188 Claim Settlement Jobs - Page 4

DEPS Process Compliance Ensure strict adherence to DEPS processes across all Operational Units (OUs). Monitor and ensure: Timely closure of tickets as per the defined SOP. Resolution of shortages following all required process steps. Continuous training and upskilling of DEPS coordinators on company policies and procedures. Claim Settlement Ensure settlement of claims within the defined SLA and policy: SBU & Siemens (COFs): within 3 working days Other clients (Credit Note, RCS, COFs): within 7 working days DEPS Case Closure Timely resolution of DEPS cases including: Unclean PODs Client escalations Cases to be closed within the specified SLA CCTV Compliance Ensure CCTV systems are effectively installed and operational across all 17 clusters: Conduct assessments and rectify any non-functional systems. Ensure surveillance standards are met at all OUs. SOP Negligence Handling Monitor and act on at least 10 SOP negligence instances monthly: 1st Instance: Provide training and issue a written warning with managerial acknowledgment. 2nd Instance: Issue a show-cause notice via Darwin Box with HR involvement. 3rd Instance: Implement a Performance Improvement Plan (PIP) and issue a final warning. 4th Instance: Proceed with termination in coordination with HR and reporting manager. UCG Process Management Create and manage a robust Unclaimed Goods (UCG) process: Ensure timely tracking and disposal of UCG. DEPS team to own and maintain UCG areas within PCs. PPM & Chronic Issue Resolution Conduct deep-dives on Planned Preventive Maintenance (PPM) activities. Use quality tools to identify root causes and eliminate chronic issues effectively. DEPS Dashboard & Metrics Reporting Maintain and report on key DEPS performance dashboards: Shortages Dashboard Damages Dashboard Interchange Dashboard Claims Dashboard

Job Description: Processing of Claims Health files. Claim Registration and Claim Adjudication. Identifying the Fraud. Adhering to SLAs and processing the claims with in the TAT as per policy terms and conditions. Supporting CRM, provider, sales and grievance teams. Eligibility Criteria: Pharm-D, BSc Nursing, B .Pharmacy freshers only(Qualified Graduates with all certificates in hand). Any Graduate with minimum 2+ years of Claims Health processing experience. Salary Budget - up to 4 lakhs. Job location Ameerpet, Hyderabad. Evaluation would be based on competency, age, experience, stability

Position Vacant Non EB - Claims (Manger /Senior Manager) No. of Vacancy 1 Qualification Academic - Graduate and above Job Description / Responsibilities Good Interpersonal connection with IBAI. Knowledge of Claim intimation process Knowledge of Surveyor appointments based on quantum of loss. Coordinating with Insurance co. & Customer for documentation. Knowledge of claim documents required for various LOB. Claim processing & settlement of admissible claims. Handling Customer Grievances. Handling escalations, solving the Queries. Scrutiny of claims. Arranging Joint meetings with all stake holders for claims discussions in case of ambiguity. Conducting survey of vehicles. Building relationships with repairers and stakeholders. Loss minimization based on technical and soft skills. Maintaining good working relationship with insurance Company, Dealers, Surveyors and customers, Understanding the issues, Follow up with Insurers for settlement like DV , submission of signed DV and claims consent from Insured etc. Desired profile of the candidate Good Communication Skills English and Local Language. Negotiation, questioning and decision-making skills Organizational and time management skills the ability to work well under pressure the ability to think strategically initiative and the ability to adapt quickly to different situations discernment and the ability to assess a situation objectively Attention to detail and sound report-writing skills. Experience- 6 to 8 years Compensation range 12 LPA Max Location Gurgaon

Role & Responsibilities Handling TPA related all process from billing to co-ordinate with TPA companies. Responsible for counseling patient's family & pre-Auth process. Maintaining & uploading patient's files on the portal. Couriering the hard copy of patient's medical file to the Insurance companies. Responsible for all co-ordination activities from patient's admission to discharge. Handling billing Department, Implants bill updating & reconciliation. Daily co-ordination with the patient and Hospital staff. Outstanding follow-up with TPA. To obtain and review referrals and authorizations for treatments. Must be aware of norms of the insurance sector. Daily follow up with Insurance companies to pass or clear the Health Insurance claims. Qualifications Bachelor's degree. Previous experience in TPA management or Banking. Good interpersonal and communication skills. Isha Thakur 9056448144 HRD

