Claim Adjudication
13 hours ago
Role :Claims Adjudication
Experience :2+years
Type:Contract
Location :Coimbatore, Chennai
Shift :US shifts
**Claims ExperienceIn this Role you will be Responsible For**
- Experienced level adjudicator providing analytical ability to review claim rules and workflows.
- Reviews claim requests to determine eligibility for processing and escalate to management as necessary.
- Responsible for the coordination and resolution of the administrative denials and appeals
- Ability to understand logic of standard medical coding (i.e. CPT, ICD-10, HCPCS, etc.).
- Ability to resolve claims that require adjustments and adjustment projects, Identify claim(s) with inaccurate data or claims that require review by appropriate team members.
- Organizing and completing tasks per assigned priorities.
- Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team
- Resolving complex situations following pre-established guidelines
**About CIEL HR**
Ciel HR marks the return of HR visionaries to the HR Services industry, powered by technology and analytics. The Founders of Ma Foi, the pioneer of the HR services sector in India, along with some of the finest brains in the HR Services Industry have envisioned and built the firm, CielHR, to deliver the full range of Recruiting services from Executive Search, Recruitment Process Outsourcing and Staffing Permanent as well as Temporary roles through its offices in India and the Middle East.
-
Claims Adjudication
2 weeks ago
Bengaluru, India CIEL HR Services Full timeUniversity degree or equivalent that required formal studies of the English language and basic Math - Immediate Joiner and chennai Location - Claims Adjudication. - 2+ year(s) of experience processing claims for the US healthcare market - Knowledge of HRP - added advantage - Claims Adjudication. - 6+ months of data entry experience that required a focus on...
-
Tl -claim Adjudication
2 weeks ago
Bengaluru, Karnataka, India Star Secutech pvt ltd Full time**Job Title**: Team Lead - Claims Adjudication **Location**: Bangalore **Experience**: 5-8 years in US Healthcare Claims Adjudication with minimum 2+ years in a Team Lead role **Key Responsibilities**: - Supervise and manage a team of claims adjudicators ensuring daily targets and quality standards are met. - Monitor team performance, allocate workload,...
-
Mainframe +Claim Adjudication
1 day ago
Bengaluru, India Cognizant Full time-Application development experience in Design, coding, testing and debugging with mainframe skills such as CICS, VSAM, COBOL, DB2, JCL, Zeke, File Aid, Changeman, AbendAid-Programming, conduct code reviews, and test software as needed, ensuring quality of deliverables-Should have experience in Claim adjudication experienceNote: Applicants should be ready to...
-
Bengaluru, Karnataka, India Tata Consultancy Services Full time ₹ 9,00,000 - ₹ 12,00,000 per yearRole: Claims Processing and AdjudicationExperience: 6 to 8 yearsJob Location: BengaluruJD : Kindly refer to the end of the postInterested candidates please mail with EP ID (registration number process mentioned) in the mentioned Email ID )Please mention "#Claims Processing and Adjudication_Bengaluru" in your EMAIL SUBJECT LINEMandatory Requirements (How to...
-
US Health Care Claims Adjudication
1 week ago
Bengaluru, Karnataka, India Webtech Softwares Full time ₹ 5,00,000 - ₹ 15,00,000 per year4+ Years of Experience in US Healthcare Claims Adjudication Open Positions :Team Leader OperationsQuality SpecialistSubject Matter Expert (SME)Process Trainer Hari Shiny
-
Life Adjudication
4 days ago
Bengaluru, Gurugram, India Sun Life Global Solutions Full time ₹ 2,00,000 - ₹ 6,00,000 per yearRole & responsibilitiesLooking for Immediate Joiner (IC Role)Shift timings- 05:30 PM to 02:00 AM (Night Shift)Life Claims Adjudicator:The Individual Insurance Claims department plays a crucial role with our clients as we offer them financial help when they most need it. We are looking for a motivated individual who is eager to learn to hold the position of...
-
SPE-Claims HC
2 days ago
Bengaluru, Karnataka, India Cognizant Full time ₹ 4,00,000 - ₹ 8,00,000 per yearJob SummaryJoin our team Clinical Claims Review Specialist where you will leverage your expertise in claims adjudication to ensure accurate and efficient processing of claims. With a focus on commercial claims and payer domain you will work remotely during night shifts contributing to our mission of providing exceptional service and support to our clients....
-
Spe-claims Hc
4 days ago
Bengaluru, Karnataka, India Cognizant Full time**Job Summary** Join our team Clinical Claims Review Specialist where you will leverage your expertise in claims adjudication to ensure accurate and efficient processing of claims. With a focus on commercial claims and payer domain you will work remotely during night shifts contributing to our mission of providing exceptional service and support to our...
-
SPE-Claims HC
4 days ago
Bengaluru, Karnataka, India Cognizant Full time ₹ 9,00,000 - ₹ 12,00,000 per yearJob SummaryClinical claim ReviewResponsibilitiesOversee the claims adjudication process to ensure accuracy and compliance with industry standards.Provide expertise in claims and payer domains to enhance operational efficiency.Analyze claims data to identify trends and areas for improvement.Collaborate with team members to streamline claims processing...
-
Sr. Associate Claims
1 week ago
Bengaluru, Karnataka, India ACKO Full time ₹ 2,50,000 - ₹ 7,50,000 per yearAbout JobThe Life Insurance Group Claim Adjudicator is responsible for reviewing, analyzing, and adjudicating group life insurance claims in accordance with policy terms, company guidelines, and regulatory requirements. The role ensures timely and accurate assessment of claims while maintaining a high level of customer service and compliance. The adjudicator...