Claims Adjudication Process
Role: Claims Adjudication Process
Experience: 2.5-4 Years
Job Location: Coimbatore, Tamil Naidu
Work Timing: US Shift(Night Shift)
Job Description:
Claims Experience is required:
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More than 3 years of experience in handling the Healthcare claims adjudication process.
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Experienced level adjudicator providing analytical ability to review claim rules and workflows.
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Reviews claim requests to determine eligibility for processing and escalate to management as necessary.
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Responsible for the coordination and resolution of the administrative denials and appeals
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Ability to understand logic of standard medical coding (i.e. CPT, ICD-10, HCPCS, etc.).
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Ability to resolve claims that require adjustments and adjustment projects , Identify claim(s) with inaccurate data or claims that require review by appropriate team members.
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Organizing and completing tasks per assigned priorities.
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Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team
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Resolving complex situations following pre-established guidelines

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Job Description:
We are looking for enthusiastic and motivated Business Development Executive (BDE) Freshers to join our growing team. This is an excellent opportunity for candidates who want to start their career in sales, business development, and client handling.
As a BDE, you will be responsible for generating leads, connecting with potential clients, understanding their requirements, and converting leads into sales through calls, emails, and online meetings.
Key Responsibilities:
- Identify and generate new business opportunities
- Make outbound calls to potential clients
- Explain company products/services clearly and confidently
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- Maintain client data and daily sales reports
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Required Skills:
- Good communication skills (English & Hindi)
- Basic knowledge of sales or marketing (training will be provided)
- Confidence, negotiation, and convincing skills
- Willingness to learn and grow in a sales environment
- Basic computer knowledge (MS Excel, Email, CRM – optional)
What We Offer:
- Fixed salary + attractive performance incentives
- Complete training and mentorship
- Career growth opportunities
- Friendly and professional work culture
Who Can Apply:
- Freshers / Recent graduates
- Candidates with internship or sales exposure preferred
- Immediate joiners preferred
- Bachelor's or Master's degree in Computer Science, Engineering, or a related field.
- Minimum of 3 years of professional experience in developing and deploying AI/ML solutions.
- Strong proficiency in Python and relevant libraries such as TensorFlow, PyTorch, scikit-learn, and Transformers.
- Hands-on experience with at least one Python web framework (FastAPI or Flask) for building APIs and backend services.
- Solid understanding of machine learning algorithms, deep learning architectures, and GenAI concepts.
- Experience with containerization technologies (Docker) and orchestration platforms (Kubernetes).
- Proven experience working with the Azure cloud platform and its AI/ML and container services.
- Familiarity with data engineering concepts and tools for data processing and preparation.
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Preferred Qualifications:
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- Familiarity with other cloud platforms (e.g., AWS, GCP).
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Knowledge in building secure, high-performing and scalable infrastructure. Experience to automate and streamline the development operations and processes. You are a master in troubleshooting and resolving issues in non-production and production environments.
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Bachelor’s degree in Computer Science, Information Technology or a related field 0 to 1 years of experience in designing and maintaining high volume and scalable micro-services architecture on cloud infrastructure Knowledge in Linux/Unix Administration and Python/Shell Scripting Experience working with cloud platforms like AWS (EC2, ELB, S3, Auto-scaling, VPC, Lambda), GCP, Azure Knowledge in deployment automation, Continuous Integration and Continuous Deployment (Jenkins, Maven, Puppet, Chef, GitLab) and monitoring tools like Zabbix, Cloud Watch Monitoring, Nagios Knowledge of Java Virtual Machines, Apache Tomcat, Nginx, Apache Kafka, Microservices architecture, Caching mechanisms Experience in enterprise application development, maintenance and operations Knowledge of best practices and IT operations in an always-up, always-available service Excellent written and oral communication skills, judgment and decision-making skills
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