121 Claim Settlement Jobs - Page 2

Role & responsibilities Sending Monthly Reports to insurance co (new additions, deletions etc) He/she will be a SPOC for all employees with reference to handling queries regarding their medical benefits/hospitalizations To close Service tickets pertaining to medical matters within a specified TAT Managing emergency support to employees Liasing closely with the insurance company for faster processing of claims Monitoring CD balance and replenishing the same in co-ordination with the accounts team

Role & responsibilities Manage insurance claims from receipt to settlement, ensuring timely processing and resolution. Coordinate with TPAs (Third Party Administrators) for claim adjudication and settlement. Handle mediclaim claims, health insurance claims, and other types of general insurance policies. Ensure accurate billing and reconciliation of patient accounts. Maintain records of all interactions with patients, providers, and insurers. Preferred candidate profile 5-8 years of experience in insurance coordination or TPA coordination role. Strong knowledge of insurance billing, claims processing, and claims settlement procedures. Proficiency in handling multiple tasks simultaneously under tight deadlines. Excellent communication skills for effective interaction with customers (patients), providers (hospitals), and insurers. Perks and benefits As per industry

Check the medical admissibility of claim by confirming diagnosis and treatment details Verify the required documents for processing claims and raise an information request in case of an insufficiency Approve or deny claims as per T&C within TAT If candidates are interested please drop your update resume/CV on my Mail ID - varsha.kumari@mediassist.in Thanks & Regards Varsha Kumari Email - varsha.kumari@mediassist.in

TPA Empanelment's Claim Processing Corporate Tie- ups

Claims Executive- EB website Link: www.dishainsurance.com Job Summary: We are seeking a qualified Claims executive to help our clients in claims and any other query solution through their own skills. Our ideal Claims executive has to have in-depth knowledge of and experience with the Claim process, Policy terms and conditions, relationship building and MIS management. We are seeking a quick learner with strong communication skills, and someone with a track record of success who can inspire the same in others Roles & Responsibilities: One stop solution for all client queries and requirements Represent our company, with a comprehensive understanding of our services in the area of claim process and policy terms and conditions. Providing the timely help to clients in claim settlements in both cashless and reimbursements claims. Co-ordinating with Insurance Company in updating endorsements, CD Balance and claims reports. Co-ordinating with TPA in claim settlements, in solving the issues due to any calculation error and any data error with the MIS reports. Co-ordinating with clients, HR Head and Finance Head in resolving any issues. Maintaining MIS reports. Co-ordinating with the Retention team. Visiting clients to understand if they have any concerns and help them in fixing the issues. Visiting the TPA and Insurance Company to maintain good relationship with the customer relation team. Desired Profile/ Who should join: Should have 3 to 6 years of experience in a general insurance company/ insurance broker / surveyor Proficient in Microsoft Excel and MS office Fair knowledge about the Insurance processes Good communication skills Problem solving attitude Flexibility with calls and mails

Department - Claims Auto Role & responsibilities Closing Ratio/Minimize cost : Negotiate with dealers ; Avoid cost wastage in workshops; Regular training of claims policies ; Faster settlements Re-open ratio/Segmentation of vehicles: Separating the Claims according to Vehicles and minimizing the expenses Repair claims: Timely follow up with agent; visit the workshop within 48hrs of receiving the claim and follow up within 2days. Maintain the Hygiene/TAT(Total Around Time) : Proper evaluation on customer claims ; Claims should be closed within defined TAT (i.e.; Approval or rejection) Sort out claims related issues according to Regulations. Policy Compliance : Ensure that the claims process adheres to the insurance company's policies and guidelines. Customer Service : Communicate with policyholders, repair shops, and other relevant stakeholders to provide updates, explain assessment findings, and address any queries or concerns. Compliance with Regulations : Ensure compliance with local, state, and national regulations regarding motor vehicle assessments, repairs, and insurance claim processes. Negotiation Skills : Engage in negotiations with repair shops, policyholders, and other involved parties to reach mutually agreeable settlements. Fraud Detection : Detect and report any suspected cases of fraud or misrepresentation during the assessment process and work closely with the investigation team to gather evidence if necessary. Preferred candidate profile - Diploma in Automobile/Mechanical (10+2+3) or BE in Automobile/Mechanical - 2-4 years experince in any of the automobile workshop specially in body shop or in an insurance company in motor claims dept.

