86 Claim Investigation Jobs - Page 3

Job Description (IFD) Communicating with clients and understanding the investigation requirements. • Meeting with clients to discuss the nature of the investigation. • Conducting field investigations on appointed cases, insurance claims, or client requests. • Conducting in-depth research on various appointed cases. • Decide the extent and validity of a claim, and in so doing, prevent fraudulent claims by determining the claim's authenticity. • Gathering and analyzing evidence reports. • Conducting photographic and audio surveillance to gather evidence • Reviewing and solving cases by authenticating insurance claims. • Coordinating with agents to understand insurance claims matters. • Answering to specific trigger in reports. • Manage multiple cases with confidence and accuracy and respond well to working to meet targets and tight deadlines. • Prepare reports, maintain records and keep track of evidence trails. Address - MD India Health Insurance TPA Pvt. Ltd. H.No.6-3-883/A/1 #: 201, 2nd Floor, imperial Plaza, Beside Topaz Building, Panjgutta, Hyderabad - 500082. Contact Number - 7030949730 ( Neha Nanoti )

Job description We Are Hiring for International Semi voice Process Profile -: Claim Processing associate ( Semi voice) Languages req: Excellent English communication Requirement -: Good Communication Skills Exp-: 6m- 5 yrs in claims Shifts:Rotational Location : Bangalore Immediate joiners only *** Only 2 rounds of interview Job description Document claim file by accurately capturing and updating claims data/information in compliance with best practices for low to moderate. exposure and complexity for Property and Content damage and Liability/Injury claims. Exercise judgement to determine policy verification and coverage determination by analysing applicable coverage for claims and determining whether the loss falls within the coverage. Exercise judgement to determine liability by gathering and analysing relevant facts, images; utilizing applicable coverages. Identify anomalies and patterns to identify fraudulent claims and refer to SIU team based on SOPs Work to have a timely resolution to claims with complete ownership from initiation/intake to settlement. Assess damages by calculating applicable damage or range of damages. Negotiate settlement of a claim by establishing the appropriate negotiation strategy and utilizing available resources within authority limits. Meet quality standards by following best practices Responsible for data integrity and the appropriate documentation of the claim file as well as for compliance with regulatory requirements. Accountability in customer satisfaction and execute on the strategy to provide the best claims service for host damage protection. Ensure customer service by proactively communicating information, responding to inquiries, following customer protocols and special handling instructions. Ensure legal compliance by following federal laws and regulations, and internal control requirements. Key skills required: Bachelor's degree or college Diploma. • Experience in P&C, Healthcare Claims dealing with damage, liability or injury claims. • Good knowledge of Insurance claims end-to-end value chain activities, challenges and best practices. • Good knowledge of how to evaluate injuries and damage using market tools and technology. •General knowledge of the coverages available under the damage protection, liability policy and some common exclusions. • Results driven, ability to multi-task, pay attention to detail and follow procedures. Proven leadership and time management skills in a team environment. Job Type: Full-time Qualification :Any graduates (Note: All the rounds are Held through telephonic) Email : careers@glympsehr.com NOTE: - Please call or whatsapp Manya @ 9606553811 / 9606557106 !!!Thanks & Regards HR TEAM!!!

