Average salary: Rs797,400 /yearly
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- ...highly automated flow. Increase system integration to improve efficiency and drive cross-functional collaboration to improve claims adjudication quality through real time information using analytics. The simplification of the claims process includes a solution for all type of...SuggestedHourly payLong term contractFull timeContract workFlexible hours
- You are as unique as your background experience and point of view. Here youll be encouraged empowered and challenged to be your best self. Youll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire...SuggestedLong term contractFull timeImmediate start
- ...understanding of one or more of the following insurance processes Policy Lifecycle (Issuance Renewals Cancellations) Claims Lifecycle (FNOL Adjudication Settlement Recoveries) Underwriting & Risk Assessment Commission & Distribution Management Billing Regulatory and Statutory...SuggestedFull timeVisa sponsorshipWork visa
- ...Room eligibility Capping/Sublimit Coverage NME - Explore corporate based insurance eligibility Pre-Auth Document Validation and Adjudication: - Validate and adjudicate pre-authorization documents. - Ensure all necessary documents are shared with the hospital and that...SuggestedFull time
- ...Respond to and resolve queries from internal employees vendors and candidates regarding BGC processes. Handle low-complexity BGC adjudication scenarios using the Customer-approved decision matrix. Communicate hiring recommendations to the Customer team and convey...SuggestedFull timeContract workFor contractors
- ...experience from Med-Legal or life insurance projects, where the role of medical data is crucial for legal claims, settlements, or insurance adjudication. Regulatory Compliance Knowledge: Ensure all work complies with relevant healthcare privacy regulations (HIPAA and GDPR)....SuggestedFull timeCasual workDay shift
- ...documents, etc. Collaborate with the Screening Team to assess potential background check delays, as well as proactively work to adjudicate applicable searches. Build cross-divisional partnerships with Sales, Compliance, Legal, Contracts, Payroll, HR, etc. to gather insight...SuggestedHybrid workWork at officeLocal areaImmediate startRemote jobMonday to Thursday
Associate Consultant - Business Consulting PI - GOV - CNS - BC - Transformation Delivery - New Delhi
...integrity of claim processes. Skilled in delivering technical training sessions designed for various stakeholders involved in claim adjudication management. Proficient in supporting capacity-building initiatives to enhance the competencies of claim adjudicators and master...SuggestedLong term contractLocal areaImmediate start- ...point of contact for assigned employees to provide holistic case management services, including reviewing medical documentation to adjudicate leaves in compliance with the corresponding leave plans, federal and state laws and benefit plans as defined by Amazon • Leverage...SuggestedFull timeContract work
- ...plan hierarchies3. Coverage : policy rules, coverage tiers, network configurations4. Claims : medical, pharmacy, and dental claims, adjudication processes- Collaborate with business analysts, data architects, and ETL developers to gather requirements and translate them into...Suggested
- ...is entered and complete Ensuring all billable services are captured coded billed and submitted Ensuring billed services are adjudicated and paid accurately Providing functional oversight of Team A billing resources (Medical Biller & Coder 1 and Medical Biller & Coder...SuggestedHourly payContract workFor contractorsLocal areaImmediate startRemote jobWorking Monday to Friday
- ...our products and services by which clients must operate their Visa programs. The services provided include Rules management Dispute adjudication Contract management and external Standards Body Management which are provided to ensure the safety security and integrity of the...SuggestedFull timeContract workHybrid workWork at officeLocal areaRemote jobWork visa
- ...highly automated flow. Increase system integration to improve efficiency and drive cross-functional collaboration to improve claims adjudication quality through real time information using analytics. The simplification of the claims process includes a solution for all type of...SuggestedHourly payFull timeContract work
- ...documents Assist in the payment process of contracts and purchase orders Assist with the preparation of tender documentation and adjudication of tenders Create and maintain commercial registers Create and maintain financial data in SAP or other systems Insert data...SuggestedFull timeContract workFor contractorsNo agencyRemote jobFlexible hours