Skill required: Group Core Benefits- Claims Case Mgmt. Group Disability Insurance Designation: Claims Management Analyst Qualifications: Any Graduation Years of Experience: 3 to 5 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.Team prepares a case studyGroup disability coverage is tied to employment. If change or loss of job, the coverage is not portable. The cost of group coverage can also change from year to year. It is a sort of insurance that pays out if a policyholder is unable to work and earn an income due to a disability. What are we looking for Problem-solving skillsWritten and verbal communicationCollaboration and interpersonal skillsAbility to meet deadlinesProcess-orientation Roles and Responsibilities: In this role you are required to do analysis and solving of lower-complexity problems Your day to day interaction is with peers within Accenture before updating supervisors In this role you may have limited exposure with clients and/or Accenture management You will be given moderate level instruction on daily work tasks and detailed instructions on new assignments The decisions you make impact your own work and may impact the work of others You will be an individual contributor as a part of a team, with a focused scope of work Please note that this role may require you to work in rotational shifts Qualification Any Graduation

Hiring for Liability, Marine and Medical Malpractices Senior Analyst role End-to-end claims adjusting experience Graduation mandatory Salary: 7.5LPA (depending on last drawn CTC) Call: 8291772291

Claims Specialist Exp- 2+ Years Loc- Pune Skills- Claims, Dispute, Claims Mgt, Reason Codes, SAP, etc Pkg- 5.5 LPA Aparupa 9311697179 Aparupa.imaginators@gmail.com

Responsible for handling cargo claims. Responsible for the management and administration of all claims filed Globally. Responsible for the coordination with local Front desk and guiding them with regards to claim handling. Provide proactive, efficient, and fair but firm claims and recovery management and obtain best possible claims and recovery settlement for the Group. Provide technical expertise and advice related to incidents, claims matter and loss prevention initiatives. Key Responsibilities Claims - Handling cargo Claims as per the set guidelines. Having a customer centric approach at the same time keeping in mind the legal requirement and closing claim within legal ambit Establish appropriate claims handling relationship in respective management area. Assess and document factual background of claims matters; establish and update claims file. Safeguard rights of recovery and drive recovery actions. Liaise with internal and external stakeholders, such as claimants (customer, recovery agents, lawyer, under writer and P&I) third party claims administrators etc. Enter and update data in the claims data base (case management) according to corporate guideline. Manage and settle claims matters in accordance with corporate guideline. Provide advice and support to Local claim desk related to any claims matters. Keeping data quality at top level. Formulate, drive and/or support loss prevention initiatives. Decision Making Authority As per Organization guidelines Function Market & Industry Knowledge / Domain Knowledge / Process working / Education: Graduate from recognized university LLB / LLM or MBA degree would be preferable. Experience: Minimum of 2 years of working experience within Shipping, Logistics, Marine surveyor, or insurance Industry. Exposure to shipping operations preferable. Experience in core claims handling (which includes independent claim settlement) will be an added advantage. Special Skills (Functional/Technical): Good Analytical skills. The knowledge of structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar. The knowledge of local maritime laws, legal codes, court procedures, precedents, government regulations, executive orders, agency rules, and the political process directly impacting claims handling of the region. Good Comprehension skills Excellent team player Well organized to carry out multi-tasks Flexible with changes Take ownership and responsibility of the job assigned Eye for the details.

About Client Hiring for One of the Most Prestigious Multinational Corporations! Job Title : Marine | End-to-end Claims Insurance Qualification : Any Graduate and Above Relevant Experience : 3 to 7 years Must Have Skills : 1.Insurance regulations and laws 2.Claims handling procedures 3.Risk management principles 4.Industry standards 5.Maritime law and regulations 6.Investigate and analyze claims documentation 7.Determine coverage and liability 8.Negotiate settlements and resolve disputes 9.Communicate effectively with insureds, claimants, suppliers and brokers 10.Apply industry-standard claims handling procedures. 11.Collaboration and teamwork Good Have Skills : Experience in Marine Adjuster Roles and Responsibilities : 1. Investigate the circumstances surrounding marine incidents, such as collisions, groundings, or cargo damage. 2. Assess the extent of damage to vessels, cargo, or freight, and estimate the cost of repairs or replacement. 3. Appropriately document information on claim file Maintain effective and ongoing communication with various internal and external contact. 4. Learn and follow best practices of clients as well as claims requirements, standards and practices as required by applicable state statutes. 5. Ensure compliance with relevant maritime law and regulations Ensure adherence to regulatory requirements, industry standards, and company policies. 6. Mitigate organizational risk, maintaining compliance and reputation Location : Kochi, Pune, Mumbai CTC Range : Upto 7.5 LPA (Lakhs Per Annum) Notice Period : Immediate Mode of Interview : Virtual Shift Timing : Night Shift Mode of Work : Hybrid Thanks & Regards, Chaitanya HR Analyst Black and White Business Solutions Pvt Ltd Bangalore, Karnataka, INDIA. Direct Number: 080-67432445 / Whatsapp @ 8431371654 chaitanya.d@blackwhite.in | www.blackwhite.in ****************************** DO REFER YOUR FRIENDS**********************************