About the client Hiring for One of the Top Multinational Corporation !!!! Job Title : P&C Claims Management Qualification : Any Graduate and Above Relevant Experience : 1 to 5 years Must Have Skills : 1.Experience in P&C Claims Management, preferably with BPO/Insurance process exposure. 2.Strong experience handling FNOL (First Notice of Loss) or FROI (First Report of Injury) cases. 3.Knowledge of claims systems like Guidewire, Duck Creek, Majesco, or similar platforms. 4.Familiarity with ISO, NCCI, and WCIRB reporting requirements. 5.Proficient in MS Office (Excel, Word) and data entry with attention to detail. 6.Strong communication and interpersonal skills with a customer-centric approach. 7.Ability to multi-task in a fast-paced and compliance-driven environment. Good Have Skills : knowledge and expertise in FNOL (First Notice of Loss) or FROI (First Report of Injury) Roles and Responsibilities : 1.Manage end-to-end claims processing for Property & Casualty lines including auto, home, general liability, and workers compensation. 2.Perform FNOL/FROI intake, assess coverage, and initiate claim setup using internal systems. 3.Verify policy information, document incidents accurately, and identify subrogation opportunities. 4.Maintain consistent communication with policyholders, claimants, vendors, and internal teams. 5.Support claims adjudication by gathering and reviewing supporting documentation, police reports, medical records, etc. 6.Ensure compliance with applicable state regulations and client-specific SLAs. 7.Coordinate with adjusters, underwriters, and legal teams where necessary. 8.Generate and maintain accurate records for audit and reporting purposes. 9.Continuously identify and escalate potential fraud or misrepresentation concerns. 10.Participate in process improvement initiatives and training sessions. Location : Mumbai CTC Range : 3.5 to 6 LPA (Lakhs Per Annum) Notice Period : Immediate Mode of Interview : Virtual Shift Timing : Night Shift Mode of Work : Work From Office -- Thanks & Regards, Lakshmi PS HR Analyst Black and White Business Solutions Pvt Ltd Bangalore, Karnataka, INDIA. Direct Number: 080-67432489/WhatsApp @7892150019 Lakshmi.p@blackwhite.in | www.blackwhite.in ****************************** DO REFER YOUR FRIENDS**********************************

We are currently hiring Medical Officers to handle the processing of cashless requests and health insurance claims for TPAs/Insurance companies and Manage volumes effectively & efficiently to maintain Turnaround time of processing cases.

About the client Hiring for One of the Top Multinational Corporation !!!! Job Title : P&C Claims Management Qualification : Any Graduate and Above Relevant Experience : 1 to 5 years Must Have Skills : 1.Experience in P&C Claims Management, preferably with BPO/Insurance process exposure. 2.Strong experience handling FNOL (First Notice of Loss) or FROI (First Report of Injury) cases. 3.Knowledge of claims systems like Guidewire, Duck Creek, Majesco, or similar platforms. 4.Familiarity with ISO, NCCI, and WCIRB reporting requirements. 5.Proficient in MS Office (Excel, Word) and data entry with attention to detail. 6.Strong communication and interpersonal skills with a customer-centric approach. 7.Ability to multi-task in a fast-paced and compliance-driven environment. Good Have Skills : knowledge and expertise in FNOL (First Notice of Loss) or FROI (First Report of Injury) Roles and Responsibilities : 1.Manage end-to-end claims processing for Property & Casualty lines including auto, home, general liability, and workers compensation. 2.Perform FNOL/FROI intake, assess coverage, and initiate claim setup using internal systems. 3.Verify policy information, document incidents accurately, and identify subrogation opportunities. 4.Maintain consistent communication with policyholders, claimants, vendors, and internal teams. 5.Support claims adjudication by gathering and reviewing supporting documentation, police reports, medical records, etc. 6.Ensure compliance with applicable state regulations and client-specific SLAs. 7.Coordinate with adjusters, underwriters, and legal teams where necessary. 8.Generate and maintain accurate records for audit and reporting purposes. 9.Continuously identify and escalate potential fraud or misrepresentation concerns. 10.Participate in process improvement initiatives and training sessions. Location : Mumbai CTC Range : 3.5 to 6 LPA (Lakhs Per Annum) Notice Period : Immediate Mode of Interview : Virtual Shift Timing : Night Shift Mode of Work : Work From Office -- Thanks & Regards, Niveditha HR Senior Analyst- TA-Delivery Black and White Business Solutions Pvt Ltd Bangalore, Karnataka, INDIA. Direct Number: 080-67432432/WhatsApp @9901039852| niveditha.b@blackwhite.in | www.blackwhite.in ****************************** DO REFER YOUR FRIENDS**********************************

