India Senior claims associate Jobs – 308 Open Jobs Today

Claims - Associate
Wellcove —Remote
- Night shift
- Remote
- Medicine
- Basic math
- English
Quick apply
Sr. Associate - Claims 5B
Genpact India Pvt. Ltd. —Gurugram, Haryana
- Full-time
- Hybrid work
- English
- Finance
- Master's degree
Quick apply
Senior Claims Associate
Insure Pro 2.0 —Bengaluru, Karnataka
- Night shift
- Customer service
- Microsoft Office
- Analysis skills
Quick apply
Senior Associate - Claims
QBE —Mumbai, Maharashtra
- Full-time
- Management
- Communication skills
Senior Associate Claims Management (US Healthcare)
CompuGroup Medical —Uttar Pradesh
- Night shift
- English
- Microsoft Office
- Bachelor's degree
- Commuter assistance
- Health insurance
Senior Associate
EXL Service —Noida, Uttar Pradesh
- Full-time
- Bachelor's degree
5d
Senior Associate
EVERSANA —Bengaluru, Karnataka
- Full-time
- Sales
- Master's degree
- SQL
Quick apply
Global U.S. Benefits Sr Associate
Tata Consultancy Services —Bengaluru, Karnataka
- Bachelor's degree
- Health insurance
Sr. Insurance Associate
MetLife —Jaipur, Rajasthan
- Full-time
- Microsoft Word
- Microsoft Excel
- Customer service
Training Senior Associate
NTT Ltd —Chennai, Tamil Nadu
- Weekend availability
- Microsoft Powerpoint
- Microsoft Excel
- Communication skills
Senior Associate AR
Guidehouse India Pvt Ltd —Hyderabad, Telangana
- Full-time
- English
- Microsoft Office
- Bachelor's degree
5d
Senior Quality Analyst
Athenahealth —Chennai, Tamil Nadu
- Full-time
- Microsoft Office
- Master's degree
- Analysis skills
- Health insurance
10d
Senior Associate - Litigation & Dispute Resolution
Singhania & Partners —Bengaluru, Karnataka
- Master's degree
Senior DevOps Engineer
Zelis —Telangana
- Full-time
- Hybrid work
- Azure
- DevOps
- Windows
4d
Sr.Associate - CLAIMS SC
ICICI Prudential Life Insurance —Mumbai, Maharashtra
- Analysis skills
Sr Associate, Tax
Carrier —Mumbai, Maharashtra
- Full-time
- English
- Master's degree
- Bachelor's degree
Sr. Associate/Associate
DDReg Pharma —Gurugram, Haryana
- Full-time
- Master's degree
- Bachelor's degree
- Communication skills
1d
Sr Associate Human Resource Specialist
SAS —Pune, Maharashtra
- Customer service
- Human resources
- No travel
Associate - Insurance - P&C Underwriting 5A
Genpact India Pvt. Ltd. —Madurai, Tamil Nadu
- Full-time
- Hybrid work
- English
- Finance
- Master's degree
Quick apply
HR Service Delivery Associate
Accenture —Bengaluru, Karnataka
- Full-time
- Bachelor's degree
- Business Administration
- Time management

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Claims - Associate

Wellcove
Remote

Quick apply

Job details

Fresher

Qualifications

Medicine
Medical coding
Basic math
English
MBBS
Analysis skills
Bachelor's degree
CPT coding

Full job description

Who We Are
Wellcove has been recognized as the nation’s leading full-service senior market solutions provider for over 25 years. Our solutions span the insurance senior market sector, focusing on long-term care and Medicare Supplement plans. However, we don’t stop there. Wellcove also addresses challenges faced in accident & health, disability, and supplemental health insurance programs.

Our team provides individuals and their families with peace of mind knowing their insurance needs will be met in a thoughtful, efficient manner. We are able to do this because of our dedicated associates, innovative solutions, and state-of-the-art technology.

Key Skills: Ability to review and analyze complex medical documentation with a high degree of accuracy to prevent errors in claims processing and familiarity with medical coding systems (CPT, ICD, HCPCS) to understand and interpret medical procedures and diagnoses.

SUMMARY

A Healthcare Complex Claims Specialist is responsible for the thorough investigation, adjudication, and processing of complex healthcare claims in adherence to industry regulations and organizational policies. This role requires a deep understanding of analyzing medical records, healthcare coding systems (e.g., CPT, ICD-10, HCPCS) to accurately assess claims.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following.

Ability to review and analyze complex medical documentation with a high degree of accuracy to prevent errors in claims processing.
Evaluate claims against established guidelines, contracts, and regulatory requirements.
Conduct detailed research on complex claims, pre-existing conditions, and other intricate scenarios.
Analyze medical records, policy documents, and other relevant information to make informed claim decisions.
Demonstrate proficiency in healthcare coding systems (e.g., CPT, ICD-10, HCPCS, Revenue codes, medical terminologies, Human Anatomy, Inpatient Vs. Outpatient claims) to accurately assess claims.
Apply knowledge of healthcare benefits and payment policies.
Provide clear and concise explanations of claim decisions to relevant parties.
Identify trends and patterns in complex claims to contribute to process improvements.
Candidate should be able to correctly calculate claim amounts for the customers.
Complying with company regulations regarding HIPAA, confidentiality, and private health information.

QUALIFICATIONS

Medical Graduates – MBBS, Physiotherapists, B-Pharma or life science graduates with minimum 1 year of experience in handling US Health Insurance claims.
Graduates and Fresher.

LANGUAGE SKILLS

Should have strong English comprehension, verbal and written skills
Strong medical science knowledge to comprehend medical reports

MATHEMATICAL SKILLS

Should have basic math knowledge of calculating simple interest, compound interest.

REASONING ABILITY

Should have good English comprehension and analytical skills
Should have excellent problem-solving skills with an eye for detail

WORK ENVIRONMENT

Should be open to work 24*7 and mandatory US timings, night shift

Ready to handle work pressure and ensure deliverables within timelines

At Wellcove, we strive to create an inclusive culture for all. We understand the importance of listening and incorporating various perspectives at every level of service. Our company does not discriminate based on gender identity, race, sexual orientation, age, religion, or disability.

Quick apply

Refine Your Search

senior claims associate jobs in india

Claims - Associate

Sr. Associate - Claims 5B

Senior Claims Associate

Senior Associate - Claims

Senior Associate Claims Management (US Healthcare)

Senior Associate

Senior Associate

Global U.S. Benefits Sr Associate

Sr. Insurance Associate

Training Senior Associate

Senior Associate AR

Senior Quality Analyst

Senior Associate - Litigation & Dispute Resolution

Senior DevOps Engineer

Sr.Associate - CLAIMS SC

Sr Associate, Tax

Sr. Associate/Associate

Sr Associate Human Resource Specialist

Associate - Insurance - P&C Underwriting 5A

HR Service Delivery Associate

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