Claims Officer- medical approvals

Responsibilities: * Approve medical claims within policy guidelines * Collaborate with TPAs on claim resolution * Ensure accurate payment processing * Maintain compliance with regulatory requirements Health insuranceProvident fund

Attending emails & calls from clients & sales team regarding approvals & claims & coordinating with insurance companies & TPA's through emails & telephoneEscalate the unresolved/special consideration casesHandling RI ClaimsMaintaining KPI records Required Candidate profile Salary : Upto 6 LPA6 Days WorkingShift : 9:30AM to 6:30PMLocation : Uttam Nagar ...

Attending emails & calls from clients & sales team regarding approvals & claims & coordinating with insurance companies & TPA's through emails & telephoneEscalate the unresolved/special consideration casesHandling RI ClaimsMaintaining KPI records Required Candidate profileSalary : Upto 6 LPA6 Days WorkingShift : 9:30AM to 6:30PMLocation : Uttam Nagar Must...

**Role : Medical Officer - CLAIM PROCESSING** 1.Medical Scrutiny by thorough assessment of documents. 2.Provide Medical opinion on admissibility of Insurance Claims. 3.Proficient with medical terms & system. 4.Understanding of Policy terms & conditions with their practical applicability & Various Protocols / Guidelines. 5.Understanding of Claims...

Job description The incumbent should be B Pharma / M Pharma/ BDS/ BHMS/BAMS graduate and would be responsible for the following jobs: - Audit all the invoices submitted by the users as per the standard guidelines - Involved in Analyzing Medical Reports to Process Medical Claims - Analyze and process the insurance claim under SLA - Final approvals for...

Claims Resolution SpecialistThe role of a Claims Resolution Specialist involves communicating with insurance companies and patients to resolve outstanding medical claims. This process requires navigating complex billing and coding rules, making this position critical in denial management.Key Responsibilities:Resolution and Follow-up:Initiate contact with...

Retrieve and collect physician background info from various resources for reporting - Analyze medical malpractice claims by identifying issues, events, diagnoses, and procedures that resulted in the action - Prepare summaries and assign the appropriate codes that apply - Review claims to formulate a synopsis of facts and collaborate with claims examiners...

Hello Everyone,Calibrated Healthcare is hiring for a US healthcare claim examiner. if interested mail your resume on*Job Title:* US Healthcare Claim Examiner*Experience:* 1+ year*Location:* [Dwarka sector 8]*Job Type:* Full-time (In-Office )*Job Summary:*We're seeking a detail-oriented and analytical Healthcare Claim Examiner to join our team. As a Claim...

Medical Processing Auditing & Analyzing medical documents Raising Queries as if required to process the claim Settle the claim on medical ground as per insurance company policies. **Job Types**: Full-time, Fresher Pay: ₹25,000.00 - ₹30,000.00 per month **Benefits**: - Commuter assistance - Health insurance - Life insurance - Paid sick time -...

Claims Executive Job Description: Key Responsibilities: • Receive and review claim submissions from distributors, retailers, and sales staff. • Validate claims against schemes, offers, and company policies. • Ensure all supporting documents (invoices, credit notes, approvals) are accurate and complete. • Process approved claims in the system...