Job Title : P&C Claims Management Qualification : Any Graduate and Above Relevant Experience : 1 to 5 years Must Have Skills : 1.Experience in P&C Claims Management, preferably with BPO/Insurance process exposure. 2.Strong experience handling FNOL (First Notice of Loss) or FROI (First Report of Injury) cases. 3.Knowledge of claims systems like Guidewire, Duck Creek, Majesco, or similar platforms. 4.Familiarity with ISO, NCCI, and WCIRB reporting requirements. 5.Proficient in MS Office (Excel, Word) and data entry with attention to detail. 6.Strong communication and interpersonal skills with a customer-centric approach. 7.Ability to multi-task in a fast-paced and compliance-driven environment. Good Have Skills : knowledge and expertise in FNOL (First Notice of Loss) or FROI (First Report of Injury) Roles and Responsibilities : 1.Manage end-to-end claims processing for Property & Casualty lines including auto, home, general liability, and workers compensation. 2.Perform FNOL/FROI intake, assess coverage, and initiate claim setup using internal systems. 3.Verify policy information, document incidents accurately, and identify subrogation opportunities. 4.Maintain consistent communication with policyholders, claimants, vendors, and internal teams. 5.Support claims adjudication by gathering and reviewing supporting documentation, police reports, medical records, etc. 6.Ensure compliance with applicable state regulations and client-specific SLAs. 7.Coordinate with adjusters, underwriters, and legal teams where necessary. 8.Generate and maintain accurate records for audit and reporting purposes. 9.Continuously identify and escalate potential fraud or misrepresentation concerns. 10.Participate in process improvement initiatives and training sessions. Location : Mumbai CTC Range : 3.5 to 6 LPA (Lakhs Per Annum) Notice Period : Immediate Mode of Interview : Virtual Shift Timing : Night Shift Mode of Work : Work From Office Thanks & Regards, Monika HR Analyst Black and White Business Solutions Pvt Ltd Bangalore, Karnataka, INDIA. Direct Number: 080-67432490/Whatsapp @9916116145 monika.j@blackwhite.in | www.blackwhite.in ****************************** DO REFER YOUR FRIENDS**********************************

Key Responsibilities: 1. Hospital Visit Management: Conduct regular visits to hospital partners to review and address pricing structures, contract terms, and service quality. Analyze and assess hospital billing and pricing strategies to ensure alignment with organizational objectives. 2. Claims Negotiation: Lead negotiations with hospital partners regarding claims and reimbursement issues to ensure favorable outcomes for the organization. Work closely with the internal claims team to resolve discrepancies and expedite claim resolutions. 4. Pending Issues and Concerns: Identify, track, and resolve pending issues and concerns related to hospital partnerships, including billing disputes, service quality, and contractual obligations. Act as a liaison between the hospital and internal teams to address and mitigate concerns promptly. 5. Coordination with Internal Stakeholders: Collaborate with internal departments to ensure alignment on hospital-related activities and strategies. Facilitate effective communication and coordination between internal teams to address issues and implement solutions. 6. Documentation and Reporting: Prepare and maintain comprehensive documentation of hospital visits, pricing agreements, claims negotiations, and issue resolutions. Document and update sales meetings, including key takeaways, action items, and progress reports. 7. Sales Meeting Coordination: Organize and lead sales meetings to discuss hospital partnerships. Provide regular updates and reports to sales teams and management on hospital-related activities and performance.

