Claims Adjuster

Role & responsibilities:Review incoming claims for accuracy, completeness, and eligibility under policy coverage.Verify customer details, policy information, and supporting documentation.Visiting loss site, provide inputs on loss minimization.Maintaining Claims MIS Sheet.Assess claims against policy terms and identify discrepancies or missing...

**Adjudication - Claim Examiner** - Review medical documents, policy documents, policy history, Claims history, and system notes - Ability to understand logic of standard medical coding (i.e., CPT, ICD-10, HCPCS, etc.) - Process Insurance Claims timely and qualitatively - Ability to resolve claims that require adjustments and adjustment projects. - Identify...

Job DescriptionAs a Claims Operations Associate, you will be responsible for processing claims adjudication and adjustment processes. You will have experience in professional HCFA and institutional UB claims, as well as knowledge of healthcare insurance policy concepts.Key Responsibilities:Audit claims as outlined by Policies and Procedures.Utilize...

**Role**: HC & Insurance Operations Associate **Shift Timings**: 6 PM-4 AM IST (AR SHIFT) **Location**: Chennai/Coimbatore (Currently Remote) **Double vaccination required** **Roles and Responsibilities**: - Process Adjudication claims and resolve for payment and Denials - Knowledge in handling authorization, COB, duplicate, pricing and corrected claims...

Healthcare Insurance Operations PositionJob Description:This role involves processing adjudication claims and resolving payment and denial issues in a timely and accurate manner. It requires knowledge of healthcare insurance policy concepts, including in-network and out-of-network providers, deductibles, coinsurance, copays, out-of-pocket maximums, and...

Insurance Operations AssociateWe are seeking a skilled professional to join our team in Chennai, India.Job DescriptionThe successful candidate will be responsible for processing claims and resolving payment and denial issues. They will also need to have knowledge of healthcare insurance policy concepts, including in-network and out-of-network providers,...

Roles and Responsibilities:Process Adjudication claims and resolve for payment and DenialsKnowledge in handling authorization, COB, duplicate, pricing, and the corrected claims processKnowledge of healthcare insurance policy concepts, including in-network, out-of-network providers, deductible, coinsurance, co-pay, out-of-pocket, maximum inside limits, and...

Greetings from NTT DATA,Roles and Responsibilities:Process Adjudication claims and resolve for payment and DenialsKnowledge in handling authorization, COB, duplicate, pricing and corrected claims processKnowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of pocket, maximum...

Job Title:Insurance Claims HandlerJob Overview:We are seeking a skilled Insurance Claims Handler to manage the entire claims process from submission to final resolution. The ideal candidate will assess claims, investigate their validity, and ensure timely and fair settlements.Key Responsibilities:Claims Processing:Handle submitted documentation, determine...

Job Title:Claims and Authorizations SpecialistKey Responsibilities:Contact insurance companies via outbound calls to follow up on unpaid or denied claims.Review Explanation of Benefits (EOBs) to identify reasons for denials or delays.Take corrective actions such as resubmissions, appeals, or adjustments based on payer responses.Update billing software with...