*2-4 years exp. in Indian Insurance end-to-end group medical claims, *Resolved queries via Freshchat/Freshdesk (Customer Support) *Policy Document assessments *Stakeholders Mgmt., Collaboration & led escalations *Email/WhatsApp comms. Required Candidate profile *2-4 years exp. in Indian Insurance claims processing, CRM/Servicing/Claims handler roles in Insurer /TPA. *Graduate in healthcare, insurance *Verbal proficiency in English & Hindi must.

We are hiring for Automobile claim settlement process. - Helping customer through email and voice for settlement of claim - Skills Required: Knowledge of warranty claim process in automobile industry / Service Advisor in workshop. HR - 75488 27248 Required Candidate profile Qualification: Diploma in Automobile / Diploma in Mechanical Experience: Experience in Automobile / Internship experience in Automobile Language - Tamil or Hindi or Telugu and English Day shift

1.Oversee claims process - commercial insurance products (Fire, Marine, Property) 2.Interpret insurance policy language to determine coverage 3.Conduct investigations to establish facts and assess damages. 4.Identify potential fraudulent claims. Required Candidate profile Handles the process of managing commercial insurance claims, from initial notification to settlement.

Job Title : Claims Admin (Sr Process Executive) Qualification : Any Graduate Experience : 1-4 Years Must Have Skills : l Working experience in SAP. Experience in English communication skills both written and verbal. The ability to work within a deadline focused environment. Excellent knowledge of MS word, excel, Work from office Good to Have Skills : NA Roles and Responsibilities : Claims Administration: l Good understanding on claim processing, creating claims/tickets, dealing with suppliers, credit note handling investigation, follow up on credit note, Booking CN, Creation of Manual RFC (request for credit) l Match RFC to credit, categorize of items refund process. Idea on debit note l Good understanding on dealing with damaged products l Provide refund to store n franchise, dealing with supplier, refund process for damaged products fixit tickets idea on credit note Location : Pune CTC Range : 3.5 - 5.5lpa (lakh per annum) Notice period : Immediate - 30 Days Shift Timings : UK Shift Mode of Interview : Virtual Mode of Work : WFO (work from office) Mode of Hire : Permanent Note : NA Note : NA -- -- Thanks & Regards, HR Deekshitha Staffing Analyst Black and White Business Solutions Pvt Ltd Bangalore,Karnataka,INDIA. Direct Number: 8067432405| deekshitha@blackwhite.in | www.blackwhite.in

Job Title : Claims Admin (Sr Process Executive) Qualification : Any Graduate Experience : 1-4 Years Must Have Skills : l Working experience in SAP. Experience in English communication skills both written and verbal. The ability to work within a deadline focused environment. Excellent knowledge of MS word, excel, Work from office Good to Have Skills : NA Roles and Responsibilities : Claims Administration: l Good understanding on claim processing, creating claims/tickets, dealing with suppliers, credit note handling investigation, follow up on credit note, Booking CN, Creation of Manual RFC (request for credit) l Match RFC to credit, categorize of items refund process. Idea on debit note l Good understanding on dealing with damaged products l Provide refund to store n franchise, dealing with supplier, refund process for damaged products fixit tickets idea on credit note Location : Pune CTC Range : 3.5 - 5.5lpa (lakh per annum) Notice period : Immediate - 30 Days Shift Timings : UK Shift Mode of Interview : Virtual Mode of Work : WFO (work from office) Mode of Hire : Permanent Note : NA Note : NA -- Thanks & Regards, HR Sneha Staffing Analyst Black and White Business Solutions Pvt Ltd Bangalore,Karnataka,INDIA. Direct Number: 8067432406| Whatsapp:8951047887| sneha.v@blackwhite.in | www.blackwhite.in