Job Title : P&C Claims Management Qualification : Any Graduate and Above Relevant Experience : 1 to 5 years Must Have Skills : 1.Experience in P&C Claims Management, preferably with BPO/Insurance process exposure. 2.Strong experience handling FNOL (First Notice of Loss) or FROI (First Report of Injury) cases. 3.Knowledge of claims systems like Guidewire, Duck Creek, Majesco, or similar platforms. 4.Familiarity with ISO, NCCI, and WCIRB reporting requirements. 5.Proficient in MS Office (Excel, Word) and data entry with attention to detail. 6.Strong communication and interpersonal skills with a customer-centric approach. 7.Ability to multi-task in a fast-paced and compliance-driven environment. Good Have Skills : knowledge and expertise in FNOL (First Notice of Loss) or FROI (First Report of Injury) Roles and Responsibilities : 1.Manage end-to-end claims processing for Property & Casualty lines including auto, home, general liability, and workers compensation. 2.Perform FNOL/FROI intake, assess coverage, and initiate claim setup using internal systems. 3.Verify policy information, document incidents accurately, and identify subrogation opportunities. 4.Maintain consistent communication with policyholders, claimants, vendors, and internal teams. 5.Support claims adjudication by gathering and reviewing supporting documentation, police reports, medical records, etc. 6.Ensure compliance with applicable state regulations and client-specific SLAs. 7.Coordinate with adjusters, underwriters, and legal teams where necessary. 8.Generate and maintain accurate records for audit and reporting purposes. 9.Continuously identify and escalate potential fraud or misrepresentation concerns. 10.Participate in process improvement initiatives and training sessions. Location : Mumbai CTC Range : 3.5 to 6 LPA (Lakhs Per Annum) Notice Period : Immediate Mode of Interview : Virtual Shift Timing : Night Shift Mode of Work : Work From Office Thanks & Regards, Amulya G Senior HR Analyst Black and White Business Solutions Pvt Ltd Bangalore, Karnataka, INDIA. Direct Number: 080-67432435/Whatsapp @6366979339 amulya.g@blackwhite.in | www.blackwhite.in ****************************** DO REFER YOUR FRIENDS**********************************

Role & responsibilities - Due Diligence - Document Indexing & Management - Sanction Screening - Compliance checks - Premium Bordereaux Processing - Knowledge of insurance systems like Acturis, Applied Epic/Eclipse will be added advantage - Experience in the insurance sector, preferably with brokers or MGAs, will be an added advantage - Familiarity with Lloyds systems integration (XIS, XCS, ICOS/IPOS) is a plus - Updating the process documents - Providing supporting documents during various internal/external audits - Advance excel knowledge Preferred candidate profile Need Fresher or who have experience into claims and settlement Must be fluent with communication

Job description Roles and Responsibilities 1. Acts as an interface between the TPA, Insurance Company and the hospital. 2. Responsible for investigation of suspicious claims. 3. Effective usage of Fraud control measures. 4. Act as a backend support to the TPA. 5. Responsible for data mining and analytics related to Fraud and Investigation (IFD) 6. MIS reporting related to fraud control and all stakeholders. 7. Should be completely fine with doing field work (for Investigations) 8. Should have own vehicle (2 Wheeler) with license. 9. Team handling exp is must . Desired Candidate Profile Preferably with an experience(min.3yrs) from TPA or Insurance profile. If Interested share your resume to talent@mdindia.com OR on 7058096238

Job Title : P&C Claims Management Qualification : Any Graduate and Above Relevant Experience : 1 to 5 years Must Have Skills : 1.Experience in P&C Claims Management, preferably with BPO/Insurance process exposure. 2.Strong experience handling FNOL (First Notice of Loss) or FROI (First Report of Injury) cases. 3.Knowledge of claims systems like Guidewire, Duck Creek, Majesco, or similar platforms. 4.Familiarity with ISO, NCCI, and WCIRB reporting requirements. 5.Proficient in MS Office (Excel, Word) and data entry with attention to detail. 6.Strong communication and interpersonal skills with a customer-centric approach. 7.Ability to multi-task in a fast-paced and compliance-driven environment. Good Have Skills : knowledge and expertise in FNOL (First Notice of Loss) or FROI (First Report of Injury) Roles and Responsibilities : 1.Manage end-to-end claims processing for Property & Casualty lines including auto, home, general liability, and workers compensation. 2.Perform FNOL/FROI intake, assess coverage, and initiate claim setup using internal systems. 3.Verify policy information, document incidents accurately, and identify subrogation opportunities. 4.Maintain consistent communication with policyholders, claimants, vendors, and internal teams. 5.Support claims adjudication by gathering and reviewing supporting documentation, police reports, medical records, etc. 6.Ensure compliance with applicable state regulations and client-specific SLAs. 7.Coordinate with adjusters, underwriters, and legal teams where necessary. 8.Generate and maintain accurate records for audit and reporting purposes. 9.Continuously identify and escalate potential fraud or misrepresentation concerns. 10.Participate in process improvement initiatives and training sessions. Location : Mumbai CTC Range : 3.5 to 6 LPA (Lakhs Per Annum) Notice Period : Immediate Mode of Interview : Virtual Shift Timing : Night Shift Mode of Work : Work From Office Thanks & Regards, Aneesha HR Analyst Black and White Business Solutions Pvt Ltd Direct Number : 08067432440| Whats app : 9035128021|aneesha.g@blackwhite.in