- ...in the Service Level Agreement (SLA). The job holder will work at the capacity of an Associate, hence working on the standard alert adjudication at a basic level. For Payments Screening, the job holder works on the Live Transactions to screen and identify Sanctions...SuggestedPermanent employmentFull timeHybrid workFlexible hoursShift workNight shift
- ...business solutions that support the healthcare claim function leveraging a knowledge of the processes and systems to receive edit price adjudicate and process payments for claims WORK LOCATION - MDC7 WORK STYLE - WFO. Flexible with Shifts including Night shifts...Full timeFlexible hoursNight shift
- ...Policy messages on various tools like support point info site etc. Referring cases to various department like HCS TMT Triage after adjudication as and when required Identify Front End Savings by investigating claims to Identify any over charge ineligible chargers contract...Full timeContract work
- ...cycle management. ~ Mandatory: Hands-on experience with ClinicMind/Vericle software. ~ Strong knowledge of billing workflows claim adjudication and payer requirements. ~ Excellent communication skills to interact with providers billing teams and technical staff. ~ Strong...Full timeWork from homeUS shift
- ...Requirements: • 1 years of experience as a Trainer (Classroom Training) in US Healthcare (Payer Side). • Strong knowledge of Claims Adjudication Adjustment and Payment Integrity. • Hands-on with NHT (New Hire Training) & OJT (On-the-Job Training) • Excellent communication...Full timeTraineeship
- ...sheets for all repair and overhaul events Fill Smart claims and submit them for approval Responsible to process warranty claims Adjudicate the different types of standard warranty and campaign warranty for engine events Fill SPOT (Special Coverage One Time) requests...Long term contractFull timeWork at officeFlexible hours
- ...prevention and wellness. ~ Working experience on Core Insurance solutions for Medicare Third-Party Claims Administration (TPA) Auto-Adjudication Claims Adjustment Explanation of Benefits (EOB) Policy checking Renewals Co-pay & Coinsurance ICD-10 CPT codes HCPCS codes HIPAA...Full timeContract workRemote jobShift work
- ...Respond to and resolve queries from internal employees vendors and candidates regarding BGC processes. Handle low-complexity BGC adjudication scenarios using the Customer-approved decision matrix. Communicate hiring recommendations to the Customer team and convey...Full timeContract workFor contractorsSide job
- ...ll Do: Own the rules layer : Design, implement, and optimize decision logic using Sparkling Logic SMARTS . Build real-time adjudication flows for transactions at grocery and pharmacy point-of-sale systems. Translate complex requirements into executable rules by...Full timeImmediate start
- ...examiner should also route the claim to different department or provider / member for any missing information that required for claims adjudication. The claims needs to be completed adhering to required TAT and quality SLA. Key Responsibility: 1. Production, Quality 2....Shift work
- ...submissions. Formulate defense strategies for complex litigations. Representation: Represent clients before tax authorities (Adjudication & Appellate levels) with confidence and technical depth. Support Senior Counsel: Collaborate with Partners and Senior...Full time
- ...quality and operational efficiency. Requirements Key Responsibilities Conduct quality audits and reviews of medical claims adjudication to ensure accuracy, completeness, and compliance with payer policies and regulatory standards. Ensure strict adherence to HIPAA...Full timeWeekday work
- ...Analyze data trends and out of pattern activities to assimilate the next course of action (Case closure Reimbursements or escalation) Adjudicate the fraud type and apply relevant mitigation steps basis policies and procedures Qualifications: Prior experience in Fraud...Full timeShift workNight shift
- ...Main Duties/Responsibilities: Adjudicate international medical/dental and vision claims in accordance with policy terms and conditions to meet personal and team productivity and quality goals. Monitor and highlight high cost claims and ensure relevant parties are...
- ...receivables ensuring the timely resolution and payment of accounts. Utilizing multiple reports and worklists ensuring that all claims are adjudicated correctly per the members benefits investigating claims that do not process as expected or for which we do not receive a...Full time
- ...integration ensuring compliance with IRDAI and SLA standards. Key Responsibilities: Map end-to-end claims process: intimation adjudication approval payment. Define workload balancing logic and queue management rules for claims teams. Design data and process...Remote jobFull time