claims processing specialist

NMC Health plc

<div><div>Claims Processing Team: Submission
<br>
<ul><li>Verifies the ICD1O CM codes and relevant CPT/ HCPCS codes on the UCF / discharge summary for submission to various insurance companies on day-to-day basis.
</li><li>Analysis of the UCF documentation issue from time to time and providing reports about areas of concern in coding and the claims.
</li><li>Uploads OP E-claims.
</li><li>Identifies commonly used ICD codes and relevant CPT codes and compile the list.
</li><li>Identifies the ICD codes (Diagnosis under Exclusion) and CPT codes (not billable).
</li><li>Reports variations / irrelevance in the CPT codes used for services/procedures.
</li><li>Assigns proper CPT/ HCPCS codes for newly added services / procedures.
</li><li>Reports the audit findings about discrepancies in the claims daily.
</li><li>Be available to the Consultants about clarification regarding the ICD/ CPT codes.
</li><li>Coordinates with Insurance Doctors and Billing Supervisor/ Accountants for E claim Submission, Resubmission, Follow Up and Final Sign off.
</li></ul>Claims Processing Team: Resubmission
<br>
<ul><li>Coder is required to review documentation by the physicians in the UCF / E &ndash; Discharge summary and look for discrepancies between the documentation and the coded, diagnosis and selected CPT codes.
</li><li>Senior Coder required to overview the notes prepared for UCF / Discharge Summary have all the required information. In case any information is missing they need to contact the physician and get it filled.
</li><li>Be available to the Consultants about any clarification regarding ICD/CPT codes.
</li><li>Senior Coder is required to speak to clinicians about specialty specific rejections and reasons for the rejections and how to avoid such rejections.</li></ul></div></div>
<br><div><div>Claims Processing Team: Submission
<br>
<ul><li>Verifies the ICD1O CM codes and relevant CPT/ HCPCS codes on the UCF / discharge summary for submission to various insurance companies on day-to-day basis.
</li><li>Analysis of the UCF documentation issue from time to time and providing reports about areas of concern in coding and the claims.
</li><li>Uploads OP E-claims.
</li><li>Identifies commonly used ICD codes and relevant CPT codes and compile the list.
</li><li>Identifies the ICD codes (Diagnosis under Exclusion) and CPT codes (not billable).
</li><li>Reports variations / irrelevance in the CPT codes used for services/procedures.
</li><li>Assigns proper CPT/ HCPCS codes for newly added services / procedures.
</li><li>Reports the audit findings about discrepancies in the claims daily.
</li><li>Be available to the Consultants about clarification regarding the ICD/ CPT codes.
</li><li>Coordinates with Insurance Doctors and Billing Supervisor/ Accountants for E claim Submission, Resubmission, Follow Up and Final Sign off.
</li></ul>Claims Processing Team: Resubmission
<br>
<ul><li>Coder is required to review documentation by the physicians in the UCF / E &ndash; Discharge summary and look for discrepancies between the documentation and the coded, diagnosis and selected CPT codes.
</li><li>Senior Coder required to overview the notes prepared for UCF / Discharge Summary have all the required information. In case any information is missing they need to contact the physician and get it filled.
</li><li>Be available to the Consultants about any clarification regarding ICD/CPT codes.
</li><li>Senior Coder is required to speak to clinicians about specialty specific rejections and reasons for the rejections and how to avoid such rejections.</li></ul></div></div>
<br><div><p>Bachelor/Diploma/High School</p></div>

