Medical Claims

Should possess U.S Health insurance claim processing experienceKnowledge of medical billing and coding terminologiesReady to work in Night Shift as well as Day shiftUnderstanding of plan documents and general benefitsFamiliarity with terms such as deductible, out of pocket, coinsurance, and copayStrong attention to detail and accuracyAbility to work in...

Generate Cases, Allocate Cases to field investigator on day to day activity. Medical Claim Closer by Mail and by Concerned Portal. Study and analyze the medical records forwarded by clients for investigation. Make appropriate triggers for investigation. Allocate the case to investigators in field. Monitor the investigation, being done by field...

Medical Claims Review: Analyze and assess pre-authorization and post-treatment reimbursement claims. Review medical records, diagnosis, investigation reports, and treatment plans to ensure clinical appropriateness and policy alignment. Validate claims based on insurance policies, internal guidelines. Decision Making: Determine the admissibility or...

**Work Locations**: Opportunities available in_**Kochi, Bangalore, Gurgaon**_, and _**Mumbai**_._ **About Visit Health** Founded in 2016 by BITS Pilani alumni, Visit Health is a leading health-tech platform with a mission to make healthcare accessible, affordable, and preventive. Evolving from a telemedicine provider to a comprehensive wellness ecosystem,...

Roles and ResponsibilitiesConduct thorough investigations into health insurance claims, including medical records review and witness statements gathering.Determine claim validity by analyzing policy terms, coverage conditions, and documentation.Coordinate with hospitals, doctors, and other stakeholders for smooth claim handling.Ensure compliance with...

Roles and ResponsibilitiesManage insurance claims from receipt to settlement, ensuring timely and accurate processing.Conduct thorough analysis of claim documents, including medical records, police reports, and other relevant documentation.Identify potential fraud risks and take necessary actions to mitigate them.Collaborate with internal stakeholders, such...

**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 organization while settlement...

Hiring Claims Executive for billing of medical claims. Candidate must have experience in tpa industry.

Company DescriptionParamount Health Services & Insurance TPA Pvt. Ltd. (PHS) is a Third Party Administrator in the health insurance sector, serving all insurance companies. PHS enhances health insurance policies through a network of healthcare service providers, medical care standardization, claims management, client servicing, and expert opinion, thereby...

As a Medical Coordinator - Claim Processing, your role involves verifying and processing insurance claims, ensuring accuracy in medical information capture, and facilitating communication among insurance companies, healthcare professionals, and patients. Your responsibilities will include: - Reviewing and processing medical insurance claims - Ensuring...