461 Claim Settlement Jobs - Page 9

Responsible to ensure quality of service given is equivalent to the set standards. Responsible to maintain payable status at its minimum; close follow up on critical issues. Random checking of bills in terms of their accuracy and make sure the corporate bills are prepared as per the agreements and prompt dispatch of the same with the help of credit cell. Responsible to record department MIS reports and submission of the same to higher authority Responsible to monitor the surgical package limits in terms of material consumption and professional charges. Systems & Procedures: Responsible to design, implement and refine systems to manage processes and to optimize performance. Responsible to dev...

About Us: Medi Assist is India's leading Health Tech and Insure Tech company focused on administering health benefits across employers, retail members, and public health schemes. We consistently strive to drive innovation and participate in such initiatives, to lower health care costs. Our Health Benefits: Administration model is designed to deliver the tools necessary for a health plan to succeed, whether its our modular claims management system, our technology that unveils data to make important decisions, or our service solutions built around the voice of the customer. In short, our goal is to link our success to that of our members Roles and Responsibilities: Check the medical admissibil...

Roles and Responsibilities Manage contractual documentation, claims management, and dispute resolution for Hydro Power, Tunnel or any underground project Draft letters and emails related to contract administration, including correspondence with clients, consultants, and stakeholders. Desired Candidate Profile 3-7 years of experience in Contract Management or Claims Management in Water Treatment Industry. B.Tech/B.E. degree in Civil or relevant field; MBA/LLB preferred but not mandatory. Strong understanding of FIDIC contracts and their application in international markets. Excellent drafting skills for preparing various types of contractual documents.

About Us: Medi Assist is India's leading Health Tech and Insure Tech company focused on administering health benefits across employers, retail members, and public health schemes. We consistently strive to drive innovation and participate in such initiatives, to lower health care costs. Our Health Benefits: Administration model is designed to deliver the tools necessary for a health plan to succeed, whether its our modular claims management system, our technology that unveils data to make important decisions, or our service solutions built around the voice of the customer. In short, our goal is to link our success to that of our members Roles and Responsibilities: Check the medical admissibil...

Fortis Hospital Mohali is hiring Head TPA on urgent basis, interested candidates can share resume at baljinder.singh@fortishealthcare.com immediate joiner will be given preferance

Ensure the invoice is done without any delay Also, need to ensure that the Invoice is submitted to the respective payers on time Payment follow-up religiously and ensure that the DSO is maintained as per the credit terms signed during empanelment Handling queries Working closely with the branch TPA coordinator to track the claim submission. Also should be strong in data analysis only then he can have control of the aging of the payers Ensure timely reports to the Corporate office Need to work on Target and achieve the same month on month. Reporting loss of revenue leakage Interested Candidate can send their CVs on 9712687709 or email on mariya.a@dragarwal.com

Role & responsibilities Processing of pre-authorization/cashless claim. Maintain processing TAT for pre-auth/cashless claim Must be able to analyze large amount of data, Identify patterns and draw conclusions from that data Must have previous experience of conducting audit, sampling and preparing reports Reviewing insurance policy documents to determine coverage limits, exclusions that may affect the claim. Reviewing medical bills, medical records, and other documentation to determine medical necessity and appropriate treatment. Preferred candidate profile Any Medical degree (Mandatory) Good communication skills Ability to multi-task Good interpersonal skills Should know internal systems Goo...

Coordination with TPAs File Management Query Handling Claims processing and settlement

Educational Requirements 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 a...

About Us: Medi Assist is India's leading Health Tech and Insure Tech company focused on administering health benefits across employers, retail members, and public health schemes. We consistently strive to drive innovation and participate in such initiatives, to lower health care costs. Our Health Benefits: Administration model is designed to deliver the tools necessary for a health plan to succeed, whether its our modular claims management system, our technology that unveils data to make important decisions, or our service solutions built around the voice of the customer. In short, our goal is to link our success to that of our members Roles and Responsibilities: Check the medical admissibil...

About Us: Medi Assist is India's leading Health Tech and Insure Tech company focused on administering health benefits across employers, retail members, and public health schemes. We consistently strive to drive innovation and participate in such initiatives, to lower health care costs. Our Health Benefits: Administration model is designed to deliver the tools necessary for a health plan to succeed, whether its our modular claims management system, our technology that unveils data to make important decisions, or our service solutions built around the voice of the customer. In short, our goal is to link our success to that of our members Roles and Responsibilities: Check the medical admissibil...

About Us: Medi Assist is India's leading Health Tech and Insure Tech company focused on administering health benefits across employers, retail members, and public health schemes. We consistently strive to drive innovation and participate in such initiatives, to lower health care costs. Our Health Benefits: Administration model is designed to deliver the tools necessary for a health plan to succeed, whether its our modular claims management system, our technology that unveils data to make important decisions, or our service solutions built around the voice of the customer. In short, our goal is to link our success to that of our members Roles and Responsibilities: Check the medical admissibil...

KR Business Solutions (KR) is a prominent management consulting service provider that offers "requirement-based" services to hospitals and healthcare organizations throughout India. Our dedicated team at KR is committed to providing complete healthcare solutions as a third-party administrator (TPA) with a specialized TPA department in a hospital. We excel in empanelment consulting, quality accreditations (NABH/NABL/ISO), cashless/reimbursement claim settlement, and hospital planning and development. With 16 years of experience, we are steadfast in our mission to deliver comprehensive TPA (medical) solutions. We are currently seeking a tele caller to join our team. As a tele caller at KR Busi...