RCM Officer - UAE National

<div><div>Claims Processing Team: Submission
<br>
<ul><li>Verifies the ICD1O CM codes and relevant CPT/ HCPCS codes on the UCF / discharge summary for submission to various insurance companies on day-to-day basis.
</li><li>Analysis of the UCF documentation issue from time to time and providing reports about areas of concern in coding and the claims.
</li><li>Uploads OP E-claims.
</li><li>Identifies commonly used ICD codes and relevant CPT codes and compile the list.
</li><li>Identifies the ICD codes (Diagnosis under Exclusion) and CPT codes (not billable).
</li><li>Reports variations / irrelevance in the CPT codes used for services/procedures.
</li><li>Assigns proper CPT/ HCPCS codes for newly added services / procedures.
</li><li>Reports the audit findings about discrepancies in the claims daily.
</li><li>Be available to the Consultants about clarification regarding the ICD/ CPT codes.
</li><li>Coordinates with Insurance Doctors and Billing Supervisor/ Accountants for E claim Submission, Resubmission, Follow Up and Final Sign off.
</li></ul>Claims Processing Team: Resubmission
<br>
<ul><li>Coder is required to review documentation by the physicians in the UCF / E &ndash; Discharge summary and look for discrepancies between the documentation and the coded, diagnosis and selected CPT codes.
</li><li>Senior Coder required to overview the notes prepared for UCF / Discharge Summary have all the required information. In case any information is missing they need to contact the physician and get it filled.
</li><li>Be available to the Consultants about any clarification regarding ICD/CPT codes.
</li><li>Senior Coder is required to speak to clinicians about specialty specific rejections and reasons for the rejections and how to avoid such rejections.</li></ul></div></div>
<br><div><div>Claims Processing Team: Submission
<br>
<ul><li>Verifies the ICD1O CM codes and relevant CPT/ HCPCS codes on the UCF / discharge summary for submission to various insurance companies on day-to-day basis.
</li><li>Analysis of the UCF documentation issue from time to time and providing reports about areas of concern in coding and the claims.
</li><li>Uploads OP E-claims.
</li><li>Identifies commonly used ICD codes and relevant CPT codes and compile the list.
</li><li>Identifies the ICD codes (Diagnosis under Exclusion) and CPT codes (not billable).
</li><li>Reports variations / irrelevance in the CPT codes used for services/procedures.
</li><li>Assigns proper CPT/ HCPCS codes for newly added services / procedures.
</li><li>Reports the audit findings about discrepancies in the claims daily.
</li><li>Be available to the Consultants about clarification regarding the ICD/ CPT codes.
</li><li>Coordinates with Insurance Doctors and Billing Supervisor/ Accountants for E claim Submission, Resubmission, Follow Up and Final Sign off.
</li></ul>Claims Processing Team: Resubmission
<br>
<ul><li>Coder is required to review documentation by the physicians in the UCF / E &ndash; Discharge summary and look for discrepancies between the documentation and the coded, diagnosis and selected CPT codes.
</li><li>Senior Coder required to overview the notes prepared for UCF / Discharge Summary have all the required information. In case any information is missing they need to contact the physician and get it filled.
</li><li>Be available to the Consultants about any clarification regarding ICD/CPT codes.
</li><li>Senior Coder is required to speak to clinicians about specialty specific rejections and reasons for the rejections and how to avoid such rejections.</li></ul></div></div>
<br><div><p>Bachelor. Diploma, High School</p></div>

