47 Claim Processing Jobs

Role & responsibilities: Outline the day-to-day responsibilities for this role. Preferred candidate profile: Specify required role expertise, previous job experience, or relevant certifications.

Role & responsibilities: Outline the day-to-day responsibilities for this role. Preferred candidate profile: Specify required role expertise, previous job experience, or relevant certifications.

Role Overview: You will be a part of a Mumbai-based health-tech company specializing in cutting-edge digital health solutions. Your primary role as a CRM Helpdesk - Claim Processing will involve managing claims and providing customer support at a client location. Your responsibilities will include deploying CRM implants, handling customer queries, guiding users in claim processes, acting as a single point of contact for corporate clients, and ensuring smooth claim facilitation. Key Responsibilities: - Deploy CRM implants at client site for claim support - Handle customer queries related to policy coverage and claim processing - Guide users in submitting and tracking claims via the claims app...

Process and review Life insurance claims, ensuring adherence to company policies and guidelines. Verify claim documentation, including Death certificate , Employment details, medical records to rule out cause of death and co-morbidities, PMR, FIR , and other supporting documents. Examine insurance applications and documents to ensure accuracy. Communicate with claimants to obtain necessary information and explain the claim process. Assess the validity and coverage of claims, determining eligibility for reimbursement or settlement. Collaborate with claimants, insurance agents, and medical professionals to gather necessary information and resolve any claim-related queries or issues. Keep claim...

What will your essential responsibilities include Process the treaty contract set up in multiple system i.e., Genius, the Frame and Procede. Process the reinsurance recoveries in the multiple system i.e., Genius, the Frame. Process the facultative reinsurance contract set ups as per the process guidelines in both ProCede and the frame. Get them reviewed. Ensure collections / advices are issued promptly to relevant parties. Respond to broker queries and collaborate with Ceded Technical accounting. Assist in data collection and adhoc processing exercises arising from time to time. reporting. Request for test bordereaux. Review them and obtain signoffs before requesting live bordereaux. Prepare...

Dear Candidates, Greetings from HealthIndia Insurance TPA Service Pvt. Ltd. Company Profile - We are provide highest level of quality health care by creating a platform which is entirely dedicated to service excellence, patient care and health education to the members . For more details kindly go through company website: https://www.healthindiatpa.com Currently we have an opening in Corporate Claims Processing Department for Medical Officer Role. Location: HEALTHINDIA INSURANCE TPA SERVICES PVT LTD. PLOT NO 312 ,2ND FLOOR, PHASE 2, UDYOG VIHAR-OPPOSITE TO ICICI BANK UDYOG VIHAR, GURUGRAM, HARYANA -122016 Roles & Responsibilities: Review and assess medical documents and clinical details for c...

Department: Operations Management Job Summary: We are seeking a dynamic and results-oriented Manager to lead our on-site teams and manage key hospital accounts. This strategic role is a blend of team leadership, operational excellence, and business development. You will be responsible for ensuring that our Patient Relationship Officers deliver outstanding service, meet their performance targets, and solidify our partnership with the hospitals. Your goal is to drive operational efficiency, ensure client retention, and identify growth opportunities through upselling and cross-selling. Key Responsibilities: Team Leadership & Management: Recruit, train, mentor, and manage a team of on-site Patie...

Department: Operations Management Job Summary: We are seeking a dynamic and results-oriented Manager to lead our on-site teams and manage key hospital accounts. This strategic role is a blend of team leadership, operational excellence, and business development. You will be responsible for ensuring that our Patient Relationship Officers deliver outstanding service, meet their performance targets, and solidify our partnership with the hospitals. Your goal is to drive operational efficiency, ensure client retention, and identify growth opportunities through upselling and cross-selling. Key Responsibilities: Team Leadership & Management: Recruit, train, mentor, and manage a team of on-site Patie...

