Claims Specialist Jobs

ABOUT US Nestem Technologies is ISO 9001:2008 Certified and Govt Registered Leading Healthcare BPO Service Provider. Medical Coding and Billing Job offered For US Healthcare BPO. MEDICAL BILLING Medical Billing is the process of submitting and following up on claims with health insurance companies in order to receive payment for services rendered by a healthcare provider. The same process is used for most insurance companies, whether they are private companies or government sponsored programs Self Supportive Training will be provided for Freshers with Placement. BILLING INDUSTRY Employment is expected to grow faster than average. Job prospects is very good; persons with a strong background in medical billing and coding will be particularly high demand. PLACEMENTS & PAY DETAILS FOR TRAINED After successful completion of the Training job offer will be provided in Leading MNC's. Placements will be in Chennai. 9000/- to 12000/- PM initially with assured career growth (Excluding Special Allowances & Other Benefits). For further Information Call us on 979 1196 983 / 044-2481 4757.

ABOUT US Nestem Technologies is ISO 9001:2008 Certified and Govt Registered Leading Healthcare BPO Service Provider. Medical Coding and Billing Job offered For US Healthcare BPO. MEDICAL BILLING Medical Billing is the process of submitting and following up on claims with health insurance companies in order to receive payment for services rendered by a healthcare provider. The same process is used for most insurance companies, whether they are private companies or government sponsored programs Self Supportive Training will be provided for Freshers with Placement. PLACEMENTS & PAY DETAILS FOR TRAINED After successful completion of the Training job offer will be provided in Leading MNC's. Placements will be in Chennai. 9500/- to 12000/- PM initially with assured career growth (Excluding Special Allowances & Other Benefits). For further Information Call us on 9791196983

Job Description: A Licensed Surveyor assesses damaged property (primarily vehicles, equipment, or commercial assets) to determine the cause, extent, and financial cost of loss for insurance claims. An active Insurance Regulatory and Development Authority of India (IRDAI) License is mandatory for this role to legally sign off on survey reports. Job Overview •Position: Licensed Insurance Surveyor & Loss Assessor •Required Certification: Valid IRDAI License (SLA Number required) •Objective: Inspect insured losses, verify damage authenticity, negotiate repair costs, and submit final assessment reports for claim settlement. Key Responsibilities •Site & Physical Inspection: Inspect damaged assets, vehicles, or property directly on-site or at workshops. •Loss Assessment: Evaluate the extent of damage, identify cause of loss, and verify coverage against the insurance policy terms. •Cost Estimation: Review repair estimates, negotiate labor/parts costs with workshops, and calculate depreciation and salvage value. •Report Submission: Draft and submit clear, accurate, and compliant Survey & Loss Assessment reports within regulatory timelines. •Fraud Detection: Spot discrepancies, pre-existing damages, or misrepresentations in claim submissions. Qualifications & Requirements •License: Valid IRDAI Surveyor & Loss Assessor License is preferable. •Education: B.E., B.Tech, or Diploma in Mechanical, Electrical, or Civil Engineering •Experience: 2 5+ years in field surveying, loss assessment, or automobile/property insurance •Skills: Strong technical knowledge of repairs and estimation, thorough understanding of IRDAI guidelines, and excellent communication skills What's App Number: 8897534176

End to end responsible for: • project design integration under D&B by converting product intent into organization’s Requirements and coordinated deliverables. • stage-gate reviews and interface management across Arch–Str–MEP to ensure buildability, compliance and cost alignment. • design change governance with quantified impacts, protecting baselines and reducing claims and rework. • construction-stage design assurance via submittal reviews, mockups and deviation control without duplicating PMC. • Ensures transparent MIS, audit-ready records and SLA-driven closures across stakeholders. Source: Adani Group | Job ID: 54250