RCM Administrator - UAE National

Sagility

<div><h2 class="jobSectionHeader"><b>About Sagility</b></h2>
<div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><p>Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.</p></div></div></div></div></div></div></div></div></div></div></div></div></div></div>
The role of an associate is to contribute to the overall team performance and profitability by implementing action plans which in return will improve and maintain client satisfaction.<p></p><div><div><div><div><div><div><div><p><b>
Job title:</b></p></div></div></div></div></div></div></div>
Process Consultant<p></p><div><div><div><div><div><div><div><p><b>
Job Description:</b></p></div></div></div></div></div></div></div><p><b>
Education:</b><br>
Any Graduate</p><p><b><br>
Experience:</b><br>
1-2 Years RCM-AP/AR(Voice) Experience</p><p></p><p><b>
Mandatory Skills:</b></p><ul><li><p>
Exceptional customer/ client interaction skills,</p></li><li><p>
Ability to manage client escalations,</p></li><li><p>
Experienced in managing client advocacy,</p></li><li><p>
Excellent in usage of MS Excel to compile, collate and summarize</p></li></ul><p><b>
Preferred Skills:</b></p><ul><li><p>
US health care (ERISA/HIPAA/State Mandates)</p></li><li><p>
Process SLA</p></li><li><p>
Awareness of ISO, ISMS</p></li><li><p>
Telephone etiquettes</p></li><li><p>
MS office</p></li><li><p>
Typing skills &amp; computer skills</p></li><li><p>
Effective communication in English</p></li><li><p>
Good analytical skills</p></li><li><p>
Comprehending ability</p></li></ul><p></p><p><b>
Roles &amp; Responsibilities:</b></p><ul><li><p>
Possess basic knowledge of RCM-AP/AR(Voice)</p></li><li><p>
Good reasoning and analytical skills</p></li><li><p>
Able to communicate fluently in the language required for the function/location</p></li><li><p>
Active listening skills</p></li><li><p>
Passion to learn</p></li><li><p>
Influencing skills</p></li><li><p>
Ability to comprehend the process requirement well</p></li><li><p>
Processing claims/handling incoming calls/making outgoing calls and take appropriate actions as per the process guidelines.</p></li><li><p>
Understand the basic professional standards and established procedures, policies before taking action and making decisions.</p></li><li><p>
Maintain customer satisfaction ratings through TAT and quality standard basis client SLA&rsquo;s</p></li><li><p>
Use company policies to determine if there can be an immediate resolution to a customer issue or if that issue requires managerial input</p></li><li><p>
Input data into the company platform to keep each customer record updated</p></li><li><p>
Responsible for multiple administrative and customer service layers that includes solving customer issues through review, investigation, adjustment (if necessary), remittance or denial of the claim by utilizing company policies and directing queries to the managerial team when necessary.</p></li><li><p>
Individuals should have commitment to customer satisfaction and an ability to make quick and accurate decisions.</p></li><li><p>
Mentor &amp; coach new members of the team based on requirement</p></li></ul><p></p><div><div><div><div><div><div><div><p><b>
Location:</b></p></div></div></div></div></div></div></div>
HyderabadIndia</div></div>

Process Consultant

Accenture

<p><b>Skill required:</b> Life &amp; Annuity - Claims Processing<br>
<b>Designation:</b> Customer Service Senior Analyst<br>
<b>Qualifications:</b>Any Graduation
<br>
<b>Years of Experience:</b>5 to 8 years
<br>
<b>About Accenture</b><br>
Accenture is a global professional services company with leading capabilities in digital, cloud and security.Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song&mdash; all powered by the world&rsquo;s largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. We embrace the power of change to create value and shared success for our clients, people, shareholders, partners and communities.Visit us at www.accenture.com
<br>
<b>What would you do?</b> We are seeking a dynamic and experienced Team Leader to oversee our Policy Owner Services team within the Life and Annuity business. The ideal candidate will bring deep domain expertise, and a passion for delivering exceptional customer service. This role is pivotal in ensuring operational excellence, team development, and client satisfaction. he term life annuity refers to a financial product that features a predetermined periodic payout amount until the death of the annuity owner called the annuitant. An annuitant typically pays into the annuity periodically when they are still working. Ability to efficiently and accurately handle insurance claims or other types of claims in various industries. Typically includes understanding relevant policies and procedures, verifying information, assessing claims for validity, and ensuring compliance with regulations.<br>
<b>What are we looking for?</b> &bull; 5-8 years of total experience in life and annuity operations. &bull; Proven expertise in policy owner services and a strong understanding of life and annuity products &bull; Excellent communication skills &ndash; both verbal and written &ndash; with the ability to influence and motivate &bull; Strong interpersonal and people management skills; experience in coaching and mentoring teams &bull; Ability to thrive in a fast-paced, customer-centric environment &bull; Excellent communication skills &ndash; both verbal and written &ndash; with the ability to influence and motivate &bull; Strong interpersonal and people management skills; experience in coaching and mentoring teams &bull; Ability to thrive in a fast-paced, customer-centric environment ?? Qualifications &bull; Bachelor&rsquo;s degree in Business, Finance, Insurance, or related field (Master&rsquo;s preferred) &bull; Professional certifications in life insurance or annuity operations are a plus
<br>
<b>Roles and Responsibilities:</b> &bull; Lead and manage a team handling policy servicing requests for life and annuity products &bull; Ensure timely and accurate processing of policy changes, beneficiary updates, premium adjustments, and other service transactions &bull; Monitor team performance against SLAs and KPIs; implement corrective actions as needed &bull; Serve as a subject matter expert on life and annuity products, policy servicing workflows, and regulatory requirements &bull; Collaborate with cross-functional teams including underwriting, claims, and compliance to resolve escalations &bull; Conduct regular team meetings, training sessions, and performance reviews to foster growth and engagement &bull; Drive process improvements and automation initiatives to enhance service delivery &bull; Maintain high levels of customer satisfaction through proactive communication and issue resolution</p>
<br>
Any Graduation

