257 Claims Operations jobs in Pakistan

Waada is looking for a Claims Executive to join our dynamic team If you have a keen eye for detail and a passion for claims processing & risk management, this is your chance to grow with us.

Key Responsibilities:

• Evaluating and managing medical and general claims efficiently.
• Using Excel, Google Sheets & CRM tools for insights and decision-making.
• Identifying and minimizing fraudulent claims.
• Enhancing claims workflow for better efficiency.
• Ensuring adherence to industry policies and standards.
• Managing disputes professionally.
• Effective coordination with stakeholders.
• Quick and effective resolution of issues.
• Handling multiple claims efficiently.

Qualifications:

MBBS/BDS or Bachelor's in a relevant field.

Experience : 6 Months or more

Job Type: Full-time

Application Question(s):

• Current Salary
• Expected Salary

Experience:

• Claims Processing: 1 year (Preferred)

Location:

• Karachi (Preferred)

Work Location: In person

Key ResponsibilitiesAccounts Receivable & Denials Management

• Monitor and manage outstanding insurance claims to reduce overall Accounts Receivable (AR) balances.
• Review and resolve claim denials on a daily basis, ensuring prompt and accurate follow-up.
• Analyze Electronic Remittance Advice (ERA) data to identify recurring denial patterns and recommend corrective measures.
• Prepare, submit, and track appeals for denied or underpaid claims with appropriate documentation.
• Investigate and resolve payment discrepancies, escalating complex cases to the Billing Manager as needed.
• Maintain and update AR aging reports, providing regular weekly and monthly performance updates.
• Process claims for specialized services, including TMS, Spravato, and psychological testing.
• Collaborate closely with the Billing Manager to meet AR resolution and collection goals.

Patient & Provider Support

• Respond to billing-related inquiries from patients, providers, and internal teams in a timely manner.
• Review and update patient accounts to ensure accuracy prior to initiating collection actions.
• Work with providers to correct claim errors, including coding and supporting documentation.
• Coordinate with insurance payers regarding prior authorizations, coverage verification, and network participation.
• Address patient billing concerns professionally and process refunds where appropriate.

System Support & Process Improvement

• Submit and monitor support tickets in eClinicalWorks (eCW) to resolve billing-related issues efficiently.
• Provide training and support to team members on AR and denial management workflows.
• Partner with U.S.-based teams to ensure timely and accurate claim submissions.
• Participate in team meetings to review AR performance, identify trends, and recommend process improvements.
• Stay current with payer policies, compliance regulations, and medical billing best practices.

Job Type: Full-time

Pay: Rs40, Rs70,000.00 per month

Ability to commute/relocate:

• Lahore: Reliably commute or planning to relocate before starting work (Required)

Application Question(s):

• Willing to work the night shift?

Experience:

• Medical Billing: 1 year (Preferred)

Language:

• English (Required)

Work Location: In person

Location: Johar Town,Lahore

Job type: Full time - onsite permanent job

Key Responsibilities:

We are looking for a credit hire specialist to work with the company in recovering payment packs to deal with invoicing questions.

Key Responsibilities:

Working as an claims handler working alongside and supporting a UK based claims team. Your key roles and responsibilities will be:

• Making out bound calls to insurance companies to confirm they have received our payment pack/ invoices.
• Knowledge of credit hire claims
• Handling incoming customer enquiries and assisting them via the telephone
• I need claims to be email chased every few days and calls made on claims every other few days, this is subject to hold times.
• The ability to work autonomously and with a team
• The ability to assess complex insurance emails and provide the required documentation.

What we offer:

• Market Competitive Salary
• Provident Fund
• Health insurance
• Gym Support
• Weekends Off

Salary Range: starting 80,000

Working Hours Mon-Fri 2:00pm- 10:00pm

Qualification:

• Candidates MUST be fluent in spoken and written English.
• Previous experience in a similar environment or administration experience is essential.

Ability to commute/relocate:

Lahore: Reliably commute or planning to relocate before starting work (Required)

Working Hours Mon-Fri 2:00pm- 10:00pm

Note: Only Shortlisted candidates will be call for interview

Job Type: Full-time

Pay: From Rs80,000.00 per month

Ability to commute/relocate:

• Lahore: Reliably commute or planning to relocate before starting work (Preferred)

Experience:

• the claims sector with UK companies: 3 years (Required)

Language:

• English (Required)

Work Location: In person

Company Description

Hikmah Institute is a nonprofit and nonpolitical educational institute dedicated to spreading the divine teachings of Islam to bring about positive change through Ilm, Da'wah, Islah, and Khidhmah. Our mission is to instill a love for Islam, helping individuals rediscover their Islamic identity for a successful life both in this world and the hereafter. We achieve this by conducting educational courses, workshops, and lectures focusing on both theoretical and practical aspects of classical Islamic knowledge, offered at our campus in Karachi and other venues. Hikmah Institute also engages in philanthropic efforts, including fundraisers and relief activities for the needy segments of our society.

