIPTION Position’s General Duties and Tasks: 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...