Customer Service Senior Analyst

<div><p>The Resubmission Officer will be responsible for filing and tracking insurance claims, process insurance and disability claims in a timely manner.</p></div>
<br><div><ul><li><p>Process the resubmission of rejected claims on the system, follow up with respective doctors for justification if necessary, and prepare them for resubmission.
</p></li><li><p>Ensure that the agreed price list and provider manual from insurance companies are followed for billing the service to the respective payers.
</p></li><li><p>Ensure that all concerned teams such as FO, coders, and doctors are updated on time with the rejections, and ensure corrective action is taken to avoid such instances in the future.
</p></li><li><p>Submit the claims with proper codes and format to insurance companies within the stipulated time.
</p></li><li><p>Perform any other jobs or duties assigned by the HOD from time to time within the scope of the job title.
</p></li><li><p>Comply with all OSH and infection control policies, standards, and procedures, and cooperate with hospital management to comply with those requirements.
</p></li><li><p>Work in accordance with the documented OSH procedures and instructions, specific responsibilities.
</p></li><li><p>Be familiar with emergency and evacuation procedures.
</p></li><li><p>Notify OSH hazards, incidents, near misses, and issues, and assist with the preparation of risk assessments and incident reports.
</p></li><li><p>Comply with waste management procedures and policies.
</p></li><li><p>Attend applicable OSH/Infection control training programs, mock drills, and awareness programs.
</p></li><li><p>Use appropriate personal protective equipment and safety systems.
</p></li><li><p>Ensure that employees follow applicable OSH/Infection control policies, procedures, and standards.
</p></li><li><p>Provide OSH information, training, and supervision to the staff.
</p></li><li><p>Report any OSH-relevant incidents, near misses, and hazards in the departments in a timely manner.
</p></li><li><p>Make sure that incident corrective actions have been implemented.
</p></li><li><p>Assist with preparation of risk assessments and monitoring the control measures.
</p></li><li><p>Ensure training is conducted, including general/departmental/FMS/OSH orientation for new employees and transferred employees, as well as refresher training for department staff.</p></li></ul></div>
<br><div><ul><li><p>Medical/paramedical (Nursing, Pharmacy, etc.) graduate from a recognized university.
</p></li><li><p>Experience in Insurance Claims Management/Adjudication (minimum 2 years).
</p></li><li><p>Experience in Medical Coding is preferable.
</p></li><li><p>Excellent command of oral and written English.</p></li></ul></div>

