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
- Evaluates medical information against criteria, benefit plan, coverage policies and determines medical necessity.
- Strong interpersonal and communication skills.
- Nova BenefitsBengaluru, Karnataka
- Verification of the claim documents.
- Follow up for the claim documents.
- Managing the escalation related to claims.
- Explaining the claim query to the employee.
- View all Nova Benefits jobs - Bengaluru, Karnataka jobs
- Salary Search: Claims Associate salaries in Bengaluru, Karnataka
- The Cigna GroupBengaluru, Karnataka
- Perform claim reviews with focus on coding and billing errors.
- Provides clinical review expertise for high dollar and complex claims, including facility and…
- Agilon HealthBengaluru, Karnataka
- Complete appropriate system entry regarding claim/encounter information.
- Review medical record information to identify all appropriate CPT II procedure coding.
- 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
- Perform claim reviews with focus on coding and billing errors.
- Provides clinical review expertise for high dollar and complex claims, including facility and…
- Medi AssistBengaluru, Karnataka
- Check the medical admissibility of a claim by confirming the diagnosis and treatment details.
- To scrutinize and process the claims within the agreed TAT by…
- View all Medi Assist jobs - Bengaluru, Karnataka jobs
- Salary Search: Medical Officer salaries in Bengaluru, Karnataka
- See popular questions & answers about Medi Assist
- Wells FargoKarnataka
- Candidate with 6+ months experience in Fraud and chargeback claims.
- Support and capture all pertinent information from customers about their claims.
- Wells FargoKarnataka
- Candidate with 6+ months experience in Fraud and chargeback claims.
- Support and capture all pertinent information from customers about their claims.
- PHONEPE LIMITEDBengaluru, Karnataka
- Concerns in escalated claim cases.
- Needs by ensuring timely, appropriate claim settlements.
- Utilize these insights to optimize claims processing and overall…
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
- Monitor critical claim-related deadlines, including wage filings, state form submissions, and medical updates.
- Shift* – Night Shift (5.30 pm to 2.30 am IST).
- Healthminds ConsultingBengaluru, Karnataka
- Verify medical claims, data, and references using credible scientific literature.
- Strong knowledge of medical terminology and life sciences.
- Connect and Heal Primary Care Private LimitedBangalore City, Bengaluru, Karnataka
- Verification and Documentation: Verify the accuracy and completeness of claim documentation, including receipts, invoices, and medical records, ensuring…
- 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)