Medical Claims jobs in Bengaluru, Karnataka
- ContactPoint 360Bengaluru, Karnataka
- Forward high cost amount claims to the medical team for evaluation.
- Optional Experience: Previous experience in medical insurance.
- The Cigna GroupBengaluru, Karnataka
- Provides clinical review expertise for high dollar and complex claims, including facility and professional bills.
- Adheres to quality assurance standards.
- Nova BenefitsBengaluru, Karnataka
- Managing the escalation related to claims.
- Communication with the employees regarding their claims.
- Follow up with the TPA/insurance for the claims.
- View all Nova Benefits jobs - Bengaluru, Karnataka jobs
- Salary Search: Claims Associate salaries in Bengaluru, Karnataka
- The Cigna GroupBengaluru, Karnataka
- Evaluates medical information against criteria, benefit plan, coverage policies and determines medical necessity.
- Strong interpersonal and communication skills.
- Agilon HealthBengaluru, Karnataka
- Review medical record information to identify all appropriate CPT II procedure coding.
- Utilize medical coding software programs or reference materials to…
- ContactPoint 360Bengaluru, Karnataka
- The intern will support a claims processing project by entering data and uploading medical provider invoices into a claims management portal, ensuring accuracy…
- The Cigna GroupBengaluru, Karnataka
- Provides clinical review expertise for high dollar and complex claims, including facility and professional bills.
- MBBS doctor with Oncology experience.
- The Cigna GroupBengaluru, Karnataka
- Provides clinical review expertise for high dollar and complex claims, including facility and professional bills.
- MBBS doctor with Oncology experience.
- Medi AssistBengaluru, Karnataka
- To scrutinize and process the claims within the agreed TAT by having an understanding of the policy terms & conditions while applying their domain medical…
- View all Medi Assist jobs - Bengaluru, Karnataka jobs
- Salary Search: Medical Officer salaries in Bengaluru, Karnataka
- See popular questions & answers about Medi Assist
View similar jobs with this employerMEDI ASSIST INSURANCE TPA PRIVATE LIMITEDBengaluru, Karnataka- To approve Claims based on the buckets allotted to each approver.
- To inform the Network department in case of any erroneous billing / excess billing.
- Rg Insure pro 20.comWhitefield, Bengaluru, Karnataka
- Proficiency with claims management systems and Microsoft Office Suite.
- Ability to manage multiple claims and deadlines in a fast-paced environment.
View similar jobs with this employerEmpower Annuity Insurance Company of AmericaBengaluru, Karnataka- Review complex claims with your team assistant and flag claims requiring further investigation.
- For a high percentage of claims, the Claim Processor will be the…
- Connect and Heal Primary Care Private LimitedBangalore City, Bengaluru, Karnataka
- The Adjudicator is responsible for managing and analyzing reimbursement claims within an organization.
- Relevant certifications or specialized training in…
- Healthminds ConsultingBengaluru, Karnataka
- Verify medical claims, data, and references using credible scientific literature.
- Strong knowledge of medical terminology and life sciences.
View similar jobs with this employerOptumBengaluru, Karnataka- Health insurance
- Prevent the payment of potentially fraudulent and/or abusive claims utilizing medical expertise, knowledge of CPT or diagnosis codes, CMS guideline along with…
- Vital Healthcare ServicesBangalore City, Bengaluru, Karnataka
- Review structured clinical data matching it against specified medical terms and diagnoses or.
- Sound medical knowledge and willing to work in non-clinic…
Medical Claims Processor Specialist
Job details
Full job description
JOB Description : Claims Processor
Summary:
Process healthcare claims and determine the amount of healthcare benefits to be paid to the providers for the given portfolio.
Tasks:
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Process and adjudicate the claims as per the Table of Benefit of the member
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Check eligibility of the insured and dependents
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Check premium status where necessary
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Check claims as per policy requirements
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Check provider’s page for bank details and correct Provider -code to use
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Forward payment notices to Claims Supervisor for validation
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Check provider agreed tariffs in case of direct billing claims
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Capture the medical services with the adequate codes (ICD 10 – CPT)
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Process correct healthcare claims and prior approval agreements within deadlines and as per contract provisions
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Forward high cost amount claims to the medical team for evaluation
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Detect any case of abuse or fraud
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Claims audit targets are being met
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Ensure daily productivity targets are met as set by management
QUALIFICATIONS
Experience:
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Optional Experience: Previous experience in medical insurance
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Experience with ICD-10 and CPT medical coding
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English a must (German/french good to have)