You will be working as an Analyst - Insurance at Hanover International Support Services Pvt. Ltd. located on Iscon Ambli Road, Ahmedabad (India Office). Your main responsibility will involve assisting in the collection and review of subcontractor and vendor insurance certificates at the site level. This includes tracking and analytics within time-sensitive deadlines and communication with subcontractors, vendors, and Hanover team members through email. Your primary duties will include using Procore, a web-based project management system, to monitor vendor insurance certificates that are close to expiration. You will be responsible for requesting renewal certificates from vendors and subcontr...

As an insurance officer, you will play a crucial role in managing and servicing insurance policies for our clients. Your responsibilities will include meeting with potential and existing clients to understand their insurance needs, assess risk profiles, and recommend appropriate coverage options. You will be tasked with gathering required information, reviewing applications, and submitting them to underwriters for approval. It will be essential for you to maintain accurate policy records, update policy details as needed, and ensure timely premium collection. Additionally, you will be responsible for investigating and processing insurance claims, communicating with clients and third parties r...

The job involves coordinating with various Third Party Administrators (TPAs) and insurance companies to facilitate claim processing and approvals. You will be responsible for verifying insurance documents, policy details, and patient eligibility. Additionally, you will assist in obtaining pre-authorization and cashless treatment approvals for insured patients. Your role will also include following up on pending claims, rejections, and reimbursements, while maintaining accurate and updated records of all insurance-related transactions and documentation. You will need to collaborate with hospital billing departments and patient relations teams to ensure timely submission of required documents....

Employee Life Cycle Management,Exit Formalities,SOP, Employee Handbook,Mediclaim,Personal Accident policy,additions,deletions,TPA, claims processing,Onboarding process,joining formalities,appraisal process,Induction proces,Policy .Recruitment

Hiring for AR Dental Callers Freshers Only Freshers With Graduation After 2019 Salary Upto 17k per Month Work from Office Night Shift with cab Work Location Coimbatore Only Immediate Joiners Good Communication Skills Needed Contact Dinesh - 9345717910

As a Client Service Representative, your primary responsibility will be to provide clear and comprehensive answers to clients regarding any coverage or billing questions they may have. This includes offering information on rate fluctuations and policy changes in a manner that ensures the client's full understanding. Additionally, you will be responsible for updating policy changes on customer accounts within our book of business and communicating these changes to clients in accordance with NAIC regulations. In this role, you will consult with clients to assist in processing quotes, issuing renewals, or implementing any updates required for current policies. You will also be responsible for g...

The Senior Manager Health Claims position at Tata AIG General Insurance Company Limited in Noida involves key responsibilities that include building and maintaining strong relationships with customers, applying medical knowledge to resolve queries, grievance redressal, handling escalations, and identifying fraudulent claims. The role also entails responding to customer inquiries, assisting clients in navigating the claims process, collecting and verifying claim documents, tracking claim status for timely resolution, and maintaining accurate client interaction records. The ideal candidate for this role should possess excellent communication skills, strong problem-solving abilities, and the ab...

You are invited to join a dynamic team for the UK Health Care Process based in Thane. As a part of the team, your primary responsibility will be Claim Processing/Backend operations. To qualify for this role, you must hold a Graduation degree in Zoology, Biology, Botany, or Chemistry. The salary for this position can go up to 25k in hand. This is a full-time job that requires you to work from the office. It is essential that you possess your own system with the following configurations: Windows 10 operating system, i3/i5 processor, minimum 4 GB RAM, and an internet speed of at least 10 mbps. In addition to the competitive salary, you will also be entitled to health insurance benefits. The wor...

You should be a PG/MBA in HR (Full time MBA) with 5-6 years of relevant experience in handling HR Compliance and liaising with Statutory Authorities independently. Your role will require excellent people management skills, a target-oriented approach, and a positive and proactive attitude. You should have a sound understanding and exposure in EPF, ESIC, Professional Tax, Gratuity related matters, Compliance, and other labor Laws. Additionally, you will be responsible for liaising with external Insurance vendors for claim processing and settlement of Employee Claims. The ideal candidate for this position should be within 35 years of age and willing to work at the Head Office in Kolkata. If you...

