Average salary: Rs706,888 /yearly
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- ...escalation. Points to be noted: Candidates qualification should be from a science background. Manual Claims Adjudication Knowledge should be able to speak on the topic. Verify medical codes diagnosis and procedure to ensure compliance with industry...SuggestedFull time
Randstad India
Coimbatore17 days ago Rs 5 - 6.5 lakhs p.a.
• Perform end-to-end processing of Life & Annuity Insurance transactions. • Adjudicate claims and validate retirement benefit transactions. • Ensure compliance with regulatory and company guidelines. • Maintain detailed documentation with high accuracy and attention to...SuggestedOrcapod Consulting Services
Secunderabada month agoRs 3.5 - 6 lakhs p.a.
• Review and adjudicate medical insurance claims in line with policy guidelines • Validate member eligibility, coverage, and completeness of claims • Interpret CPT, ICD10, and HCPCS codes to make accurate claim decisions • Analyze clinical documents such as prescriptions...SuggestedOrcapod Consulting Services
Coimbatorea month agoRs 3 - 6 lakhs p.a.
...company and regulatory policies • Ensure compliance with health insurance guidelines and internal policy standards • Perform claims adjudication, verifying claim details, policy coverage, and eligibility • Monitor quality and performance metrics for timely claim processing...SuggestedOrcapod Consulting Services
Secunderabada month ago- Walk-in For Medical Billing (Claim Adjudication) - Healthcare Domain Start Date Starts Immediately CTC (ANNUAL) Competitive salary Competitive salary...SuggestedImmediate startUS shiftShift workNight shift
- ...Role : Adjudicator (Disagreement Resolution + Guideline Governance) Location: India | Type: Full-time | Reports to: Quality Lead / Program Lead Mission: Convert disagreement into defensible ground truth while continuously tightening the guideline system. About Us...SuggestedFull time
codvo.ai
Pune4 days ago Rs 8 - 12.5 lakhs p.a.
...benefits, and approve/reject per SOP • Provide guidance and support to junior advisors in resolving complex claims • Identify potential fraud, waste, and abuse (FWA); flag suspicious cases and work with compliance teams • Manual Claims Adjudication experience required...SuggestedOrcapod Consulting Services
Coimbatorea month ago- Claims Adjudicator (2-7 Years Experience) - Coimbatore TN We are seeking a meticulous and experienced Claims Adjudicator to join our team in Coimbatore Tamil Nadu. This is a proactive full-time opportunity for a professional dedicated to the accurate and efficient processing...SuggestedFull time
Randstad India
Coimbatorea month ago - Competencies: ~ Knowledge of individual life insurance ~ Excellent written and verbal communication skills with an ability to handle written inquiries of a sensitive nature ~5 years of client service experience or 5 years in a Life claims environment ~ Strong problem...Suggested
Sun Life
Gurgaon6 days ago Rs 4.5 - 7.5 lakhs p.a.
• Assess complex health insurance claims and ensure compliance with industry standards (ICD 9, ICD 10, CPT) • Review clinical, day case, inpatient, and outpatient claims to approve or reject as per SOP • Identify potential fraud, waste, and abuse (FWA) and escalate suspicious...SuggestedShift workOrcapod Consulting Services
Coimbatorea month agoRs 5 - 9.5 lakhs p.a.