Job Title: Insurance Desk Executive TPA Coordination / Claims Specialist Location Options: KIMS Hospital, Nashik Survey No. 571/1A/1, Plot No. 63, Mumbai Agra Highway, Nashik, Maharashtra – 422001 KIMS Hospital, Thane West – Queens St, near Brentford Cooperative Society, Hiranandani Estate, Thane West, Maharashtra – 400615 Organization: Ayu Health Hospitals Experience Required: 0–2 years (Freshers are welcome to apply) Preferred Gender: Male Candidates Preferred Location: Candidates residing near hospital locations will be given preference About Ayu Health: Ayu Health is one of India’s fastest-growing healthcare networks, dedicated to making high-quality healthcare accessible and affordable for all. With a focus on technology-driven solutions, Ayu Health partners with reputed hospitals and clinics across the country to deliver standardized care, transparent pricing, and a seamless patient experience. We are on a mission to build India’s most trusted healthcare brand. Key Responsibilities: Handle insurance/TPA desk operations at the hospital premises Coordinate with TPA and insurance representatives for claim submission and follow-up Manage and organize patient insurance documentation accurately Track approvals, follow up on pending claims, and address rejections effectively Communicate professionally with patients, hospital staff, and insurance partners Support hospital administrative needs and maintain documentation records Multi-task and work collaboratively within the hospital environment Candidate Requirements: 0–2 years of experience in TPA coordination, insurance desk, or claims processing in hospitals (Freshers with good communication skills can apply) Strong interpersonal and communication skills Basic understanding of hospital processes is a plus Ability to manage documents and work efficiently under pressure Must be reliable, punctual, and a team player Preference will be given to candidates living nearby the hospital location Male Candidates only Immediate Joiners will be preferred

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years About Accenture Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. Visit us at www.accenture.com What would you do We help insurers redefine their customer experience while accelerating their innovation agenda to drive sustainable growth by transforming to an intelligent operating model. Intelligent Insurance Operations combines our advisory, technology, and operations expertise, global scale, and robust ecosystem with our insurance transformation capabilities. It is structured to address the scope and complexity of the ever-changing insurance environment and offers a flexible operating model that can meet the unique needs of each market segment.Claim processing team collects end-end data dataDevelop and deliver business solutions that support the claims process across its lifecycle, including first notice of loss, claims investigation, payment administration or adjudication, provider reimbursement (health care), subrogation and recovery. What are we looking for Ability to establish strong client relationshipAbility to handle disputesAbility to manage multiple stakeholdersAbility to meet deadlinesAbility to perform under pressure- Roles and Responsibilities: In this role you are required to solve routine problems, largely through precedent and referral to general guidelines Your primary interaction is within your own team and your direct supervisor In this role you will be given detailed instructions on all tasks The decisions that you make impact your own work and are closely supervised You will be an individual contributor as a part of a team with a predetermined, narrow scope of work Please note that this role may require you to work in rotational shifts Qualification Any Graduation

Role: Executive / Sr Executive - Account Management (CRM) Receive and check claim documents for completeness and advice employees regarding pending documents, if any. Track and control documents to ensure TAT of claims/cards as per SLA. Feedback from Insurers and Corporates. Additional revenue opportunities from existing Corporates. Non voice coordinator Respond to queries from the employees of the corporate through e-mails. Maintain weekly reports on claims and queries and the TAT of the same Escalate issues as per the escalation matrix. To attend to any other assignments assigned to you from time to time. Candidates must have TPA experience Interested candidates can reach out via email at sarika.pallap@mediassist.in or WhatsApp their CVs to 8951865563