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Job Profile Summary Leads automation and AI transformation strategy across the Payment Integrity, Revenue Integrity, and Grievances and Appeals COEs. Builds and manages a team to ideate, prioritize, and oversee delivery of automation and agentic AI initiatives that improve claims accuracy, recovery, and appeals outcomes. Partners with COE and business leadership to align automation roadmaps to enterprise priorities, governance standards, and measurable business impact. Job Description A Brief Overview Leads a team to drive automation and AI-enabled transformation across Payment Integrity, Revenue Integrity, and Grievances and Appeals. Sets strategic direction for how automation and intelligent workflow opportunities are identified and scaled across these COEs, and ensures successful, on-time delivery through strong program oversight. Balances delivery accountability with team development, ensuring the group operates as a cohesive practice rather than three disconnected initiatives. What you will do Leads and develops a team, setting priorities, allocating capacity across COEs, and holding the team accountable to delivery and quality standards. Sets the automation transformation strategy for Payment Integrity, Revenue Integrity, and Grievances and Appeals in partnership with COE leadership. <

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary: We are seeking a compassionate, customer-obsessed Customer Service Representative to care for our customers. Our customers include members of our benefit plans, employers that offer benefits, and doctors, hospitals, and other healthcare providers. In this role, you will create connections with our customers by helping with their benefits and claims to improve their health and well-being. You will be responsible for educating customers about their benefits and claims while resolving issues and directing them to helpful resources. This position requires adaptability and empathy, as you will be handling a variety of inquiries and ensuring customer satisfaction through kind and respectful interactions. As the face of our company, you will care for our customers by researching issues, documenting outcomes, resolving inquiries and delivering a high level of customer satisfaction. Your ability to listen and respond to customer needs is crucial in inspiring trust and loyalty. Key Responsibilities: Actively listen and be an advocate for customers, understand their needs and provide guidance and support Resolve customer inquiries and issues efficiently while documenting all interactions. Educate customers about available resources and assist them in navigating their options. Anticipate customer needs and provi

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Fraud, Waste, and Abuse (FWA) Analyst II identifies and develops potential healthcare fraud leads through data mining, claims analysis, and investigative research. As a key contributor to the SIU lead development process, this role evaluates provider, member, pharmacy, and ancillary healthcare billing patterns for signs of fraud, waste, abuse, and other anomalies. The Analyst II uses internal claims data, analytical tools, business rule results, and industry intelligence to assess potential FWA concerns and determine whether they warrant formal investigation. This role requires strong analytical skills, healthcare claims expertise, and the ability to translate complex data into actionable investigative leads and recommendations. Essential Responsibilities Lead Development & Fraud Detection Develop proactive and reactive leads to identify potential fraud, waste, and abuse. Generate FWA leads by mining claims databases, reporting tools, and investigative systems. Validate and refine leads generated by business rules to assess their credibility and investigative value. Examine spike analyses, utilization trends, payment anomalies, and outlier reports for unusual billing patterns. Evaluate provider, member, pharmacy, DME, transportation, and facility billing for indicators of fraud or abuse. Moni

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Fraud, Waste, and Abuse (FWA) Analyst II identifies and develops potential healthcare fraud leads through data mining, claims analysis, and investigative research. As a key contributor to the SIU lead development process, this role evaluates provider, member, pharmacy, and ancillary healthcare billing patterns for signs of fraud, waste, abuse, and other anomalies. The Analyst II uses internal claims data, analytical tools, business rule results, and industry intelligence to assess potential FWA concerns and determine whether they warrant formal investigation. This role requires strong analytical skills, healthcare claims expertise, and the ability to translate complex data into actionable investigative leads and recommendations. Essential Responsibilities Lead Development & Fraud Detection Develop proactive and reactive leads to identify potential fraud, waste, and abuse. Generate FWA leads by mining claims databases, reporting tools, and investigative systems. Validate and refine leads generated by business rules to assess their credibility and investigative value. Examine spike analyses, utilization trends, payment anomalies, and outlier reports for unusual billing patterns. Evaluate provider, member, pharmacy, DME, transportation, and facility billing for indicators of fraud or abuse. Moni

