595 Claims Adjudication Jobs - Page 23

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 Descriptions: Check the medical admissibility of claims by confirming the diagnosis and treatment details. Verify the required documents for processing claims and raise an information. Request a case of an insufficiency. Approve or Deny claims as per T&C witihin TAT. Required Qualification : B.Sc. Nursing, Msc Nursing, Interested candidates can share there profiles to sarika.pallap@mediassist.in or WhatsApp to 8951865563.

Job description R1 RCM India is proud to be recognized amongst India's Top 50 Best Companies to Work Fo2023 by Great Place To Work Institute. We are committed to transform the healthcare industry with our innovative revenue cycle management services. Our goal is to make healthcare simpler and enable efficiency for healthcare systems, hospitals, and physician practices. With over 30,000 employees globally, we are about 14,000 strong in India with offices in Delhi NCR, Hyderabad, Bangalore, and Chennai. Our inclusive culture ensures that every employee feels valued, respected, and appreciated with a robust set of employee benefits and engagement activities. Responsibilities: Follow up with the payer to check on claim status. Responsible for calling insurance companies in USA on behalf of doctors/physicians and follow up on outstanding accounts receivables. Identify denial reason and work on resolution. Save claim from getting written off by timely following up. Candidates must be comfortable with calling on denied claims. Interview Details: Interview Mode: Face-to-Face Interview Walk-in Days : Monday to Friday Walk in Timings : 1PM to 4 PM Walk in Address: Candor Tech Space Tower No. 3, 6th Floor, Plot 20 & 21, Sector 135, Noida, Uttar Pradesh 201304 Contact Information: Alina Zaman-9289544594/Keshav Kaushal-9205669978/ Nasar Arshi 9266377969/Arpita Mishra-8840294345, Anushka- 8317044614/ Vishal-9560031640 Desired Candidate Profile Candidate must possess good communication skills. Only Immediate Joiners can apply. Only Candidate with relevant experience in AR/Denial Management can apply Provident Fund (PF) Deduction is mandatory from the organization worked. B.Tech/B.E/LLB/B.SC Biotech aren't eligible for the Interview. Undergraduate with Min. 12 Months Exp is mandatory. Benefits and Amenities: 5 days working. Both Side Transport Facility and Meal. Apart from development, and engagement programs, R1 offers transportation facility to all its employees. There is specific focus on female security who work round-the-clock, be it in office premises or transport/ cab services. There is 24x7 medical support available at all office locations and R1 provides Mediclaim insurance for you and your dependents. All R1 employees are covered under term-life insurance and personal accidental insurance.

Job Description: Thryve is hiring! We have an exciting opening in US Healthcare, See the criteria below for our Fax Intake Coordinator position. Company's Profile: Thryve Digital Health LLP is an emerging global healthcare partner that delivers strategic innovation, expertise, and flexibility to its healthcare partners. Being a US healthcare conglomerate captive, we have direct access to deeper insights that help us accelerate our learning process and keeps us ahead of the curve. Thryve delivers next-generation solutions that enable our healthcare partners to provide positive experiences to their consumers. Our global collaborative of healthcare, operations, and IT experts creates innovative and sustainable processes for our clients, which keeps the ever-evolving consumers engaged and assists them in managing the future of their healthcare better. We recognize that our people are our strength and the diverse talents they bring to our global workforce are directly linked to our success. Thryve is an equal opportunity employer and places a high value on integrity, diversity, and inclusion in the organization. We do not discriminate based on any protected attribute. For more information about the organization, please visit www.thryvedigital.com Role Description: Role: Process Analyst or Senior Process Analyst Position: Non-Technical Skill: Fax Intake Coordinator Experience: 1-2.5 Years (Any US Healthcare background) Shift: Rotational Night Shifts(6:30 PM to 3:30 AM or 10:00 PM to 7:00 AM) Work Location: Hyderabad Work Mode: Onsite (all 5 days work from office) Education: Any Graduate ( Engineering / Tech graduates are not preferred) Venue : Unit No - 601, Building Number 12D, 6th Floor, M/s Sundew Properties Ltd, IT/ITES SEZ, Mindspace Hi-Tech City, Madhapur, Hyderabad - 500081 Walk-In Date:24th May 2025, Saturday. Walk-In Time : 09:30 AM -12:30 PM Intake Coordinator is responsible for reviewing the fax that we receive and understand the medical terminology on each page of the fax. Should be able to identify the type of fax and provide authorization within TAT. Essential Responsibilities: Build cases based on the documentation on the fax after thorough review and complete the case build with in the TAT based on SLA. Ensure login timings are adhered to as the process is time-bound, and the TAT is 4-6 hours. Ensure cases are built based on updated and current tip sheets following all essential rules. To ensure quality and productivity is met based on our SLAs. Flexible enough to meet overtime requirements and take responsibility for delivering all cases assigned. Other job responsibilities as assigned from time to time. Other additional duties as assigned or requested. Requirements: 1-2.5 years experience in US Healthcare with clinical orientation/experience claims, benefits, pre-authorization, Medical Coding, Enrollment with educational qualifications as mentioned. Good communication skills including listening, reading, and speaking with ability to communicate effectively. Ability to work in rotational shifts with rotational week offs and different US shifts/night shifts continuously. Ability to thrive in an environment of change and fluctuating priorities. Preferred: Knowledge on US Healthcare industry Ability to use independent judgement and critical thinking. Any Clinical certification