Job description We Are Hiring for International Semi voice Process Profile -: Claim Processing associate ( Semi voice) Languages req: Excellent English communication Requirement -: Good Communication Skills Exp-: 6m- 5 yrs in claims Shifts:Rotational Location : Bangalore Immediate joiners only *** Only 2 rounds of interview Job description Document claim file by accurately capturing and updating claims data/information in compliance with best practices for low to moderate. exposure and complexity for Property and Content damage and Liability/Injury claims. Exercise judgement to determine policy verification and coverage determination by analysing applicable coverage for claims and determining whether the loss falls within the coverage. Exercise judgement to determine liability by gathering and analysing relevant facts, images; utilizing applicable coverages. Identify anomalies and patterns to identify fraudulent claims and refer to SIU team based on SOPs Work to have a timely resolution to claims with complete ownership from initiation/intake to settlement. Assess damages by calculating applicable damage or range of damages. Negotiate settlement of a claim by establishing the appropriate negotiation strategy and utilizing available resources within authority limits. Meet quality standards by following best practices Responsible for data integrity and the appropriate documentation of the claim file as well as for compliance with regulatory requirements. Accountability in customer satisfaction and execute on the strategy to provide the best claims service for host damage protection. Ensure customer service by proactively communicating information, responding to inquiries, following customer protocols and special handling instructions. Ensure legal compliance by following federal laws and regulations, and internal control requirements. Key skills required: Bachelor's degree or college Diploma. • Experience in P&C, Healthcare Claims dealing with damage, liability or injury claims. • Good knowledge of Insurance claims end-to-end value chain activities, challenges and best practices. • Good knowledge of how to evaluate injuries and damage using market tools and technology. •General knowledge of the coverages available under the damage protection, liability policy and some common exclusions. • Results driven, ability to multi-task, pay attention to detail and follow procedures. Proven leadership and time management skills in a team environment. Job Type: Full-time Qualification :Any graduates (Note: All the rounds are Held through telephonic) Email : careers@glympsehr.com NOTE: - Please call or whatsapp Manya @ 9606553811 / 9606557106 !!!Thanks & Regards HR TEAM!!!

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years About Accenture Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. Visit us at www.accenture.com What would you do We help insurers redefine their customer experience while accelerating their innovation agenda to drive sustainable growth by transforming to an intelligent operating model. Intelligent Insurance Operations combines our advisory, technology, and operations expertise, global scale, and robust ecosystem with our insurance transformation capabilities. It is structured to address the scope and complexity of the ever-changing insurance environment and offers a flexible operating model that can meet the unique needs of each market segment.Claim processing team collects end-end data dataDevelop and deliver business solutions that support the claims process across its lifecycle, including first notice of loss, claims investigation, payment administration or adjudication, provider reimbursement (health care), subrogation and recovery. What are we looking for Ability to establish strong client relationshipAbility to handle disputesAbility to manage multiple stakeholdersAbility to meet deadlinesAbility to perform under pressureNA Roles and Responsibilities: In this role you are required to solve routine problems, largely through precedent and referral to general guidelines Your primary interaction is within your own team and your direct supervisor In this role you will be given detailed instructions on all tasks The decisions that you make impact your own work and are closely supervised You will be an individual contributor as a part of a team with a predetermined, narrow scope of work Please note that this role may require you to work in rotational shifts Qualification Any Graduation