Responsible for handling cargo claims. Responsible for the management and administration of all claims filed Globally. Responsible for the coordination with local Front desk and guiding them with regards to claim handling. Provide proactive, efficient, and fair but firm claims and recovery management and obtain best possible claims and recovery settlement for the Group. Provide technical expertise and advice related to incidents, claims matter and loss prevention initiatives. Key Responsibilities Claims - Handling cargo Claims as per the set guidelines. Having a customer centric approach at the same time keeping in mind the legal requirement and closing claim within legal ambit Establish appropriate claims handling relationship in respective management area. Assess and document factual background of claims matters; establish and update claims file. Safeguard rights of recovery and drive recovery actions. Liaise with internal and external stakeholders, such as claimants (customer, recovery agents, lawyer, under writer and P&I) third party claims administrators etc. Enter and update data in the claims data base (case management) according to corporate guideline. Manage and settle claims matters in accordance with corporate guideline. Provide advice and support to Local claim desk related to any claims matters. Keeping data quality at top level. Formulate, drive and/or support loss prevention initiatives. Decision Making Authority As per Organization guidelines Function Market & Industry Knowledge / Domain Knowledge / Process working Education: Graduate from recognized university LLB / LLM or MBA degree would be preferable. Experience: Minimum of 2 years of working experience within Shipping, Logistics, Marine surveyor, or insurance Industry. Exposure to shipping operations preferable. Experience in core claims handling (which includes independent claim settlement) will be an added advantage. Special Skills (Functional/Technical): Good Analytical skills. The knowledge of structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar. The knowledge of local maritime laws, legal codes, court procedures, precedents, government regulations, executive orders, agency rules, and the political process directly impacting claims handling of the region. Good Comprehension skills Excellent team player Well organized to carry out multi-tasks Flexible with changes Take ownership and responsibility of the job assigned Eye for the details

Urgent requirement for BHMS,BDS,BAMS -Hyderabad Fresher/Expereince candidate should have atleast 1 year of 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. Only Male Doctor required for Field Investigation

Job Responsibilities: Computation and timely settlement of Trade Channel Schemes including Price Drop settlement Timely processing of the Channel Scheme Exceptions Drive reconciliation with Channel partners and ensure closure of all recon items Ensure the collection of the No Dues Certificate (NDC) from Chanel partners on Quarterly basis Provide support to External customers (Channel partners) and Internal customers (Regional Sales teams, business teams & finance team) through coordinating actions on Claims process improvements and Claims Settlement Handle timely communication of monthly channel schemes through SMS system. Ensure accurate monthly provisioning of Channel spends and closure of books of accounts Handle automation initiatives/projects that help drive productivity and simplify Commercial processes. Audit Coordination with HQ auditors, Internal Auditors and statutory auditors Review of internal controls and ensure no surprises/leakages in controls. Co-ordination with the BI team for issues in data through DMS Next, GMCS etc. Execute Market visits to get the feedbacks from the Channel Partners on Scheme payout settlements & related issues. Key Competencies required- Working Knowledge of relevant commercial laws / statutes Business Acumen and excellent relationship management skills Positive attitude and strong desire to automate processes Knowledge of SAP, ERP system, Excel . Communication skills both with internal teams and external customers

Any Graduate 06 months exp in insurance domain or Property and casualty Book Roll Endorsement Underwriting Call/Whatsapp RASHMI 8130669625 Required Candidate profile 1 Year bpo experience Candidate must be okay with walkin interview Excellent communication skills required.

Walk-In Interview registration will end by 11:00AM Job responsibilities : Processing of Health Claims. Claim Registration and Claim Adjudication. Identifying the Frauds. Adhering to SLAs and processing the claims with in the TAT as per policy terms and conditions. Supporting CRM, Provider, sales and grievance teams Office Address: Tata AIG General Insurance Company Limited, C/o Imperial Towers, Floor-5, Landmark - Next to Metro (Ameerpet) Station, Ameerpet, Hyderabad

Venue Walk-In Interview on 30-May-2025, Registration will End by 11:00AM Responsibilities: Applying medical knowledge in evaluating the medical claim files to ascertain the medical admissibility. Must understand the policy wordings including Terms & conditions to adjudicate the Admissibility/Rejection. Processing of claims as per regulatory guidelines. Adhering to the TATs in processing. Quality review of processed files. Grievance redressal, handling escalations and Identifying the fraudulent claims. Required understanding and evaluation criteria: Qualified MBBS, BAMS, BHMS having all certificates in hand Preferably from Insurance and TPA experience Clinical Acumen/knowledge in terms of hospital and medical procedures Understanding of Treatment Protocol Understanding of Diagnostic Protocol Ready to work from Office, No Work from Home, open on rotational shifts/ rotational week offs Office Address: Tata AIG GIC Limited, C/o Imperial Towers, Floor-5, Landmark - Next to Metro (Ameerpet) Station, Ameerpet, Hyderabad, Telangana (State)

