claims processor

WHEALTH INTERNATIONAL L.L.C

<ul><li>Analyze medical claims for accuracy, ensuring all details align with provided documentation and coding guidelines.</li><li>Investigate and resolve claim discrepancies, contacting providers and patients to gather necessary information and clarify issues.</li><li>Process claims efficiently using specialized software, meeting daily processing targets and maintaining a high level of accuracy.</li><li>Verify patient eligibility for benefits, confirming coverage details and communicating any limitations to relevant parties.</li></ul>

Medical Claims Processor

Nextcare

<div>
 
 Job Overview
 
 
 
 The
 
 Claims Payment Processor &amp; Reconciliation
 
 
 Officer
 
 main duties are; to manage financial transactions between medical providers, insurance companies, and internal finance teams to ensure timely and accurate claims payments, resolve any discrepancies, to report the processed claims to the payer, prepare EFTs (Electronic fund transfer) for claims, updates the accounting and other financial software, and send statement of accounts and outstanding to our clients. This role also incudes the receivables calculation and collection from Providers.
 
 
 
 What You Do
 
 
 
 <ul>
 <li>
 Generates regularly outstanding reports from all the payers and send them to the payers monthly
 </li>
 <li>
 Prepare the payments for the providers within the TAT
 </li>
 <li>
 Monitors the Claims aging payments flow from all payers and follow up on payments when needed.
 </li>
 <li>
 Ensures the financial transactions are booked in a timely manner and are compliant with proper supporting backup.
 </li>
 <li>
 Ensures control procedures are followed.
 </li>
 <li>
 Ensures all accounting deadlines are met.
 </li>
 <li>
 Provides professional correspondence internally and externally, i.e. members of insurance companies and their client-related claims.
 </li>
 <li>
 Resolves discrepancies.
 </li>
 <li>
 Monitors transactions to determine accuracy, completeness and conformance to established policies and internal procedures.
 </li>
 <li>
 Keeps track of records and files and provide correct information of record details when required.
 </li>
 <li>
 Calculation and collection of receivables from the providers.
 </li>
 <li>
 Organizes all data and files for easy access
 
 
 </li>
 </ul>
 
 What You Bring
 
 
 
 <ul>
 <li>
 Bachelor&rsquo;s Degree; Finance / Account or equivalent background preferred.
 </li>
 <li>
 1+ years relevant experience; in a TPA , Hospitals or Medical Centers is an added advantage.
 </li>
 <li>
 High sense of responsibility
 </li>
 <li>
 Team player.
 </li>
 <li>
 Physically fit to carry out duties.
 </li>
 <li>
 Legally permitted to work in the country of operations.
 </li>
 <li>
 Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills
 
 
 </li>
 </ul>
 At Allianz Partners, AI is revolutionizing customer service and claims management through innovative solutions. These AI-driven tools enhance productivity by streamlining complex claims processes, reducing administrative burdens, and accelerating resolution times. Our AI-powered technology has made claims processing faster, offering quicker resolutions. All while ensuring human oversight for claims to maintain service integrity. By embracing AI and Emerging Technologies, Allianz Partners continues to lead the industry, meeting ever-changing customer needs with innovative solutions. Our commitment to Ethical AI practices safeguards data integrity and trust, ensuring responsible deployment across all operations. This approach not only enhances customer experiences but also supports strategic initiatives like fraud detection and personalized product offerings, solidifying Allianz Partners' position as a leader in the insurance sector.
 
 
 81880 | Finance &amp; Accounting | Professional | Non-Executive | Allianz Partners | Full-Time | Permanent
 
 
 Allianz Group is one of the most trusted insurance and asset management companies in the world. Caring for our employees, their ambitions, dreams and challenges, is what makes us a unique employer. Together we can build an environment where everyone feels empowered and has the confidence to explore, to grow and to shape a better future for our customers and the world around us.
 