Job Description: Thryve is hiring! We have an exciting opening for Fresher in US Healthcare, See the criteria below for our Fax Intake Coordinator (Apprentice) position. Company's Profile: Thryve Digital Health LLP is an emerging global healthcare partner that delivers strategic innovation, expertise, and flexibility to its healthcare partners. Being a US healthcare conglomerate captive, we have direct access to deeper insights that help us accelerate our learning process and keeps us ahead of the curve. Thryve delivers next-generation solutions that enable our healthcare partners to provide positive experiences to their consumers. Our global collaborative of healthcare, operations, and IT experts creates innovative and sustainable processes for our clients, which keeps the ever-evolving consumers engaged and assists them in managing the future of their healthcare better. We recognize that our people are our strength and the diverse talents they bring to our global workforce are directly linked to our success. Thryve is an equal opportunity employer and places a high value on integrity, diversity, and inclusion in the organization. We do not discriminate based on any protected attribute. For more information about the organization, please visit www.thryvedigital.com Role Description: Role: Fresher (Apprentice) for initial 6 months Position: Non-Technical Skill: Fax Intake Coordinator Shift: Rotational Night Shifts(6:30 PM to 3:30 AM or 10:00 PM to 7:00 AM) Apprentice Stipend: 21,000 (for six months) + Medical Insurance 5,00,000 Post Apprentice: 3,25,000 /PA +Medical Insurance 5,00,000 + Conversion bonus 24,000/- Work Location: Hyderabad Work Mode: Onsite (all 5 days work from office) Education: Any Graduate (Engineering/Tech graduates are not preferred) Venue : Unit No - 601, Building Number 12D, 6th Floor, M/s Sundew Properties Ltd, IT/ITES SEZ, Mind space Hi-Tech City, Madhapur, Hyderabad - 500081. Walk-In Date:24th May 2025, Saturday. Walk-In Time : 09:30 AM -12:30 PM Intake Coordinator is responsible for reviewing the fax that we receive and understand the medical terminology on each page of the fax. Should be able to identify the type of fax and provide authorization within TAT. Essential Responsibilities: Build cases based on the documentation on the fax after thorough review and complete the case build with in the TAT based on SLA. Ensure login timings are adhered to as the process is time-bound, and the TAT is 4-6 hours. Ensure cases are built based on updated and current tip sheets following all essential rules. To ensure quality and productivity is met based on our SLAs. Flexible enough to meet overtime requirements and take responsibility for delivering all cases assigned. Other job responsibilities as assigned from time to time. Other additional duties as assigned or requested. Requirements: Knowledge in US Healthcare with clinical orientation/experience claims, benefits, pre- authorization, Medical Coding, Enrollment with educational qualifications as mentioned. Good communication skills including listening, reading, and speaking with ability to communicate effectively. Ability to work in rotational shifts with rotational week offs and different US shifts/night shifts continuously. Ability to thrive in an environment of change and fluctuating priorities. Preferred: Knowledge on US Healthcare industry Ability to use independent judgement and critical thinking. Any Clinical certification