Role Description

This is a full-time on-site role for an Operations Manager located in Karachi. The Operations Manager will be responsible for overseeing day-to-day operations, ensuring the smooth execution of educational courses, workshops, and lectures. Tasks include managing staff, coordinating with instructors and volunteers, developing operational policies, and ensuring organizational goals are met. The Operations Manager will also track and report on the effectiveness of various programs, handle administrative duties, and assist in fundraising and outreach activities.

Qualifications

• Experience in operations management, project management, and administrative duties
• Strong leadership and team management skills
• Excellent organizational and multitasking abilities
• Effective communication and interpersonal skills
• Ability to work collaboratively with diverse teams and stakeholders
• Knowledge of Islamic educational systems and scholarship is a plus
• Bachelor's degree in Business Administration, Management, or a related field
• Proficiency in Microsoft Office and other relevant software applications

Key Responsibilities:

• Manage and supervise daily operations across different departments.
• Monitor workflow, productivity, and performance to ensure targets are met.
• Develop, implement, and improve operational policies and procedures.
• Coordinate with senior management to align operational strategies with business goals.
• Oversee resource planning, scheduling, and allocation.
• Ensure compliance with company standards, policies, and industry regulations.
• Manage budgets, forecasts, and operational costs effectively.
• Identify process gaps and implement improvements for efficiency and quality.
• Prepare reports on operational performance and present to management.
• Lead, train, and motivate teams to achieve departmental objectives.

Requirements:

• Bachelor's degree in Business Administration, Management, or a related field. (Master's preferred)
• 4–5 years of proven experience in operations management or a related role.
• Strong leadership and team management skills.
• Excellent problem-solving and decision-making abilities.
• Solid understanding of budgeting, reporting, and operational systems.
• Strong communication and interpersonal skills.
• Ability to work under pressure and manage multiple tasks effectively.

Job Type: Full-time

Pay: Rs50, Rs80,000.00 per month

Education:

• Bachelor's (Required)

Experience:

• Maximum: 3 years (Required)

Location:

• Lahore Gulberg Colony (Required)

Work Location: In person

About Our Client:

A leading U.S-based wound care medical billing company in Pakistan is hiring for a lead role

Job Description:

We are seeking a seasoned Manager Operations to lead our U.S-based wound care medical billing company in Pakistan. This is a senior managerial role responsible for overseeing the entire Revenue Cycle Management (RCM) ensure seamless coordination between U.S. management and Pakistan operations.

Key duties & Responsibilities:

• Lead and manage all aspects of the Revenue Cycle Management (RCM) including charge capture, coding, claims submission, payment posting, AR follow-up, denials management, and patient collections.
• Manage multiple teams across billing, coding, AR follow-up, denial management, payment posting, and QA.
• Define team roles, responsibilities, and reporting lines to maintain clear accountability.
• Ensure optimal staffing levels by coordinating with HR for recruitment and workforce planning.
• Analyze the data and ensure the integrity of reports/data in order to drive informed decision-making and long-term strategy.
• Ensure compliance with industry regulations, guidelines, and standards, including HIPAA, ICD-10, and CPT.
• Drive KPIs across teams, clean claim rates, denial rates, collection targets, and client satisfaction.
• Present detailed monthly/quarterly reports to senior leadership and clients, & represent the company in high-level client meetings.
• Proficiency in EMRs, RCM tools, and reporting dashboards (e.g., , Athena, Net health, or wound care-specific EMRs Advanced MD, e clinical Works,).

Requirements:

• Managerial Experience
  : The ideal candidate must have
  at least 10 years
  of proven experience in RCM operations with deep technical knowledge of complete RCM lifecycle, including coding, claims, AR management, denials, collections, and compliance. This individual will drive revenue performance, operational efficiency, and strategic alignment across all departments.
• Analytical
  : Strong analytical skills, with the ability to analyze financial performance metrics and identify areas for improvement.
• Industry Knowledge:
  Staying up-to-date with industry trends, regulatory changes, and best practices in medical billing and revenue cycle management is crucial.
• Strong understanding of CMS guidelines, payer policies, coding (ICD-10, CPT, HCPCS), and compliance standards.
• Individual should have advance English speaking skills. This is necessary because he has to connect with foreign directors on regular basis

Experience
: 10+
years

Work Timings
:
5:30 pm - 2:30 am

Work Days
: Monday - Friday

Work Mode
: Onsite

Location
: Rawalpindi

Benefit
: Bonuses+ Medical

About HR Ways:

HR Ways is an Award winning Technical Recruitment Firm helping software houses and IT Product companies internationally and locally to find IT Talent. HR Ways is engaged by 300+ Employers worldwide ranging from worlds biggest SaaS Companies to most competitive Startups. We have entities in Dubai, Canada, US, UK, Pakistan, India, Saudi Arabia, Portugal, Brazil and other parts of the world.

