Medical Claim
7 days ago
JOB SUMMARY The Claims Processor will review and adjudicate claims verifying eligibility, approval of services, and accurate pricing. Education: Bachelor’s Degree Experience: 3 to 5 years of medical claims billing and claims processing experience with mandatory knowledge of CPT4 and ICD10 codes.
KEY JOB RESPONSIBILITIES
- Completes accurate analysis of claim determination for payment or denial based on established rules and processes.
- Monitor claim inventory of assigned accounts and ensure turnaround and productivity benchmarks are met.
- Processes claims from returned pended claims reports and those containing claim edits.
- Manually prices claims based on specific rates.
- Audit peer’s work for continued cross training and education.
- Follow-up on provider calls on status, explanation of payment, billing errors, and refund requests.
- Communicate to Claims Leadership any issues that would impede the accurate and timely processing of claims.
KNOWLEDGE, SKILLS, AND ABILITIES
- Must be alert at all times; pay close attention to details.
- Must be able to work under stress on a regular or continuous basis
**Job Types**: Full-time, Fresher
**Salary**: ₹300,000.00 - ₹900,000.00 per year
**Benefits**:
- Health insurance
- Provident Fund
Schedule:
- Night shift
- US shift
Supplemental pay types:
- Performance bonus
- Shift allowance
- Yearly bonus
Ability to commute/relocate:
- Mysuru, Mysore - 570021, Karnataka: Reliably commute or planning to relocate before starting work (required)
**Experience**:
- total work: 1 year (preferred)
-
Claim Process Associate
10 hours ago
Mysuru, Karnataka, India SAS Poorna Arogya Health Care Pvt Ltd Full timeThe Claims Process Associate is responsible for managing and processing insurance claims by reviewing documentation, verifying details, and ensuring claims are processed in a timely and accurate manner. The role involves communication with customers, insurers, and other parties to resolve issues and ensure claims are settled appropriately. **Key...
-
Bengaluru, Karnataka, India MEDI ASSIST INSURANCE TPA PRIVATE LIMITED Full time**Job description**: **Roles and Responsibilities** 01. Involves Processing of Claims ( Preauthorization / Reimbursement claims) 02. Validating and processing these claims within TAT 03. With good communication and medical Knowledge 04. TPA Experience is an added advantage **Financial**: To see to that there is no financial implication for the...
-
Claims Associate
1 week ago
Bengaluru, Karnataka, India Dinoxo Full time**Job Title**:Claims Management Specialist **Location**:Whitefield **Office Address**:Primeco Union City Bengaluru, Headquarters 560048, IN **About the Job**: Claims Management Specialist is responsible for processing and managing cashless insurance claims efficiently and accurately, ensuring timely closure to policyholders and seamless coordination with...
-
Medical Officer-claims Processing
1 week ago
Bengaluru, Karnataka, India MEDI ASSIST INSURANCE TPA PRIVATE LIMITED Full time**Job description** **Role**:Medical Officer** **Work from Office only** **Job Descriptions**: - To approve Claims based on the buckets allotted to each approver. - To inform the Network department in case of any erroneous billing / excess billing. - To approve online preauthorization requests received. - In case of any suspicious case, the same will be...
-
Medical Officer
1 week ago
Bengaluru, Karnataka, India Medverve Healthcare Full timeJob Title: Medical Officer Location: Bangalore Company: Medverve Healthcare Pvt Ltd Experience: Frshers in non clinical Qualification: BAMS About Us: MedVerve is co-Founded and run by a core team of qualified professionals from Healthcare Industry, with experience in Insurance Companies, TPAS, Hospitals and IT Healthcare. Bringing in strong skills in...
-
Senior Medical Coder
2 weeks ago
Mysuru, India Forefront Healthcare Pvt Ltd Full timeWe are looking for experienced Multi-Specialty Medical Coders who are proficient in coding across various medical specialties. The ideal candidate should be well-versed with CPT, ICD-10-CM, and HCPCS Level II coding, and have a deep understanding of payer guidelines and compliance standards. This role requires accuracy, attention to detail, and the ability...
-
Claims Representative
7 days ago
Bengaluru, Karnataka, India The Cigna Group Full timeAbout Us At CIGNA Healthcare we are guided by a common purpose to help make financial lives better through the power of every connection. Responsible Growth is how we run our company and how we deliver for our clients, teammates, communities, and shareholders every day. One of the keys to driving Responsible Growth is being a great place to work for our...
-
Claims Representative
2 days ago
Bengaluru, Karnataka, India The Cigna Group Full timeAbout Us At CIGNA Healthcare we are guided by a common purpose to help make financial lives better through the power of every connection. Responsible Growth is how we run our company and how we deliver for our clients, teammates, communities, and shareholders every day. One of the keys to driving Responsible Growth is being a great place to work for our...
-
Claims Representative
22 hours ago
Bangalore, Karnataka, India The Cigna Group Full timeAbout UsAt CIGNA Healthcare we are guided by a common purpose to help make financial lives better through the power of every connection Responsible Growth is how we run our company and how we deliver for our clients teammates communities and shareholders every day One of the keys to driving Responsible Growth is being a great place to work for our...
-
Doctors Tpa Insurance Claims
7 days ago
Whitefield, Bengaluru, Karnataka, India Tresbien HR Staffing Full timeGreetings! Hiring Doctors Medical Officers for Non Clinical Profile (Health Claims) to be processed. Experience - 3 to 5 Years Qualification - MBBS, BDS, BHMS & BAMS Location - Whitefield, Bangalore **Job Description**: - Examining & passing Medical\Health claims of patients. Analysis Reports & processing claims. Final approval of mediclaims. Good...
