Average salary: Rs797,400 /yearly
More statsSearch Results: 50 vacancies
...Medical Adjudicator
- Manage the adjudication of prescription orders
- Conversion of inbound request into completed orders
- Coordinate the scheduling and fulfillment of diagnostic tests and procedures prescribed by healthcare providers
- Workflow Optimization...
...Medium
US Timings
English
1 - 2 Years of experience in US Healthcare and in Benefit Configuration - Benefit coding / Auto Adjudication Set up processes.
Experience on Facets tool will be preferred.
Excellent US Healthcare knowledge in Benefits coding and validation...
...Surveillance / Monitoring
Sound understanding of Sanctions, PEP and other watch list which is required to perform core job for alert adjudication in accordance with bank’s policies
Ability to independently research, analyze, and recommend solutions to close open items and...
...projects with minimum of 150 employees.
~ Experience in US Healthcare Payor operation.
~ Working & Team handling Experience in claim adjudication/ Payment integrity/Enrollment
~10-12 years of experience in managing teams and minimum of overall delivery SLA management.
~...
...hospital contracts & taking appropriate action basis that
• Referring cases to various department like HCS, TMT, Triage after adjudication as and when required
• Identify any over charge, ineligible chargers, contract compliance, Provider or Member Fraud
Qualifications...
...and non-regulatory models and/or behavioral models (models in the area of Financial Crime like Fraud or AML, Marketing Campaigns, Adjudication models etc.), ensuring compliance with regulatory standards, and driving innovation in risk management practices.
Responsibilities...
...possess excellent organizational skills.
Willingness to travel 10%.
Ensures timely collection of documents and components of Adjudication Packages for Clinical Endpoint Committees to allow quality and complete adjudication of potential clinical endpoints occurring in clinical...
Remote job
...Handle departmental audits, enquiries, and similar interventions.
Preparing replies for show cause notices and representing before adjudicating authorities for SCN Handle assessments and appeals on various GST matters across India.
Draft submissions in relation to audit,...
...medical claim files to ascertain the medical admissibility.
•Must understand the policy wordings including Terms & conditions to adjudicate the Admissibility/Rejection.
•Processing of claims as per regulatory guidelines.
•Adhering to the TATs in processing.
•Quality...
...procedure and constantly innovating and improvising on the processes & plans for closing assignments
Appearances and arguments before adjudication and appellate authorities up to the Tribunal. Develop and maintain an effective working relationship with the tax authorities...
...KYCs and PMLA check
Compliance with IFSC regulations
AIF online applications to SEBI and resolving SEBI query
Handle SEBI adjudication proceedings and liaising with law firms
Reporting to Vistra group compliance
BRSA updation and implementation through change...
...That’s why HealthRules Payer has been ranked number one its class among CAP Solutions. Besides delivering 90%-97% first-pass auto-adjudication rates and 99%+ accuracy, it enables our customers to react swiftly to the latest regulatory shifts and competitive pressures. It opens...
...Exposure to Data Strategy and GenAI for Health Use Cases
• Should have project experience in working around (any 3-5):
o Claims Adjudication & Reimbursement
o Member Enrollment
o Benefits Administration
o Utilization Management
o Claims Audit & Reporting
o...
...procedure and constantly innovating and improvising on the processes & plans for closing assignments
Appearances and arguments before adjudication and appellate authorities up to the Tribunal. Develop and maintain an effective working relationship with the tax authorities...
...a payment hub with support for all major payment rails. Healthcare organizations can leverage NetXD's platform to automate claims adjudication and payment delivery processes rapidly. Digital Asset Native companies can leverage NetXD's General ledger.- We are witnessing a historic...
...of land acquisition documents viz sale deed, GPA, R of R, Legal opinions, mutation extracts, 109 process, NA orders and stamp duty adjudication etc and acquaintance with real estate sector.
Case briefing and liaison with external lawyer and follow up of court cases and obtaining...
...MANAGER 8L to 14 Lakhs
MANAGER 12L to 18 Lakhs ++
Responsibality :-
Responsible for setting up FNOL
Adjudication of limited threshold
Receiving queries over phone relating to Express claims
Submit payment via cheque/bank transfers...
...portals, eRx
Billing/Revenue cycle Management PMS, Claims management, EDI/X12, Clearinghouses, Denials Appeals etc.
Payers/PBMs Adjudication, Underwriting, Contract management, Benefits management, Health Plan design,
Regulations Meaningful Use 1/2/3, PQRS, MIPS, MACRA...
...; 10 RERA advice
Advising on mode and documents to be executed to perfect title; and
Computing the stamping duty / apply for adjudication and facilitate registration of documents
Have a good understanding of the commercial aspects of a transaction and the requirements...
...Revenue Cycle Management (RCM), Denial Prediction Engine, POS Collection, Liability Estimation, AR Decision Support Tools, Real-time Adjudication, & more.
Clinical Support Solutions: Suite of clinical support services that help providers deliver better clinical outcomes,...