Job Title : Claims Admin (Sr Process Executive) Qualification : Any Graduate Experience : 1-4 Years Must Have Skills : l Working experience in SAP. Experience in English communication skills both written and verbal. The ability to work within a deadline focused environment. Excellent knowledge of MS word, excel, Work from office Good to Have Skills : NA Roles and Responsibilities : Claims Administration: l Good understanding on claim processing, creating claims/tickets, dealing with suppliers, credit note handling investigation, follow up on credit note, Booking CN, Creation of Manual RFC (request for credit) l Match RFC to credit, categorize of items refund process. Idea on debit note l Good understanding on dealing with damaged products l Provide refund to store n franchise, dealing with supplier, refund process for damaged products fixit tickets idea on credit note Location : Pune CTC Range : 3.5 - 5.5lpa (lakh per annum) Notice period : Immediate - 30 Days Shift Timings : UK Shift Mode of Interview : Virtual Mode of Work : WFO (work from office) Mode of Hire : Permanent Note : NA Note : NA -- Thanks & Regards, HR Janhavi Staffing Analyst Black and White Business Solutions Pvt Ltd Bangalore,Karnataka,INDIA. Direct Number: 8067432471| janhavi@blackwhite.in | www.blackwhite.in

Educational Bachelor of Engineering Service Line Enterprise Package Application Services Responsibilities A day in the life of an Infoscion As part of the Infosys consulting team, your primary role would be to actively aid the consulting team in different phases of the project including problem definition, effort estimation, diagnosis, solution generation and design and deployment You will explore the alternatives to the recommended solutions based on research that includes literature surveys, information available in public domains, vendor evaluation information, etc. and build POCs You will create requirement specifications from the business needs, define the to-be-processes and detailed functional designs based on requirements. You will support configuring solution requirements on the products; understand if any issues, diagnose the root-cause of such issues, seek clarifications, and then identify and shortlist solution alternatives You will also contribute to unit-level and organizational initiatives with an objective of providing high quality value adding solutions to customers. If you think you fit right in to help our clients navigate their next in their digital transformation journey, this is the place for you! Additional Responsibilities: Ability to work with clients to identify business challenges and contribute to client deliverables by refining, analyzing, and structuring relevant data Awareness of latest technologies and trends Logical thinking and problem solving skills along with an ability to collaborate Ability to assess the current processes, identify improvement areas and suggest the technology solutions One or two industry domain knowledge Technical and Professional : Minimum 2+ years of overall SAP experience. Must have Hands-on project experience latest SAP TPM (Trade Promotion Management) covering technical/functional skills for end-to- end configuration and customization SAP CRM, CBP, TPM, Funds management, Pricing, Claims and Settlement. Must have configuration experience of planning product hierarchy, operational planning, scenario planning, baseline planning other planning supported in CBP screen. Also, must have master data configuration knowledge in SAP CRM for SAP Trade management solution. Must have knowledge about ECC integration for master data replication, SAP SD OTC cycle, pricing, rebates, deduction claim settlement functionality. Lead and drive the CRM/ TPM process workshops and lead the Functional Design Requirement gathering, functional, technical design Budgeting, planning help to program manager. Experience in AMS project /support projects, Different ticket tracking & monitoring tools in CRM /TPM Functionality. Preferred Skills: Technology-SAP Functional-SAP Trade Management-SAP Trade Promotion Management

Manage group insurance, claims, compliance, audits, assets, and policy renewals; ensure risk coverage, legal adherence, cost efficiency, and insurer coordination across all business units.

To be liaison between the patient, the hospital, and TPA, managing claim processing by coordinating with the TPA to facilitate timely claim settlements and patient billing, all while adhering to insurance guidelines and regulations.

Primary responsibility of TPA Executive is Follow ups and Clearing of outstanding dues with TPA’s & other govt. agencies and split billing. Required Candidate profile Reporting of daily, weekly, monthly on dues outstanding follow ups to the reporting manager. Insurance patient billing, Packages and other billing process, Resolve queries.