Company Description

Pyramids Global, LLC, established in 2013, specializes in Revenue Cycle Management and Practice Management solutions for medical providers and healthcare institutions across the United States. Our expertise lies in optimizing medical billing processes and providing detailed business insights for healthcare providers from solo practices to large multi-provider organizations. Our services include Front Desk Support, Medical Coding, Medical Billing, Patient Help Desk, and Credentialing and Enrollments. We are dedicated to delivering result-oriented management solutions to ensure our clients' success.

Role Description

This is a full-time on-site role for an Operations Manager located in Rawalpindi. The Operations Manager will oversee and manage the day-to-day operations of the medical billing and revenue cycle management processes. Responsibilities include ensuring that all billing and coding activities are carried out efficiently, managing staff, monitoring performance metrics, handling client communications, and implementing process improvements to enhance operational productivity and client satisfaction. The role also involves coordinating with different departments to ensure seamless operations, managing financial reports, addressing any operational issues, and providing strategic recommendations to the management team.

Qualifications

• In collaboration with the senior management, prepares and analyzes weekly and monthly financial reports, and accounts receivable reports.
• Ensure accurate collection and compilation of statistical reports.
• Responsible for coordinating and directing the activities of the billing operations follow overall departmental protocol; and that State, Federal, and payer requirements, guidelines, and regulations are complied with;
• It also involves providing effective supervision, including training, work allocation, and problem resolution to billing office personnel.
• Responsible for evaluating the performance of employees and making recommendations for appropriate actions to be taken; as well as motivating personnel to achieving peak performance and productivity.
• Carry out performance evaluation of personnel and recommend necessary actions
• Provide motivation to employees to achieve their best performance and high degree of productivity
• Ensure quality and appropriate trainings are provided to newly hired and existing billing/intake staff through effective supervision and coordination of the training process, and by adhering to established company operating policies, procedures and systems, protocols, techniques, and standards
• Collaborate with other departments to get and analyze additional information about patients to be able to record and process billing effectively
• Remain updated on HIPAA and all other health information management issues and regulations
• Ensure strong team building and protocol in the billing department by holding weekly staff meetings
• Give report of all concerns and issues to the department head for prompt necessary action.

Company Description

AES Express, Pakistan's most seller-focused courier company, is built exclusively for eCommerce brands. We deliver speed, reliability, and steady cash flow to help you grow your business. Our services include next-day COD remittance, rider tracking via WhatsApp, easy reverse logistics, dedicated account managers, and premium branded flyers. Serving Karachi, Lahore, Islamabad, and Rawalpindi, AES Express ensures rapid delivery for your customers and timely payments for you.

Role Description

This is a full-time, on-site role for an Operations Manager located in Karachi. The Operations Manager will be responsible for overseeing daily operations, managing team performance, ensuring timely and accurate deliveries, and maintaining high customer satisfaction. The role involves coordinating with various departments, optimizing logistics processes, implementing company policies, and addressing operational challenges.

Qualifications

• Operational and Logistics Management skills
• Strong leadership and team management abilities
• Excellent problem-solving and decision-making skills
• Proficiency in using logistics software and tools
• Effective communication and interpersonal skills
• Experience in the courier or eCommerce industry is a plus
• Bachelor's degree in Business Administration, Logistics, or related field

Job Description (JD):

The House Operations Manager will oversee the day-to-day management of the house, ensuring smooth operation, maintenance, and supervision of all household staff. This position requires a proactive individual who ensures comfort, security, and efficient functioning of the residence.

Key Responsibilities:

• Supervise and coordinate all household activities including maintenance, housekeeping, security, and kitchen operations.
• Manage household staff schedules, attendance, and performance.
• Liaise with vendors, maintenance contractors, and service providers.
• Ensure cleanliness, safety, and readiness of the entire property.
• Monitor inventory of supplies and approve household purchases.
• Maintain expense records and prepare periodic operational reports.
• Coordinate with family members for guest arrangements and events.
• Handle emergencies and ensure confidentiality and discretion at all times.

Job Specification (JS):

• Education: Bachelor's degree in Administration, Hospitality, or related field.
• Experience: Minimum 5 years of experience in household or hospitality management.
• Skills:
• Excellent communication and leadership skills.
• Strong organizational and problem-solving abilities.
• Proficiency in record-keeping and vendor coordination.
• Polished, professional, and trustworthy demeanor.
• Location: Hyderabad.
• Reporting To: House Owner / Family Representative.

Interested candidates are requested to share their resume at WhatsApp:

Job Type: Full-time

Work Location: In person