US Healthcare Claims Professional

Open Position :Team Leader OperationsQuality SpecialistSubject Matter Expert (SME)Process Trainer3.6 Years of Experience in US Healthcare Claim Processing and Adjudication Senior Talent Acquisition Shiny Hari

Job Title: Team Lead – Claims AdjudicationLocation: IndoreExperience: 5–8 years in US Healthcare Claims Adjudication with minimum 2+ years in a Team Lead roleKey Responsibilities:Supervise and manage a team of claims adjudicators ensuring daily targets and quality standards are met.Monitor team performance, allocate workload, and ensure timely processing...

Infireex is looking for Healthcare recruiters wherein you'll recruit across diverse verticals includingTravel Nursing, Allied Health, Physician Recruitment, Local Contracts, and Full-Time (Direct Hire) Placements. From filling a Med-Surg RN contract, to sourcing a local speech therapist, or hiring a full-time hospitalist—you'll manage the process...

Key ResponsibilitiesMedical Review Claims Adjudication:Assess and validate medical claims based on clinical documentation and policy coverage.Interpret diagnostic reports, treatment plans, and prescriptions to determine claim eligibility.Coordinate with internal medical teams to ensure accuracy in claims decision-making.Customer Interaction...

Experience : 3.5 Years in Claim adjudication: US HEALTHCARETL/QA/SME : On papers mandatoryWalkin Drive on 3rd and 4th Oct @Indore Relevant candidates only can reach me on

DescriptionVendor ManagementHandling litigation claimsHandling MIS & compliance related activitiesHandling corporate office activitiesCandidate must have:In depth technical knowledge of automobiles with experience in motor claim assessments & settlements for all productsGood interpersonal skillsMust be proactive & effective learnerExperience: Minimum 3 years...

Key ResponsibilitiesCollaborate with business and technical stakeholders to gather, analyze, and document healthcare domain requirements.Analyze clinical, operational, and claims data to support reporting, dashboards, and BI initiatives.Create comprehensive Business Requirement Documents (BRDs), Functional Specifications, and Data Mapping Documents.Partner...

Job Title: Specialist – Quality (US Healthcare Claims)Experience: 3.5+ years in US Healthcare Claims AdjudicationQualification: Any GraduateInterview - Walkin drive on Job Description:We are hiring a Quality Specialist with expertise in US Healthcare claims adjudication. The role involves conducting audits, ensuring compliance, identifying errors, and...

Responsibilities * Conduct thorough claims adjudication, processing, and review to ensure accuracy and compliance with regulatory requirements.* Manage claims from receipt to resolution, ensuring timely and efficient processing.* Collaborate with internal stakeholders to resolve complex claims issues and improve overall quality of service.* Maintain...

Job Summary:We are seeking a qualified and experienced medical professional with a strong background in health insurance claim settlement and customer service. The ideal candidate will leverage their clinical knowledge to evaluate and process health insurance claims efficiently while ensuring a high level of customer satisfaction. This hybrid role bridges...