Job Title: Business Support Associate Location: Bangalore, India Job Summary: We are seeking a detail-oriented and tech-savvy Business Support Associate with excellent communication skills and proficiency in Excel for US healthcare process. Roles & Responsibilities: Insurance Eligibility & Verification: Through website portals and representatives. Claim Submission: Accurately submit dental and medical insurance claims. Claims Follow-up: Regularly follow up on pending claims for timely resolution. Payments Posting: Record payments from insurance companies and patients. Reporting: Summarize daily tasks, claims, and payments. Virtual Assisting: Assisting Admin related projects Skills: Good Communication Skills: Strong verbal and written communication. Proficient with Excel: Data entry, analysis, and report generation. Tech-Savvy: Comfortable with various software and technology tools. Qualifications: Experience in a US healthcare setting is preferred. Familiarity with US insurance procedures. Strong attention to detail and organizational skills. Bachelor's Degree in any Field. Shift Timings: Night Shift/ 6:30pm - 3:30am

We are Hiring hybrid wfh Back office Process Backoffice Marine/Motor Claims Insurance (Min 3yr To 9yrs BPO),Sal 10.00 LPA ( Pune / Mumbai Location) Process : Back office Process /UK Insurance Process Min 1yr to 4yrs exp. International BPO !!!Easy Selection and Spot Offer!!! Salary upto 4.5 Lacs + Incentives. Walk in at Infinites HR Services, Cerebrum IT Park, B3, 1st Floor, Kalyani Nagar Pune 411014. Call : Call : WhatsApp call only Dipika- 9623462146 / 7391077623 / 7391077624 Fenkin Empire off no 404, 4th Floor, Thane West, 400601. Land Mark: Bhanushali Hospital, Station Road. Walkin Distance from Thane Railway Station. Meet Ali : 8888850831 / 8888850831 Regards Dipika 9623462146

Candidate should be working as a Team leader / Quality analyst / SME / Trainer on papers in US Healthcare for Claims adjudication process. Qualification - Graduate Shift - US rotational shifts Work Location - Chennai Required Candidate profile Immediate Joiners OR Max 1 month notice period candidates can apply Call HR Swapna @ 7411718707 for more details.

SUMMARY Job Title: Healthcare Claims Associate German Language Location: Powai, Mumbai Experience Level: 1 6 years Employment Type: Full-time Shift: UK shift Job Summary: We are looking for a detail-oriented and multilingual professional to join our healthcare operations team as a Healthcare Claims Associate with fluency in German . The ideal candidate will be responsible for processing, reviewing, and validating healthcare claims in accordance with company policies and healthcare regulations. Fluency in German is essential as the role involves interpreting and processing claims originating from German-speaking regions. Key Responsibilities: Review, verify, and process healthcare claims using internal systems. Analyze submitted medical documents and ensure compliance with insurance policies. Translate and interpret medical and insurance documents from German to English and vice versa. Communicate with German-speaking clients, hospitals, or insurance providers as required. Identify and flag any inconsistencies or fraudulent claims. Collaborate with internal teams to resolve claim issues and escalate when needed. Maintain accurate records and documentation of all claim activities. Ensure adherence to SLAs and quality metrics. Qualifications & Skills: Bachelor's degree in Healthcare, Business Administration, or a related field. Fluency in German (B2/C1 level or higher) verbal and written. 1 6 years of experience in healthcare claims processing or insurance domain preferred. Strong understanding of medical terminology and healthcare billing systems. Familiarity with ICD, CPT codes, and healthcare regulations is a plus. Excellent communication, analytical, and problem-solving skills. Ability to work in a fast-paced and deadline-driven environment. Experience with tools like Facets, QNXT, or other claims adjudication systems is a plus. Preferred: Certification in German language (Goethe, TestDaF, or equivalent). Experience working with European or German healthcare clients.