Become a part of our caring community The Market Finance Lead is a key member of the Gulf South Region’s finance team responsible for connecting market financial performance with operational effectiveness. This role will partner closely with Corporate Finance, Network Performance, Network Contracting, and regional Health Services teams. This individual will manage a team covering a diverse set of responsibilities around Medicare Advantage financial business operations with a heavy focus on value-based providers. This role reports to the Market Finance Director. This role analyzes financial results, claims experience, utilization trends, contract performance, membership, and provider performance data to identify opportunities, influence business decisions, and support market growth and operational improvement. The Market Finance Lead will partner closely with regional leadership, actuarial, corporate finance, clinical, risk adjustment, market operations, network performance, network contracting, sales/MarketPoint, and value-based care providers. This individual will translate complex financial and operational data into meaningful insights, recommendations, and action plans that improve performance across the market. As the Market Finance Lead, you will: Manage a team to review value-based providers’ financial performance, membership, cost and utilization trends, contractual results, and opportunities for improvement. Lead the financial portion of provider engagement prep sessions prior to joint operating committee meetings to advise the Network Performance team on contract performance and opportunities for improvement. Lead analysis and reporting related to value-based provider and contract performance, including financial results, utilization, claims experience, membership, and operational trends. Leverage data analytics, business ins

Become a part of our caring community The Actuarial Analyst 2, Analytics/Forecasting supports value-based initiatives within the HealthCare Economics team, partnering across actuarial, finance, analytics, and business teams to develop actionable financial insights and forecasting solutions. This role will play a key part in the design and development of a holistic modeling solution, building new methodologies and frameworks from the ground up to support performance measurement, financial reconciliation, and strategic decision-making across multiple value-based care programs. You work assignments are varied and frequently require interpretation of complex business issues, independent judgment, and the ability to recommend and execute appropriate courses of action with limited guidance. The Actuarial Analyst 2, Analytics/Forecasting will be responsible for analyzing and forecasting claims and revenue trends, developing innovative forecasting methodologies, and translating complex business requirements into scalable analytical solutions. This individual must be able to independently evaluate data, identify gaps, propose holistic approaches, and develop end-to-end solutions that integrate financial, operational, and claims-based insights. Responsibilities include designing forecasting methodologies, establishing reporting metrics, validating model results, and supporting the evolution of value-based care analytics. You will understand department, segment, and organizational strategy and operating objectives, including their linkages to related areas. You will make decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Use your skills to make an impact Required Qualifications Bachelor's Degree Successful completion of

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary Leads and manages the QA team by setting strategic objectives and ensuring the implementation of effective quality assurance processes. Collaborates with cross-functional teams to define testing requirements, develop test plans, and ensure timely and thorough testing of software products. Analyzes testing metrics, provides reports to stakeholders, and drives continuous improvement in QA practices to deliver high-quality and reliable software solutions. Required Qualifications 5-7 years work experience in a claims or claims audit position. Adept at execution and delivery (planning, delivering, and supporting) skills Adept at business intelligence Adept at problem solving and decision making skills Adept at collaboration and teamwork Adept at growth mindset (agility and developing yourself and others) skills Preferred Qualifications 5&#43;years of quality management, audit, compliance or operational quality experience Adept at growth mindset (agility and developing yourself and others) skills Demonstrated experience using quality metrics, KPIs, dashboards, and business intelligence tools to identify trends and present recommendations to senior leadership Experience leading root-cause analysis, corrective and preventive action (CAPA), risk mitigation, and co

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Job Description Summary The Application Developer is responsible for designing, building, and maintaining automation solutions that support claims processing workflows within the Rocket Automation platform. This role partners closely with business, governance, and operations teams to translate defined requirements into scalable, reliable automation capabilities. The Developer serves as a technical expert, ensuring solutions are built to enterprise standards and operate efficiently in production, while supporting continuous improvement of automation performance and stability. Key Responsibilities Design, develop, and enhance automation solutions based on clearly defined business requirements and processing rules Translate functional requirements into technical logic, ensuring accuracy and scalability of automation workflows Perform unit testing, system testing, and validation of automation solutions prior to deployment Support production deployments, including release readiness, implementation, and post-production monitoring Troubleshoot and resolve defects, errors, and performance issues in production automation processes Maintain and enhance existing automation solutions to improve efficiency, accuracy, and throughput Monitor automation performance and system health, identifying opportunities for optimization and i

