Average salary: Rs200,000 /yearly
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- ...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
Pune3 days ago - ...: • Enforce zero-tolerance policies on substance abuse, ragging, bullying, and harassment (UGC-compliant). • Investigate and adjudicate disciplinary cases; conduct regular announced and surprise hostel inspections. • Oversee biometric/RFID entry logs, overnight absence...SuggestedFull timeLocal areaRelocationNight shiftWeekend work
Newton School
Pune3 days ago - ...degree (BSC, B-Pharma, B. Com, BA, Nursing, Life Science etc.) Experience: 1-3 years in any US Healthcare Process like Release of Information, Claims Adjudication/Adjustment, Medical Billing, RCM etc. Healthcare document retrieval experience will be an added advantage....Suggested
clinetic, an mro company
Pune2 days 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
- ...strong advantage. ~ Working knowledge of benefits administration — plan configuration, member-provider relationships, and claims adjudication flows. Delivery & Program Management Demonstrated experience managing enterprise software delivery programs involving .NET...SuggestedContract workRemote jobFlexible hours
Simplify Healthcare
Pune4 days ago - ...issues, including: Conducting complainant, witness and subject employee interviews; Analyzing data from various internal systems; Case adjudication; Proposing remedial action based on investigation findings; Production of completed investigation documentation Independently...SuggestedTemporary workFlexible hours
Amazon Railings
Pune11 days ago - ...Listed below are the primary job duties and responsibilities that are required: Review claims for legitimacy and accuracy Adjudicate claims by approving or denying them according to established guidelines. Conducts investigation of pended claims and follow up with...SuggestedFull timeNight shift
Mphasis
Pune2 days ago Rs 6.5 - 9.5 lakhs p.a.
...(P&C) Insurance. At least 2 years of hands-on experience in a team handling or supervisory role. Proven experience in claims adjudication, claims adjusting, and end-to-end claims processing. Preference for candidates holding CPCU or equivalent insurance designations...SuggestedFull timeWork at officeImmediate startShift workNight shift- ...detection, phase recognition, SAM-style masks). ~ Quality, IAA & Release Gates ~Define gold sets and acceptance thresholds: ~Phase/event F1 ≥ 0.92 ~Tool mAP ≥ 0.85 ~Anatomy Dice ≥ 0.85 ~Run double-labeling (≥10%), adjudication, and weekly QA reviews....SuggestedShift work
codvo.ai
Pune3 days ago - ...claims processes and operating models.Strong understanding of :- Pre-authorisation workflows- Reimbursement and cashless claims- Auto-adjudication and manual assessment flows Claims intake and registration- Medical coding and clinical pathways- Provider and hospital workflows-...SuggestedRemote job
- ...clients, procedures, and modalities. Set and enforce standard operating models from intake de identification annotation QA/IRR adjudication dataset release + evidence packs. Ensure programs meet or exceed SLAs, quality thresholds, and release timelines at scale. Operating...SuggestedHourly payLong term contractFull timeHybrid workShift work3 days week
codvo.ai
Pune3 days ago - ...healthcare revenue cycle management or a related field. Understanding of medical billing codes, insurance processes, and claim adjudication. Strong communication skills for effective interaction with insurance companies and patients. Attention to detail and accuracy...Suggested
SRKay Consulting Group
Pune13 days ago - ...B. Com, BA, Nursing, Life Science etc.) Experience: 0-3 years in any US Healthcare Process like Release of Information, Claims Adjudication/Adjustment, Medical Billing, RCM etc. Healthcare document retrieval experience will be an added advantage. Important Notice: This...SuggestedFull timeWork at officeShift work
clinetic, an mro company
Pune17 hours ago - ...Program delivery (E2E): Stand up and run the annotation 'factory' from intake → de-ID → task orchestration → annotation → QA/IRR → adjudication → dataset release + evidence pack. Ontology + guidelines execution: Partner with clinical SMEs to operationalize a procedure-specific...SuggestedHourly payFull time
Codvo.ai
Pune3 days ago - ...reporting requirements (e.g., IRDAI, IFRS, Solvency II). Ensure models capture core insurance processes such as claims intake, adjudication, settlement, renewals, endorsements, and cancellations. Collaboration & Stakeholder Engagement Partner with business analysts...Suggested
EXL
Pune3 days ago - ...that support the claims process across its lifecycle, including first notice of loss, claims investigation, payment administration or adjudication, provider reimbursement (health care), subrogation and recovery. What are we looking for You will be responsible for developing...Flexible hoursShift work
Accenture
Pune3 days ago - ...translate policies into executable rules and evaluators. Run stakeholder UAT cycles: test planning, evidence collection, false-positive adjudication, iterative tuning. Manage vendor engagements: technical due diligence, integration interfaces, performance/SLA validation, joint...Permanent employmentFull timeContract workHybrid workFlexible hours
Rs 1.5 - 4 lakhs p.a.
...cross functional interactions Extensive knowledge of the Property Casualty insurance lifecycle including underwriting rules claims adjudication and financial reporting Stay ahead of Guidewire Release cycles to evaluate new features eg Jutro digital frameworks or Advanced...LTM
Pune19 days ago