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Associate Manager Qualifications: Any Graduation Years of Experience: 10 to 14 years Language - Ability: English(Domestic) - Advanced About Accenture Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. Visit us at www.accenture.com What would you do We help insurers redefine their customer experience while accelerating their innovation agenda to drive sustainable growth by transforming to an intelligent operating model. Intelligent Insurance Operations combines our advisory, technology, and operations expertise, global scale, and robust ecosystem with our insurance transformation capabilities. It is structured to address the scope and complexity of the ever-changing insurance environment and offers a flexible operating model that can meet the unique needs of each market segment.Claim processing team collects end-end data dataDevelop and deliver business solutions that support the claims process across its lifecycle, including first notice of loss, claims investigation, payment administration or adjudication, provider reimbursement (health care), subrogation and recovery. What are we looking for Claims ProcessingProblem-solving skillsHands-on experience with trouble-shootingStrong analytical skillsWritten and verbal communicationClaims Administration Roles and Responsibilities: In this role you are required to do analysis and solving of moderately complex problems Typically creates new solutions, leveraging and, where needed, adapting existing methods and procedures The person requires understanding of the strategic direction set by senior management as it relates to team goals Primary upward interaction is with direct supervisor or team leads Generally interacts with peers and/or management levels at a client and/or within Accenture The person should require minimal guidance when determining methods and procedures on new assignments Decisions often impact the team in which they reside and occasionally impact other teams Individual would manage medium-small sized teams and/or work efforts (if in an individual contributor role) at a client or within Accenture Please note that this role may require you to work in rotational shifts Qualification Any Graduation

Job description We Are Hiring for International Semi voice Process Profile -: Claim Processing associate ( Semi voice) Languages req: Excellent English communication Requirement -: Good Communication Skills Exp-: 6m- 5 yrs in claims Shifts:Rotational Location : Bangalore Immediate joiners only *** Only 2 rounds of interview Job description Document claim file by accurately capturing and updating claims data/information in compliance with best practices for low to moderate. exposure and complexity for Property and Content damage and Liability/Injury claims. Exercise judgement to determine policy verification and coverage determination by analysing applicable coverage for claims and determining whether the loss falls within the coverage. Exercise judgement to determine liability by gathering and analysing relevant facts, images; utilizing applicable coverages. Identify anomalies and patterns to identify fraudulent claims and refer to SIU team based on SOPs Work to have a timely resolution to claims with complete ownership from initiation/intake to settlement. Assess damages by calculating applicable damage or range of damages. Negotiate settlement of a claim by establishing the appropriate negotiation strategy and utilizing available resources within authority limits. Meet quality standards by following best practices Responsible for data integrity and the appropriate documentation of the claim file as well as for compliance with regulatory requirements. Accountability in customer satisfaction and execute on the strategy to provide the best claims service for host damage protection. Ensure customer service by proactively communicating information, responding to inquiries, following customer protocols and special handling instructions. Ensure legal compliance by following federal laws and regulations, and internal control requirements. Key skills required: Bachelor's degree or college Diploma. • Experience in P&C, Healthcare Claims dealing with damage, liability or injury claims. • Good knowledge of Insurance claims end-to-end value chain activities, challenges and best practices. • Good knowledge of how to evaluate injuries and damage using market tools and technology. •General knowledge of the coverages available under the damage protection, liability policy and some common exclusions. • Results driven, ability to multi-task, pay attention to detail and follow procedures. Proven leadership and time management skills in a team environment. Job Type: Full-time Qualification :Any graduates (Note: All the rounds are Held through telephonic) Email : careers@glympsehr.com NOTE: - Please call or whatsapp Manya @ 9606557106 / 9606553811 !!!Thanks & Regards HR TEAM!!!

Urgent requirement for BHMS,BDS,BAMS -Rajasthan(Jaipur) Freshers/candidate with clinical or TPA experience. Interested candidates can call on 9371762436 or share their updated resumes to career@mdindia.com Job Description: Scrutiny of medical documents and adjudication. Assess the eligibility of medical claims and determine financial outcomes. Identification of trigger factors of insurance related frauds and inform the concerned department. Determine accuracy of medical documents. Required Candidate profile: BHMS,BDS,BAMS graduate. Male candidate prefer. Good Medical & basic computer knowledge Should have completed internship (Permanent Registration number is mandatory) Freshers can also apply. Work from office. Venue details: MDIndia Health Insurance TPA Pvt. Ltd Naval Tower, J.L.N. Marg, 4 & 6th Floor, Near Fortis Hospital, Jaipur 302017 .