Be at the forefront of innovation with NVIDIA! Our CUDA Libraries & Frameworks Product Marketing Manager role offers an outstanding opportunity to build the future of accelerated computing. This is your chance to join an elite team in Santa Clara, where your contributions will have a lasting impact on technology and society! We are looking for a technical, AI-first CUDA Product Marketing Manager. This is a hands-on PMM role for someone who uses AI coding agents and automation as part of daily execution, not as an occasional productivity aid. Come help craft the story for CUDA, core NVIDIA acceleration libraries like cuDNN, NCCL, NIXL, and AI frameworks like PyTorch, JAX, vLLM, and SGLang. What you'll be doing: Own positioning and messaging for CUDA as a developer platform, including the CUDA programming model, compilers, and core libraries. Make technical capabilities clear, credible, and useful for developers and technical decision-makers. Translate technical features for core libraries such as cuDNN, NCCL, CUTLASS, and TensorRT-LLM into data-driven developer narratives, release messages, proof points, ecosystem informed claims, and field-ready assets. Describe how NVIDIA speeds up AI frameworks and runtimes such as PyTorch, JAX, vLLM, and SGLang, linking low-level platform features to benefits for developers. Use AI coding agents daily to build PMM operating systems: competitive-intelligence agents, automated research pipelines, content auditing, reporting, and partner mapping. Turn documentation, performance benchmarks, GitHub issues, customer signals, and roadmap updates, into messaging assets. Lead go-to-market execution for CUDA launches and core library releases. What we need to see: Bachelor's degree in Computer Science or relevant field (or equivalent experience).

This role is responsible for executing operational tasks within the insurance function, ensuring comprehensive coverage for assets, liabilities, and business ventures. This role focuses on managing annual insurance renewals, preparing and issuing RFPs, handling claims, and maintaining accurate policy documentation. By collaborating with internal teams and engaging with insurers, the Team Member ensures seamless insurance operations, compliance with regulatory standards, and effective risk mitigation. Through standardized processes and strong stakeholder management, this role supports the group’s resilience and operational continuity. Source: Adani Group | Job ID: 58504

Corporate Paralegal About Backblaze Backblaze is a public company that makes storing and using data astonishingly easy. When our founding team got together, they committed to helping people save their data. Today, the Backblaze Storage Cloud provides a foundational platform around the world for a broad community of developers, IT generalists, entrepreneurs, and individuals who seek the easy, affordable, trusted solutions we provide. We have managed to nurture a team-oriented culture with amazingly low turnover. Our approach is guided by honesty, transparency, and a commitment to doing the right thing. Our customers are happy, and so are our coworkers: in the most recent “Great Place to Work” survey, 97% of our team rated Backblaze as “a great place to work.” Check out what our employees are saying on Glassdoor! About the Role We are seeking a Legal Paralegal to support Backblaze’s public-company, corporate, and governance operations. This role is the execution engine behind the Legal & Compliance team: public-company filings, board and committee preparation, entity and governance records, and litigation and insurance claims support. It frees attorney time and keeps a fast-moving public-company calendar running on schedule. The ideal candidate is exceptionally organized, detail-oriented, and comfortable handling confidential and market-sensitive information with discretion. This is a high-ownership role for someone who takes pride in accurate, on-time execution and wants to grow with a lean, high-impact team. This role reports to the Head of Legal & Compliance and is fully remote. What You’ll Do Public Company and Securities Support Support the preparation and filing of periodic and current reports, including Forms 10-K, 10-Q, and 8-K. Coordinate filing logistics with internal stakeholders, outside counsel, auditors, investor relations, and financial printers or filing agents, including EDGAR submission support, exhibit management, and filing-package assembly