 
 At Allianz, we stand for unity: we believe that a united world is a more prosperous world, and we are dedicated to consistently advocating for equal opportunities for all. And the foundation for this is our inclusive workplace, where people and performance both matter, and nurtures a culture grounded in integrity, fairness, inclusion and trust.
 
 
 We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, social class, disability or sexual orientation, or any other characteristics protected under applicable local laws and regulations.
 
 
 
 Great to have you on board.
 
 Let's care for tomorrow.
</div>

Finance - Claims Payment Processor & Reconciliation-Ops

Northwest Administrators

<div>Are you looking for a new career in a challenging industry? Does paid training for a job that provides a sense of accomplishment as you help others sounds like your perfect fit? If so, check out our role on our pension claims processing team!

What you'll be doing...

As a pension claims processor, you will be assisting customers who are going through a significant change in their life&mdash;planning for retirement. You will have your own case load to manage that requires timely and accurately performed tasks according to benefit plan rules and federal time restrictions. You will:
<ul>
<li>Meet with customers, in person and by phone, to explain the claims process</li>
<li>Verify benefit eligibility and follow up on eligibility issues</li>
<li>Correspond with customers about documents necessary to complete their benefit claim</li>
<li>Accurately enter data into claims processing system</li>
</ul>
Successful completion of the 12-week paid training program is required! Training begins in our Seattle, WA office on January, 13th, 2026.

Who you are...
<ul>
<li>Organized. Able to juggle and prioritize workloads, have strong analytical skills</li>
<li>Communicator. Strong verbally and in writing including interpersonal skills</li>
<li>Service Minded. Passionate about customer service-delivering it like you expect to receive it</li>
<li>Detailed. Attentive to detail with excellent problem-solving skills</li>
<li>Technically Savvy. Proficient with technology, intermediate level with Excel and Word</li>
</ul>
Who we are...

Northwest Administrators, Inc. is an industry leader in third-party administration of employee benefits. We administer one of the largest multi-employer pension plans in the country, along with numerous large health and welfare plans. As part of our team, you will benefit from many training and development opportunities and can expect a better-than-market benefits package.
<ul>
<li>Union scale wages, raises every 6 months, starting at $24.64/hr up to $34.30/hr.</li>
<li>Medical, Dental, Vision &amp; Rx benefits</li>
<li>Employer provided/fully funded Defined Benefit Pension</li>
<li>Up to 8.6 days of Paid Leave and 10 Holidays</li>
<li>Strong team environment with good work-life balance</li></ul><div> 
Equal Employment Opportunity

NWA is proud to be an Equal Employment Opportunity employer. All employment decisions are based on business needs, job requirements and individual qualifications, without regard to race, color, religion, national origin, sex, sexual orientation, gender identity or expression, age, physical or mental disability, marital status, amnesty, veteran status, citizenship, family medical history or genetic information or any other characteristic protected by local, state, or federal laws. NWA prohibits any discrimination or harassment based on any of these characteristics.

We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact Human Resources at HR@nwadmin.com to request accommodation.

Northwest Administrators Inc. | Privacy Policy (nwadmin.com)</div></div>

Benefit Processor

Medi Assist Insurance TPA Private Limited

Job description:Roles and Responsibilities01. Involves Processing of Claims ( Preauthorization / Reimbursement claims)02. Validating and processing these claims within TAT with Quality03. With good communication and medical Knowledge04. TPA Experience is an added advantageFinancial : To see to that there is no financial implication for the organization while settlement of claimsRole : Medical OfficerRequired Knowledge /Skill : Good Medical knowledgeEducation : BHMS/BAMS/ BDS/ BHMSWorking timing: General Shift ( Hybrid Mode of working )Job Location : Sector 91, MohaliNote : This position is for Working from office only. Please do not apply if you are looking for working from home.Job Types: Full-time, FresherPay: &#8377;20,000.00 - &#8377;25,000.00 per monthWork Location: In person

Medical Officer _ Hybrid Mode of working_ Fresher ( Doctors )

NTT DATA

<div>NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our end client and their team.
 
