Medical Summary jobs in Bengaluru, Karnataka
- ContactPoint 360Bengaluru, Karnataka
- Optional Experience: Previous experience in medical insurance.
- Experience with ICD-10 and CPT medical coding.
- Process healthcare claims and determine the amount…
- IQVIABengaluru, Karnataka
- Provide medical escalation support for medical information projects.
- Other A medical degree from an accredited and internationally recognized medical school…
- View all IQVIA jobs - Bengaluru, Karnataka jobs - Safety Director jobs in Bengaluru, Karnataka
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- Zimmer BiometBengaluru, Karnataka
- Basic working knowledge of medical device clinical and regulatory documentation.
- Preferred: 2+ years experience in medical or regulatory writing.
- Healthminds ConsultingBengaluru, Karnataka
- Experience in medical writing, clinical evaluation, PMCF, CER, clinical research, or medical device regulatory documentation.
- XO Health Inc.Bengaluru, Karnataka
- Experience in payment integrity, provider relations, or medical billing.
- Verify eligibility, coverage, and medical necessity under policy guidelines using…
- View all XO Health Inc. jobs - Bengaluru, Karnataka jobs
- Salary Search: Claims Analyst salaries in Bengaluru, Karnataka
- Zimmer BiometBengaluru, Karnataka
- 4+ years medical or regulatory writing experience.
- Provides expert peer review of medical writing deliverables.
- Advanced scientific writing expertise.
- Herewise consultancyBangalore City, Bengaluru, Karnataka
- Cab Facility:* Available within applicable company boundaries.
- The ideal candidate should have prior experience in US Healthcare / US Insurance processes and…
- Herewise consultancyBangalore City, Bengaluru, Karnataka
- Cab Facility:* Available within applicable company boundaries.
- The ideal candidate should have prior experience in US Healthcare / US Insurance processes and…
- FortreaBengaluru, Karnataka
- Responsible for preparation and review of clinical documents such as patient safety narratives and clinical study report (CSR) appendices.
- AbbVieBengaluru, Karnataka
- Provide expert medical/scientific advice for assigned products and related therapeutic areas, including responding/coordinating to requests for scientific/…
- St. John’s National Academy of Health SciencesBengaluru, Karnataka
- ENABLE 2 is a hybrid type-2 implementation trial evaluating the effectiveness and scalability of an integrated, multi-level cardiovascular care model for…
- St. John’s National Academy of Health SciencesBengaluru, Karnataka
- FMGE qualification mandatory for foreign medical graduates.
- Competitive salary as per industry standards.
- MBBS degree from a recognized institution.
View similar jobs with this employerAccentureBengaluru, Karnataka- This experience includes day to day operations, department activities, medical and health services, budgeting and rating, research and education, policies and…
- Navitas Life SciencesBengaluru, Karnataka
- Managing medical writing activities associated with individual studies, coordinating medical writing activities within and across departments with minimal…
- Healthminds ConsultingBengaluru, Karnataka
- 7–10+ years in medical affairs, regulatory affairs, promotional medical writing, scientific communications, or HEOR.
- US Shift: 5:30 pm to 3 am IST.
- Navitas Life SciencesBengaluru, Karnataka
- Good understanding of medical and Pharmacovigilance terminologies.
- Basic competence with medical and therapeutic terminology.
Job Post Details
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)