Key Responsibilities: Assess complex medical claims for APAC insurance providers similar to AXA, AIA, Alliance Care. Verify medical codes, diagnoses, and procedures to ensure compliance with ICD-9, ICD-10, CPT, and other industry standards. Review Clinical & Day Case...SuggestedOrcapod Consulting Services
Coimbatorea month ago- ...reimbursement methodologies, or pricing analytics ~Experience with healthcare data systems such as QNXT, Facets, or similar claims adjudication platforms ~Familiarity with ETL/ELT pipeline concepts and data warehouse architecture (enough to have informed conversations with...SuggestedFull timeContract workHybrid workWork at officeFlexible hoursNight shift
- ...Roles and Responsibilities: ~ Process Adjudication claims and resolve for payment and Denials Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process Knowledge of healthcare insurance policy concepts including in network, out of network...SuggestedWorking Monday to FridayShift workWeekend work
- ...Responsibilities Review and evaluate AI-generated outputs related to policy language interpretation risk classification claims adjudication and actuarial projections. Create realistic scenarios based on insurance workflows such as underwriting submissions claims...SuggestedFull timeContract workSummer workRemote job
Mercor
Mumbai14 days ago - ...Qualifications Domain expertise in U.S. Healthcare: familiarity with HL7 v2 FHIR R4 X12 EDI (270/) payer/provider workflows claims adjudication and common interoperability tools (e.g. Mirth Connect). Experience with eventdriven and streaming patterns; caching (Redis)...SuggestedFull timeContract work
Genzeon Global
Hyderabada month ago - ...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 duration...Contract work
Amazon Thunder
Secunderabad9 days ago - ...throughout Graduation) ~ Overall, 8 and above years of work experience for international customer service u201Cvoiceu201D ~ Claim adjudication (Disability) experience is required ~ Ability to work evening/night shifts rotational shift b/w 5:00 PM to 6:00 AM IST ~7 days...Contract workTemporary workLocal areaWorldwideNight shiftAfternoon shift
NGA Human Resources, an Alight company
Gurgaon9 days ago - ...administrator. Role focuses on reviewing AI-generated outputs for accuracy and identifying data quality or workflow issues prior to downstream adjudication. Key Responsibilities: Review AI-generated claim summaries and extracted data against source documents (UB-04s, itemized...Hybrid workWork at officeRemote jobFlexible hours
ntt data north america
Bangalore6 days ago - ..., with proven ability to work under pressure and meet deadlines. Strong logical and analytical ability to identify anomalies and adjudicate alerts. Ability to work independently and multi-task in a fast-paced environment. Willingness to accept new assignments and challenges...Flexible hoursShift work
Jpmorgan & Co
Secunderabad6 days ago Rs 5 - 5.5 lakhs p.a.
...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 duration...Remote jobContract workWork from homeAmazon Development Centre (India) Private Limited
Bangalorea month agoRs 4 - 6 lakhs p.a.
...Individual & Group) and processes (specifically Claims). Must be able to analyse and outline the claims process from intake through adjudication and payment, to identify areas for improvement. Should have working knowledge of the Majesco ClaimVantage product. Must be...Contract workIfintalent Global Private Limited
Chennaia month ago- ...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
EY Consulting & Fabernovel
Delhia month ago - ...large teams in a BPO/TPA/payor setup supporting U.S. clients. ~ Familiarity with CMS regulations, eligibility guidelines, and claims adjudication workflows. ~ Excellent leadership, communication, and client management skills. ~ Ability to work in US shifts and manage...US shift
Firstsource
Bangalore6 days ago Rs 30 - 35 lakhs p.a.
...Relations, Utilization Management) per design specifications. Workflow Development Build out case management flows: claims intake, adjudication, grievances, and appeals using CSM case stages, SLAs, and assignment rules. Develop utilization management processes: prior...Full timeLocal areaRemote jobxo health inc.
Bangalore4 days ago- ...hospitals. 4. FWA investigations are to be conducted in the agreed percentage of claims.(Partner end) 5. The reimbursement claim adjudication rule engine (automated) should be aligned with the ABHI process. 6. Real time client Dashboard for client reviews. 7. ABHI to...Part time
Aditya Birla Group
Thane6 days ago Rs 0.5 lakh p.a.
...business solutions that support the healthcare claim function, leveraging knowledge of the processes and systems to receive, edit, price, adjudicate, and process payments for claims. Preferred candidate profile Only Commerce grads BATCH OF 2023 & 2024 Candidates should...Night shiftAfternoon shiftTrigent Software Private Limited
Mumbai27 days agoRs 7 - 12 lakhs p.a.
...Estimation Manager JD - Experience – 5+ Years * Estimation of interior fit-out projects. * Preparation of bills of quantities. * Adjudication of contractor's claims (measurement). * Estimating and cost control. * Managing full tender process. * Interpreting...Full timeFor contractorsFor subcontractoriQuest Management Consultants Private Limited
Mumbaia month ago- ...rotational offs Basic computer literacy and typing skill Experience with international healthcare insurance processes (e.g., claims adjudication, EOB, authorizations) Knowledge of HIPAA regulations Graduate in any stream (preferably Life Sciences, Healthcare, or related...Night shift
telus digital
Noida5 days ago - ...can meet the unique needs of each market segment. You would be part of General Insurance team, where would you be managing, Claims Adjudication, Claims Processing /Portfolio Management. Checking on Fraudulent Claims Rating and quoting including receipt, clearance, data gathering...Flexible hoursShift work
Accenture
Bangalore20 days ago - ...processes, reimbursement methodologies, and regulatory requirements. Strong understanding of healthcare payer policies and claims adjudication processes. Excellent communication and interpersonal skills, with the ability to effectively lead and motivate a team. Strong...Private practice
Ventra Health
Chennai6 days ago