To contact the insured for Underwriting referred proposals to procure the complete medical history using Audio and/or Video tools. To Follow up with customer for past medical records and/or relevant health documents Maintain end to end TAT / SLAs. Required Candidate profile Location – Bangalore Candidate must know to speak Hindi & Malayalam. CTC – Upto 3.5 LPA.

Job Title : Marine | End-to-end Claims Insurance Qualification : Any Graduate and Above Relevant Experience : 3 7 years Must Have Skills : 1.Insurance regulations and laws 2.Claims handling procedures 3.Risk management principles 4.Industry standards 5.Maritime law and regulations 6.Investigate and analyze claims documentation 7.Determine coverage and liability 8.Negotiate settlements and resolve disputes 9.Communicate effectively with insureds, claimants, suppliers and brokers 10.Apply industry-standard claims handling procedures. 11.Collaboration and teamwork Good Have Skills : Experience in Marine Adjuster Roles and Responsibilities : 1.Investigate the circumstances surrounding marine incidents, such as collisions, groundings, or cargo damage. 2.Assess the extent of damage to vessels, cargo, or freight, and estimate the cost of repairs or replacement. 3.Appropriately document information on claim file Maintain effective and ongoing communication with various internal and external contact. 4.Learn and follow best practices of clients as well as claims requirements, standards and practices as required by applicable state statutes. 5.Ensure compliance with relevant maritime law and regulations Ensure adherence to regulatory requirements, industry standards, and company policies. 6.Mitigate organizational risk, maintaining compliance and reputation Location : Kochi, Pune CTC Range : 4.5 7.5 LPA (Lakhs Per Annum) Notice Period : Immediate Mode of Interview : Virtual Shift Timing : Night Shift Mode of Work : Hybrid 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**********************************

Min 1-3 years of experience in claims and dispute resolution, Insurance claims, conflict resolution, fraud or risk investigations, and/or crisis management(Strong in depth insurance background) Required Candidate profile 2+ yrs exp in customer service with calling experience plus claims mandatory Package upto 10 lpa Drop CV on supreet.imaginators@gmail.com

Adhere billing process guidelines Review claims, Verify coverage Assist with inquiries Prepare claim forms & documents & timely claim processing Record Keeping & upload files on the portal Assist pre-authorizations Resolve billing issues/escalation Required Candidate profile Any graduation or BBA/BHA min. 1 year Billing Experience is preferred Please Email your resume at hr@jimsh.org

Job Summary: We are seeking a dedicated and detail-oriented professional to manage insurance claims on behalf of clients across various lines of business. The ideal candidate will ensure accurate documentation, effective coordination with insurers, and timely settlement of claims, while maintaining high standards of service and compliance. Key Responsibilities: Register and manage claims across multiple insurance segments (e.g., Health, Motor, Property, Marine, etc.) Liaise with clients and insurance companies to collect required claim documents and provide status updates Monitor and ensure timely follow-ups to drive claim resolution and settlements Maintain accurate claim records and prepare regular MIS reports for internal and client use Ensure adherence to regulatory requirements and internal company standards throughout the claims process Proactively follow up with insurers to expedite claim approvals and settlements Escalate delays, disputes, or complex claims to senior management or resolve through effective negotiation Candidate Requirements: Graduate degree (preferably in Commerce, Insurance, or a related field) Minimum 2 years of experience in claims handling within a broking firm or insurance company Strong knowledge of insurance products and end-to-end claim processes Effective communication and interpersonal skills, with a focus on client servicing and coordination High attention to detail and the ability to manage multiple claims simultaneously

Check the medical admissibility of claim by confirming diagnosis and treatment details Verify the required documents for processing claims and raise an information request in case of an insufficiency Approve or deny claims as per T&C within TAT If candidates are interested please drop your update resume/CV on my WhatsApp no - 8951865563 Thanks & Regards Sarika Email - sarika.pallap@mediassist.in

Managing CGHS, ECHS, CAPF and ESIC and All Government Portals: Medical file Audit Claim Processing Uploading Query Management Required Candidate profile Mandatory practical experience of government empanelment such as CGHS ECHS ESIC CAPF etc. and medical file audit and processing for Railways, CGHS, ECHS and other govt empanelment's.

We Have Urgent Requirement of TPA Manager