Role & Responsibilities Handling TPA related all process from billing to co-ordinate with TPA companies. Responsible for counseling patient's family & pre-Auth process. Maintaining & uploading patient's files on the portal. Couriering the hard copy of patient's medical file to the Insurance companies. Responsible for all co-ordination activities from patient's admission to discharge. Handling billing Department, Implants bill updating & reconciliation. Daily co-ordination with the patient and Hospital staff. Outstanding follow-up with TPA. To obtain and review referrals and authorizations for treatments. Must be aware of norms of the insurance sector. Daily follow up with Insurance companies to pass or clear the Health Insurance claims. Qualifications Bachelor's degree. Previous experience in TPA management or Banking. Good interpersonal and communication skills. Astha Saklani 7087994355 HRD

About Client Hiring for One of the Most Prestigious Multinational Corporations! 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, 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

Responsibilities: * Manage claims from intake to settlement. * Adjudicate medical necessity & settle claims fairly. * Ensure timely claim payment & employer satisfaction. * Process mediclaim & health insurance claims accurately.

To co-ordinate with cashless patients, Insurance companies and corporate for smooth functioning of cashless treatment provided to the patient. To send the pre-authorization forms to the concerned TPAs and to follow-up till receipt of initial approval

Manage existing contracts with PSU Contract Mgmt, Negotiation, and Execution, Compl., Risk and Claim Mgmt,Performance Monitoring & Reporting,Collaboration & Stakeholder Mgmt, Contract Administration & Documentation,Legal and Regulatory Compl. Required Candidate profile -B.E/Tech + (Contract Mgmt is a value addition OR NICMAR), Minimum of around 1 years of exp, exposure.

Medical Billing (Claim Settlement)(voice+backend) AR Trainee - HSC/Graduate Freshers AR Associate SR AR (female) Location - Airoli/Andheri Education - HSC/Graduate fresher Shift- 5.30pm - 2.00am/6.30pm -3.30am/8.30pm-5.30am Contact - 9819009366 Required Candidate profile Salary AR Trainee - 10,700k for 3 months after 3 months 13.5k+5k after 6 months 14.5k+5k AR Associate-15knon bpo & 17k for bpo SR AR-25K In-hand sat & sun fixed off (home drop will be given)

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!!!

Role & responsibilities - Having experience in drafting, reviewing, negotiating, and managing contracts to ensure compliance, protect organizational interests, and optimize outcomes. - They also provide expert advice on contractual matters and stay updated on relevant laws and regulations. - Negotiating contract terms and conditions to achieve favorable outcomes for the organization. - - Managing contracts throughout their lifecycle, including amendments, extensions, and terminations. - Ensuring contracts are compliant with relevant laws, regulations, and company policies. - Overseeing contract implementation and monitoring performance. - Candidate must have at least 5 years of experience in Underground Metro projects This vacancy is for the project- AGRA KANPUR METRO Location will be either Agra or in Lucknow

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

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**********************************

Walk-in Drive North America Insurance Claims Role: North America Insurance Claims Walk-in Time: 12:00 PM to 1:00 PM Work Mode: Hybrid Work Location: Vikhroli Experience Required: 1 to 4 Years Qualification: Graduation (Any Stream) Shift Timing: 6:30 AM to 3:30 PM Interview Venue: WTW iThink Techno Campus, 7th Floor, A & B Wing, Off Pokhran Road No. 2, Close to Eastern Express Highway, Thane West 400607 Roles & Responsibilities Notify Claims to the insurer on behalf of the Client Maintaining and updating the centralized inbox and tracking database regularly Liaising with team members and US peers to ensure all aspects of Claims are addressed Extreme focus on quality with the understanding of financial implications Ensuring Claims operational reports are reviewed daily and followed up with Carriers Escalate errors and breaches to the Lead Work as per compliance requirements of the organization Revert to emails in a professional manner Active participation in all interactions (Team huddles, Stakeholder discussions, etc.) Qualification Graduation Skills:- Excellent command over written and spoken English Attention to detail, quality and accuracy Ability to prioritise and organise tasks, work within stiff timelines Ability to learn new processes and systems Flexible and adaptable to changing demands Ability to work under pressure and meet tight deadlines Should be a quick learner and team player Ability to work independently and as part of a team Extreme competence in comprehension Insurance experience preferred