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years What would you do? We help insurers redefine their customer experience while accelerating their innovation agenda to drive sustainable growth by transforming to an intelligent operating model. Intelligent Insurance Operations combines our advisory, technology, and operations expertise, global scale, and robust ecosystem with our insurance transformation capabilities. It is structured to address the scope and complexity of the ever-changing insurance environment and offers a flexible operating model that can meet the unique needs of each market segment.Claim processing team collects end-end data dataDevelop and deliver business solutions that support the claims process across its lifecycle, including first notice of loss, claims investigation, payment administration or adjudication, provider reimbursement (health care), subrogation and recovery. What are we looking for? Written Communication Claims Processing Roles and Responsibilities: In this role you are required to solve routine problems, largely through precedent and referral to general guidelines Your primary interaction is within your own team and your direct supervisor In this role you will be given detailed instructions on all tasks The decisions that you make impact your own work and are closely supervised You will be an individual contributor as a part of a team with a predetermined, narrow scope of work Please note that this role may require you to work in rotational shifts Qualification Any Graduation

Responsibilities: * Manage health & motor claims from intake to settlement * Investigate claims, gather evidence & negotiate settlements * Ensure compliance with regulatory requirements

Handling TPA related all process from billing to co-ordinate with TPA companies. Maintaining & uploading patient's files on the portal. Handling billing Department, Implants bill updating & reconciliation.

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years About Accenture Accenture is a global professional services company with leading capabilities in digital, cloud and security.Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. We embrace the power of change to create value and shared success for our clients, people, shareholders, partners and communities.Visit us at www.accenture.com What would you do We help insurers redefine their customer experience while accelerating their innovation agenda to drive sustainable growth by transforming to an intelligent operating model. Intelligent Insurance Operations combines our advisory, technology, and operations expertise, global scale, and robust ecosystem with our insurance transformation capabilities. It is structured to address the scope and complexity of the ever-changing insurance environment and offers a flexible operating model that can meet the unique needs of each market segment.Claim processing team collects end-end data dataDevelop and deliver business solutions that support the claims process across its lifecycle, including first notice of loss, claims investigation, payment administration or adjudication, provider reimbursement (health care), subrogation and recovery. What are we looking for Ability to establish strong client relationshipAbility to handle disputesAbility to manage multiple stakeholdersAbility to meet deadlinesAbility to perform under pressure- Roles and Responsibilities: In this role you are required to solve routine problems, largely through precedent and referral to general guidelines Your primary interaction is within your own team and your direct supervisor In this role you will be given detailed instructions on all tasks The decisions that you make impact your own work and are closely supervised You will be an individual contributor as a part of a team with a predetermined, narrow scope of work Please note that this role may require you to work in rotational shifts Qualification Any Graduation

Hiring Clinical Investigator for Mohali location ! Eligibility Criteria: Education BHMS,BAMS,MBBS,BPT Candidates with prior US Healthcare or Clinical experience will be preferred. Noncertified Physicians can apply however should be ready to complete the same within specified timeline. (CPC/CIC) Good communication skills. Candidates with corporate experience will be preferred. Immediate joiners preferred. Should be ready to work from office. Should be ready to work in night shift. Job Location - Mohali Interested candidates can share resume - Jitendra.pandey@cotiviti.com Regards, Jitendra 7350534498

Hiring Clinical Doctors for Medical coding role in Mohali !! Eligibility Criteria: Education BHMS,BAMS,MBBS,BPT Candidates with prior US Healthcare or Clinical experience will be preferred. Fresher Physicians can also apply with good clinical knowledge. Noncertified Physicians can apply however should be ready to complete the same within specified timeline. (CPC/CIC) Good communication skills. Candidates with corporate experience will be preferred. Immediate joiners preferred. Should be ready to work from office. Should be ready to work in night shift. Job Location - Mohali Interested candidates can share resume - Jitendra.pandey@cotiviti.com Regards, Jitendra 7350534498