About Us: Medi Assist is India's leading Health Tech and Insure Tech company focused on administering health benefits across employers, retail members, and public health schemes. We consistently strive to drive innovation and participate in such initiatives, to lower health care costs. Our Health Benefits: Administration model is designed to deliver the tools necessary for a health plan to succeed, whether its our modular claims management system, our technology that unveils data to make important decisions, or our service solutions built around the voice of the customer. In short, our goal is to link our success to that of our members Roles and Responsibilities: Check the medical admissibil...

About Us: Medi Assist is India's leading Health Tech and Insure Tech company focused on administering health benefits across employers, retail members, and public health schemes. We consistently strive to drive innovation and participate in such initiatives, to lower health care costs. Our Health Benefits: Administration model is designed to deliver the tools necessary for a health plan to succeed, whether its our modular claims management system, our technology that unveils data to make important decisions, or our service solutions built around the voice of the customer. In short, our goal is to link our success to that of our members Roles and Responsibilities: Check the medical admissibil...

About Us: Medi Assist is India's leading Health Tech and Insure Tech company focused on administering health benefits across employers, retail members, and public health schemes. We consistently strive to drive innovation and participate in such initiatives, to lower health care costs. Our Health Benefits: Administration model is designed to deliver the tools necessary for a health plan to succeed, whether its our modular claims management system, our technology that unveils data to make important decisions, or our service solutions built around the voice of the customer. In short, our goal is to link our success to that of our members Roles and Responsibilities: Check the medical admissibil...

Position Details Participating in Investigation of new Special Projects for the products and collecting Techno-commercial details for business case evaluation for Accessories & Genuine parts. 2. Identifying the potential Suppliers for the products shortlisted out of investigation projects. 3. Collecting the details from Accessories Business Unit for preparation of Request For Quotations & Floating RFQ to Potential Suppliers 4. Instrumental in getting suppliers in Quality & Sustainability ratings of Potential Suppliers 5. Evaluation of techno-commercial and negotiation with potential suppliers 6. Providing the Techno-commercial offers (Estimations in case of new special projects feasibility) ...

Check the medical admissibility of a claim by confirming the diagnosis and treatment details. Scrutinize the claims, as per the terms and conditions of the insurance policy Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiation of open billing and package, etc. Understand the process difference between a PA and an RI claim and verify the necessary details accordingly. Verify the required documents for processing claims and raise an IR in case of an insufficiency. Coordinate with the LCM team in case of higher billing and with the provider team in case of non-availability of tariff. Approve or deny the claims as per the ...

We’re looking for a dynamic Claims Manager to handle end-to-end claims across health, motor, property, and more.ou’ll be the bridge between clients, insurers, TPAs, and internal teams ensuring smooth, timely settlements and top-notch service.

Check the medical admissibility of a claim by confirming the diagnosis and treatment details. Scrutinize the claims, as per the terms and conditions of the insurance policy Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiation of open billing and package, etc. Understand the process difference between a PA and an RI claim and verify the necessary details accordingly. Verify the required documents for processing claims and raise an IR in case of an insufficiency. Coordinate with the LCM team in case of higher billing and with the provider team in case of non-availability of tariff. Approve or deny the claims as per the ...

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...

At Allstate, great things happen when our people work together to protect families and their belongings from life's uncertainties. For over 90 years, our innovative drive has kept us a step ahead of our customers" evolving needs. We have advocated for various safety measures like seat belts, airbags, and graduated driving laws. We are industry leaders in pricing sophistication, telematics, and more recently, device and identity protection. In the role of Analyst III, you will provide a superior level of customer service and attention to customers requiring vehicle repairs. Your responsibilities will include inspecting vehicle damage, writing damage repair estimates, negotiating settlements w...

PRINCIPAL ACCOUNTABILITIES: Responsible for Sales accounting and claims processing Preparation of Monthly Reporting of business activities including P&L and working capital. Responsible for driving evaluation of trade marketing & distribution spends and driving efficiency. Monthly review of profitability, cost analysis and variance analysis for all SKUs/Brands of business Business Partnering with Regional Sales Managers and Sales Heads for all finance related matters, identifying risks and variance compared to budget and initiate timely action to mitigate risk and bridge the gap. Accountable for Quarterly forecasting and yearly budgeting for and long-term planning based on Business insights,...

About Us: Medi Assist is India's leading Health Tech and Insure Tech company focused on administering health benefits across employers, retail members, and public health schemes. We consistently strive to drive innovation and participate in such initiatives, to lower health care costs. Our Health Benefits: Administration model is designed to deliver the tools necessary for a health plan to succeed, whether its our modular claims management system, our technology that unveils data to make important decisions, or our service solutions built around the voice of the customer. In short, our goal is to link our success to that of our members Roles and Responsibilities: Check the medical admissibil...

About Us: Medi Assist is India's leading Health Tech and Insure Tech company focused on administering health benefits across employers, retail members, and public health schemes. We consistently strive to drive innovation and participate in such initiatives, to lower health care costs. Our Health Benefits: Administration model is designed to deliver the tools necessary for a health plan to succeed, whether its our modular claims management system, our technology that unveils data to make important decisions, or our service solutions built around the voice of the customer. In short, our goal is to link our success to that of our members Roles and Responsibilities: Check the medical admissibil...