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4 Claim Process Jobs

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5.0 - 9.0 years

0 Lacs

vijayawada, andhra pradesh

On-site

As a Distributor Manager, your primary responsibility is to ensure that distributors achieve maximum ROI in accordance with industry standards. This involves various key tasks including inventory management, FIFO and expiry management, as well as ensuring that distributors and retailers receive fresh stocks promptly. You will be in charge of monitoring the claims process, ensuring timely submission to avoid delays, and providing necessary supporting documents for quick reimbursement. Additionally, you will track the POSM received and utilized in the market and manage competition by monitoring and analyzing competitor prices, promotions, new launches, and marketing activities. Your role will also involve promoting the sales of Cat 2&3 products through distribution network expansion activities, market intelligence development, competitor analysis, and market share reports. You will be responsible for collecting sales realizations, coordinating with RH & Distribution Manager to identify gaps in product presence, and conducting market surveys to understand sales potential and competitor strategies. Furthermore, you will be tasked with preparing launch plans for new markets, managing CAT-2&3 sales offices, controlling costs, placing freezers in the market, and minimizing leakages and damages within allocated budgets. You will also be responsible for optimizing manpower utilization, conducting team training and development, and organizing customer contract programs while addressing complaints effectively.,

Posted 3 days ago

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0.0 - 2.0 years

3 - 4 Lacs

Kolkata, Hyderabad, Chennai

Work from Office

Role & responsibilities Process cashless and reimbursment claims (Should have knowledge of processing retail policies of National/United/New India/Oriental insurance companies. Preferred candidate profile BAMS/BUMS/BHMS Fresher or max 2 years experience in the similar field. Ready to work in shifts

Posted 4 weeks ago

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0.0 - 1.0 years

2 - 3 Lacs

Bengaluru

Work from Office

Experience: 0-12 months Qualification: BDS, BHMS, BAMS Key Responsibilities: Good communication skill. Knowledge in computers like MS office. Good medical knowledge. Independently process Post hospitalization claims; process complex claims with minimal assistance Needs to validate the information on all medical claims received. Claims must be thoroughly reviewed and ensure that there is no missing or incomplete information Suggest operational policies, workflows and process improvement initiatives Proactive approach by informing Providers regarding missing or repetitive errors by various hospital departments and improvisation of the same. Applying medical and surgical aspects to scrutinize the patient reports and other documents. Application of medical knowledge to bifurcate the claims. Analyzing and justifying the care and management given to the patient Thorough understanding of medical terminology in relation to diagnosis and procedures and meeting daily targets. Updating skills and medical knowledge with routine enhancement programs. Adjudication of claims as per the office memorandum of the concern scheme protocols Responsible for the accurate and timely processing of post discharge cashless claims. Meets quantity and quality claims processing standards. In-depth understanding of the hospitals processes, policies and procedures Verify Medical, billing related documents for further claim processing. What We Offer: Opportunities for professional development and career advancement. A collaborative and dynamic work environment.

Posted 4 weeks ago

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5.0 - 9.0 years

7 - 11 Lacs

Gurugram

Work from Office

Roles and Responsibility Analyze complex data sets to identify trends and patterns in health-related claims. Develop and implement effective analytical models to predict future claim outcomes. Collaborate with cross-functional teams to design and implement process improvements. Provide expert guidance on health-related risk assessment and mitigation strategies. Conduct thorough analysis of medical records to determine claim validity. Develop and maintain comprehensive reports on claim performance metrics. Job Requirements Strong knowledge of insurance industry regulations and standards. Proficient in analyzing large datasets using advanced statistical techniques. Excellent communication and interpersonal skills. Ability to work effectively in a fast-paced environment with multiple priorities. Strong problem-solving skills with attention to detail. Experience working with healthcare professionals to understand claim requirements. A graduate or postgraduate degree is required.

Posted 1 month ago

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