Submission & Resubmission Officer

Naffco

<div></div><div><p><i>Experience:</i> 4 - 9 yrs. | Opening: 1
<br>
<i>Education:</i>Any Graduation, MBA/PG Diploma in Business Mgmt(HR/Industrial Relations)<br>
<i>Nationality:</i> Any Nationality<br>
<i>Industry Type:</i>Industrial Products / Heavy Machinery<br>
<i>Functional Area:</i>HR / Human Relations / Industrial Relations Oct 28,2025<br>
</p><p></p><div><div>
</div></div><div></div><h3 class="jobSectionHeader"><b>Job Description</b></h3>
<p></p><div><p><b>1. Employee Welfare &amp; Engagement</b></p><ul><li>
Implement and monitor staff welfare programs, initiatives, and activities.</li><li>
Plan and organize employee engagement events, recognition programs, and health initiatives.</li><li>
Serve as a point of contact for employee grievances, welfare-related queries, and support services.</li><li>
Conduct periodic employee satisfaction surveys and follow-up actions.</li></ul><p><b>
2. Insurance Administration</b></p><ul><li>
Manage employee insurance programs (health, life, accident, etc.) and liaise with insurance providers.</li><li>
Ensure timely renewals, claims processing, and resolution of insurance-related issues.</li><li>
Maintain accurate records of all employee insurance coverage and claims.</li></ul><p><b>
3. HR Operations &amp; Compliance</b></p><ul><li>
Support HR in implementing company policies and procedures related to welfare and benefits.</li><li>
Ensure compliance with labor laws, insurance regulations, and internal HR policies.</li><li>
Assist in onboarding and exit formalities with a focus on welfare and benefits.</li><li>
Prepare reports on employee welfare, insurance claims, and related metrics.</li></ul><p><b>
4. Coordination &amp; Reporting</b></p><ul><li>
Liaise with internal departments and management regarding welfare programs and insurance updates.</li><li>
Provide guidance and support to employees on insurance benefits, entitlements, and claims.</li><li>
Maintain confidentiality of employee records and sensitive HR information.</li></ul><p></p>
</div><p></p><div><h3 class="jobSectionHeader"><b>Desired Candidate Profile</b></h3>
<p></p><div><ul><li>Bachelor&rsquo;s degree in Human Resources, Business Administration, or related field.</li><li>
2&ndash;5 years of HR experience, preferably in employee welfare, benefits, or insurance administration.</li><li>
Good knowledge of UAE labor law and insurance regulations (if applicable).</li></ul><p></p>
</div><p></p>Keyword: HR Welfare Specialist,Staff Welfare,Benefits Officer,Employee Wellbeing Officer,HR Compliance,HR &amp; Benefits Analyst,Insurance Administration,Benefits and Welfare Coordinator,HR Benefits Specialist</div></div><p></p>

HR Officer – Staff Welfare & Insurance

Acidus Management Solutions Pvt Ltd

<p>We are seeking a detail-oriented and experienced <b>DME Medical Billing Specialist</b> to join our team. The ideal candidate will be responsible for processing and submitting DME (Durable Medical Equipment) claims to insurance companies, ensuring compliance with billing policies and procedures, and following up on unpaid or denied claims.</p><p><b>Key Responsibilities:</b></p><ul><li>Prepare and submit clean claims to Medicare, Medicaid, and commercial insurers for DME services</li><li>Review prescriptions, documentation, and authorizations to ensure compliance with payer requirements</li><li>Verify patient insurance coverage and obtain necessary authorizations or referrals</li><li>Follow up on unpaid claims, rejections, and denials in a timely manner</li><li>Post payments and adjustments accurately</li><li>Communicate with patients, insurance companies, and healthcare providers to resolve billing issues</li><li>Maintain current knowledge of billing regulations and payer requirements specific to DME</li><li>Ensure HIPAA compliance and patient confidentiality in all interactions</li></ul><p><b>Qualifications:</b></p><ul><li>Minimum 1&ndash;3 years of experience in DME medical billing</li><li>Strong knowledge of HCPCS codes, modifiers, and DME documentation requirements</li><li>Familiarity with Medicare, Medicaid, and private insurance billing guidelines</li><li>Proficiency in billing software (e.g., Brightree, Kareo, or similar platforms)</li><li>Excellent communication and organisational skills</li><li>Ability to work independently and meet deadlines.</li><li>Immediate Joiner.</li></ul><p><b>Contact- 8438290250</b></p><p><b>Email - hrtp@acidusms.com</b></p><p>Job Type: Full-time</p><p>Pay: &#8377;20,000.00 - &#8377;30,000.00 per month</p><p>Benefits:</p><ul><li>Provident Fund</li></ul><p>Work Location: In person</p>

DME Medical Billing Specialist

Search 10000+ Claims processing specialist jobs near you this November. New roles added regularly across leading industries. Apply today.