In this Role the candidate will be responsible for: 
<ul><li>Processing of Professional and institutional claims</li><li>Reviewing the policies and benefits</li><li>Comply with company regulations regarding HIPAA, confidentiality, and PHI</li><li>Abide with the timelines to complete compliance training of NTT Data/Client</li><li>Work independently to research, review and act on the claims</li><li>Prioritize work and adjudicate claims as per turnaround time/SLAs</li><li>Ensure claims are adjudicated as per clients defined workflows, guidelines</li><li>Sustaining and meeting the client productivity/quality targets to avoid penalties</li><li>Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA.</li><li>Timely response and resolution of claims received via emails as priority work</li><li>Correctly calculate claims payable amount using applicable methodology/ fee schedule</li></ul> 
Requirements: 
<ul><li>3 year(s) hands-on experience in Healthcare Claims Processing</li><li>High school diploma or GED.</li><li>Previously performing - in P&amp;Q work environment; work from queue; remotely</li><li>Key board skills and computer familiarity -</li></ul>
o Toggling back and forth between screens/can you navigate multiple systems. 
o Working knowledge of MS office products - Outlook, MS Word and MS-Excel. 
 
Preferred Skills &amp; Experiences: 
<ul><li>Amisys or Xcelys</li><li>Medicaid and Medicare Claims processing experience</li><li>Ability to communicate (oral/written) effectively in a professional office setting</li><li>Effective troubleshooting where you can leverage your research, analysis and problem-solving abilities</li><li>Time management with the ability to cope in a complex, changing environment</li></ul></div>

HC & Insurance Operations Processing Sr Rep

SIDC

Hiring Dental Insurance Clerk (1)Work Location: Abu Dhabi, Western RegionKey Responsibilities:<ul><li>Coordinate with third-party insurance companies to obtain pre-authorization and claim approvals for dental procedures.</li><li>Verify patient insurance coverage and eligibility for dental services.</li><li>Review treatment plans and submit accurate insurance pre-approvals.</li><li>Communicate effectively with patients, dentists, and insurance providers regarding coverage and claims.</li><li>Maintain accurate records of insurance correspondence, approvals, and denials.</li><li>Assist in resolving insurance-related inquiries or discrepancies.</li></ul>Requirements:<ul><li>Proven experience in dental insurance processing or healthcare administration.</li><li>Strong knowledge of dental procedure coding (CDT) and terminology.</li><li>Familiarity with insurance policies, pre-authorization procedures, and claims submission.</li><li>Excellent organizational and communication skills.</li><li>Attention to detail and ability to handle confidential patient information professionally.</li><li>Proficiency in Microsoft Office and dental practice management software.</li></ul>Preferred:<ul><li>Experience working in a dental clinic or hospital setting in Abu Dhabi.</li></ul>Job Type: Full-timePay: AED2,500.00 - AED3,000.00 per month

Dental Insurance Clerk for Western Region Branch

IGI LIFE INSURANCE LIMITED

&middot; Evaluate medical claims including both out-patient claims and In-Hospitalization Claims under the policy terms and conditions and recommend claims for approval&middot; Handle claims from receipt of notification to settlement and take into consideration opinions of the outside Doctor's regarding the claims&middot; Correspond with clients and agents/Investigator regarding claim queries&middot; Coordinate with Accounts Department regarding claims payments&middot; Telephonic/Outdoor investigation of facts involved in claims.&middot; Monitor team reports, direct necessary action, and inform head of department regarding pertinent information&middot; Prepare the Service Quality complaint log, handle Service Quality projects and maintain claims TAT&middot; Participate in assigned claims projects as and when requiredQualifications/ Experience/ Capabilities&middot; Minimum level of Education for this job: Bachelors (medical related field preferred)&middot; Minimum Experience required for this job: 2 years (preferably in health claims of an insurance company)Job Type: Contract Contract length: 1 monthWork Location: In person

Officer Claims

Search 2526+ Claims processor jobs near you this November. New roles added regularly across leading industries. Apply today.