15 adjudication jobs in India.

• Contract

... claim data, and final payment outcomes with strong adherence to productivity, quality, and compliance expectations. Key Responsibilities End-to-End Claims Adjudication • Process medical claims in TriZetto Facets Claims module, including review, adjudication, pend/suspend handling, corrected claims, and reprocessing as required. ...

• Remote
• Contract

... Medicaid policy requirements, translating policies into BPA rules, supporting Benefit Plans, Assignment Plans, Provider Contracts, and ensuring accurate claims adjudication through BPA configuration and governance. The BPA SME will collaborate with Business Analysts, DOM SMEs, Operations, Reference teams, Developers, and Testing ...

• Remote
• Contract

$93600 USD - $135200 USD / hour

... professional healthcare workflows. In this role, you’ll use your real-world pharmacy experience to create realistic prescription-processing and medication-adjudication scenarios, develop reference answers, and evaluate AI-generated responses for accuracy, safety, and proper workflow judgment. This is expert-level work where ...

• Remote
• Contract

$93600 USD - $135200 USD / hour

... professional healthcare workflows. In this role, you’ll use your real-world pharmacy experience to create realistic prescription-processing and medication-adjudication scenarios, develop reference answers, and evaluate AI-generated responses for accuracy, safety, and proper workflow judgment. This is expert-level work where ...

• Remote
• Contract

$93600 USD - $135200 USD / hour

... professional healthcare workflows. In this role, you’ll use your real-world pharmacy experience to create realistic prescription-processing and medication-adjudication scenarios, develop reference answers, and evaluate AI-generated responses for accuracy, safety, and proper workflow judgment. This is expert-level work where ...

• Remote
• Part-time
• Contract

Job Title: Consultant Radiologist - PET/CT and Chest CT (RECIST Adjudication) Type: Consultant - 3 month contract Location: Remote (India) ~ Role Summary We are seeking experienced Consultant Radiologists based in India to support a 3 month imaging project focused on]chest CT and PET/CT review for lung cancer https://jobeax.com/link/6pIIpI4UlZfGhZe5 ...

• Remote
• Contract

$156k USD - $208k USD / hour

... narrative. - A KYC packet requiring identification of discrepancies and preparation of a remediation list. - A batch of sanctions screening hits requiring adjudication and a written rationale for each. Compensation & Engagement - Hourly rate: $75–$100/hour, based on experience. - Annual compensation equivalent: $156,000–$208,000. ...

• On-site

$12.5 USD

... foundation, purpose-built AI agents automate critical trade workflows. Prism digitizes and extracts data from trade documents, Clara streamlines sanctions adjudication, dedicated agents accelerate HS and ECCN classification, and Hermes helps enterprises discover suppliers, identify buyers, and uncover new trade opportunities. ...

• Remote
• Contract

$124800 USD / hour

... sensitive information has been handled correctly. - Identify, flag, and categorize document-processing defects. - Escalate ambiguous or complex cases for further adjudication. - Apply consistent judgment and attention to detail across high-volume review workflows. - Help improve review protocols and quality standards based on recurring ...

• Remote
• Contract

$124800 USD / hour

... sensitive information has been handled correctly. - Identify, flag, and categorize document-processing defects. - Escalate ambiguous or complex cases for further adjudication. - Apply consistent judgment and attention to detail across high-volume review workflows. - Help improve review protocols and quality standards based on recurring ...

• Remote
• Hybrid

... alerting for operational stability. Apply payer domain understanding to translate business rules such as benefit structures member attribution and claim adjudication logic into precise data transformations. Collaborate with product owners data analysts and actuaries to refine requirements and deliver data solutions that ...

• Hybrid
• On-site
• Contract

... authorization, clinical operations, or related payer/provider functions. - Experience with healthcare platforms such as provider data management systems, claims adjudication systems, Facets, QNXT, or similar tools would be an advantage. - Familiarity with healthcare coding systems, including CPT, HCPCS, ICD, DRG, and APC. - Strong ...

• Remote
• Full-time
• Contract

... focus on serious and non-serious adverse events, protocol inquiries, physician assessment of diagnostics, Data and Safety Monitoring Boards, and Endpoint Adjudication Committees. In collaboration with Safety Specialists and Medical Monitors, you will liaise and establish effective relationships with internal functional ...

... Close coordination with AMIN CCO to ensure regular review of risk and controls are undertaken. - Ensure compliance with AML/CFT norms as applicable including Adjudication of various sanctions and AML alerts escalated to FME by the Administrator/ TA as per the business processes and timely escalation of true alerts to Compliance ...

• Full-time
• Part-time
• Contract

... compliance and regulatory requirements and implementation in the claims process. - Creating detailed standard operating process for seamless functioning of claims adjudication - Case management of potential cases to Network team, maintaining data of referred/saving achieved/impact against cashless outgo. - Automation and rule driven ...