You will be working as a Process Executive in Gurgaon and Noida locations with 0-6 months of experience. Your main responsibility will be managing a database containing various types of claims effectively. This will involve updating and maintaining claim files to ensure complete records are kept. You will also need to respond promptly to both internal and external inquiries regarding claim information. Your tasks will include reviewing, preparing, creating, and sending letters, reports, and forms related to claims. Communication with claimants, clients, and medical contacts regarding claim action and processing will be essential. You will be responsible for identifying notification issues, c...

You will be responsible for claim processing, which involves evaluating NME, determining tariff applicability, understanding policy terms and conditions, deducting discounts, being familiar with investigation criteria, having knowledge of insurer-wise policy terms and conditions, and managing basic documentation required for claim processing. To qualify for this position, you should have a minimum of 1 year of experience in claims processing within the TPA or Health Insurance domain. It is preferred that you have exposure to group health policies and experience in coordinating with hospitals or corporate clients. This is a full-time and permanent position based in Jaipur. Please note that th...

Description We are seeking dedicated AR CALLERS (Voice Process) to join our team. The ideal candidate will be responsible for managing accounts receivable through effective communication with clients. This role requires a proactive approach to follow up on outstanding payments and provide excellent customer service. Responsibilities Handle inbound and outbound calls related to accounts receivable. Follow up with clients regarding outstanding payments and invoices. Maintain accurate records of calls and interactions in the system. Resolve customer queries and issues related to payments effectively. Collaborate with the finance team to ensure timely collections. Provide excellent customer serv...

You will be joining Sinex Management Pvt Ltd, a company specializing in providing comprehensive medical billing and revenue cycle management services to healthcare providers. Your primary goal will be to optimize revenue, minimize claim denials, and streamline billing processes to allow medical professionals to focus on patient care. By leveraging the expertise of our billing specialists, you will ensure accurate claim submissions, timely reimbursements, and adherence to industry standards. Our tailored solutions cater to various healthcare settings, such as small clinics, group practices, and independent physicians, to enhance cash flow and reduce administrative burdens. Your role will be a...

You will be responsible for managing and processing insurance claims under the Ayushman Bharat scheme. Your role will involve ensuring timely and accurate processing of claims, maintaining comprehensive records, and providing exceptional support to beneficiaries. Your key responsibilities will include evaluating and processing Ayushman Bharat insurance claims while ensuring compliance with guidelines and policies. You will also be required to review and verify the accuracy and completeness of claim documents submitted by beneficiaries and hospitals. Effective communication with healthcare providers, beneficiaries, and insurance companies to resolve any discrepancies or issues related to clai...

As a Health Admin Services New Associate at Accenture, you will be a part of the Healthcare Claims team responsible for the administration of health claims. Your role will involve core claim processing tasks such as registering claims, editing & verification, claims evaluation, and examination & litigation for health, life, and property & causality claims. You will play a crucial role in embedding digital transformation in healthcare operations end-to-end, driving superior outcomes and value realization today, while enabling streamlined operations to serve the emerging health care market of tomorrow. We are looking for individuals who are adaptable, flexible, and have a commitment to quality...

Job Summary: As a Telemedical Underwriter, you will play a crucial role in our underwriting process by assessing and evaluating insurance applications using telemedical technologies. You will work closely with our team of underwriters, medical professionals, and technology experts to ensure accurate risk assessment and efficient decision-making. Responsibilities: Telemedical Verification: Conduct telemedical verifications for insured members using audio, chat, and video communication channels to create comprehensive Medical Examination Reports (MER). Analyse medical records, test results, and other relevant documentation to assess the insurability and risk level of applicants. Profile Analys...

TPA Executive to manage pre-authorizations, insurance claims & coordination with TPAs and government health scheme. The role requires accurate documentation, timely claim submissions, & effective communication with internal departments and insurers. Required Candidate profile Graduate with 1–3 years of hospital TPA experience. Proficient in handling CGHS, ECHS, PMJAY claims, insurance coordination, billing & documentation. Strong communication, MS Office & software skills.