Job Summary We are seeking an experienced Architect with 12 to 15 years of experience to join our team. The ideal candidate will have strong technical skills in React JS and Java along with domain expertise in Medicare and Medicaid Claims Claims and Payer. This hybrid role requires a proactive individual who can drive technical solutions and contribute to the companys mission of improving healthcare systems. Responsibilities Lead the design and development of scalable and efficient software solutions using React JS and Java Oversee the implementation of technical solutions that align with business requirements and industry standards Provide technical guidance and mentorship to the development team to ensure best practices are followed Collaborate with cross-functional teams to gather and analyze requirements ensuring comprehensive understanding of project goals Develop and maintain technical documentation to support the development and deployment of software solutions Ensure the security performance and reliability of applications through rigorous testing and quality assurance processes Drive continuous improvement initiatives to enhance the development process and overall product quality Monitor and evaluate emerging technologies and industry trends to incorporate innovative solutions into the architecture Facilitate effective communication between stakeholders including business analysts project managers and developers Conduct code reviews to ensure adherence to coding standards and best practices Troubleshoot and resolve complex technical issues providing timely and effective solutions Contribute to the strategic planning and execution of technology roadmaps to support business objectives Ensure compliance with regulatory requirements and industry standards in all technical solutions Qualifications Possess a strong background in React JS and Java with proven experience in developing complex applications Demonstrate expertise in Medicare and Medicaid Claims Claims and Payer domains Exhibit excellent problem-solving skills and the ability to troubleshoot and resolve technical issues effectively Showcase strong communication and collaboration skills to work effectively with cross-functional teams Have a proactive approach to learning and staying updated with the latest industry trends and technologies Display a commitment to quality and a keen eye for detail in all aspects of software development Hold a bachelors degree in Computer Science Information Technology or a related field Preferably have a masters degree or relevant certifications in software architecture or related disciplines Show experience in leading and mentoring development teams to achieve project goals Demonstrate the ability to create and maintain comprehensive technical documentation Exhibit strong organizational skills and the ability to manage multiple tasks and projects simultaneously Have a solid understanding of regulatory requirements and industry standards in the healthcare domain Display a passion for improving healthcare systems and contributing to the companys mission.

Preferred candidate profile Candidate should be from Property and Casualty Claims Process Immediate Joiners Only Good English Communications

Basic Section No. Of Openings 2 Grade 1B Designation SENIOR CODER Closing Date 21 May 2025 Organisational Country IN State TAMIL NADU City CHENNAI Location Chennai-I Skills Skill Medical Coding Healthcare HIPAA CPT ICD-9 EMR Medical Billing Healthcare Management Revenue Cycle ICD-10 Education Qualification No data available CERTIFICATION No data available About The Role Role Description Overview: Coder is accountable to manage day to day activities of coding the Patients chart & Diagnosis report. Responsibility Areas: Coding or auditing charts, based on requirements Updating/Clearing the production/pending reports To work closely with the team leader. To review emails for any updates Identify issues and escalate the same to the immediate supervisor Strict adherence to the company policies and procedures. Sound knowledge in Medical Coding concept. Should have 6 months to 3 Yrs of Coding Experience. Understand the client requirements and specifications of the project. Meet the productivity targets of clients within the stipulated time (Daily & Monthly) Applying the instructions/updates received from the client during production. Coding or auditing charts, based on requirements. Prepare and Maintain reports

Job description R1 RCM India is proud to be recognized amongst India's Top 50 Best Companies to Work Fo2023 by Great Place To Work Institute. We are committed to transform the healthcare industry with our innovative revenue cycle management services. Our goal is to make healthcare simpler and enable efficiency for healthcare systems, hospitals, and physician practices. With over 30,000 employees globally, we are about 14,000 strong in India with offices in Delhi NCR, Hyderabad, Bangalore, and Chennai. Our inclusive culture ensures that every employee feels valued, respected, and appreciated with a robust set of employee benefits and engagement activities. Responsibilities: Follow up with the payer to check on claim status. Responsible for calling insurance companies in USA on behalf of doctors/physicians and follow up on outstanding accounts receivables. Identify denial reason and work on resolution. Save claim from getting written off by timely following up. Candidates must be comfortable with calling on denied claims. Interview Details: Interview Mode: Face-to-Face Interview Walk-in Day : Friday (16-May-25) Walk in Timings : 1PM to 4 PM Walk in Address: Candor Tech Space Tower No. 3, 6th Floor, Plot 20 & 21, Sector 135, Noida, Uttar Pradesh 201304 Contact Information: Alina Zaman-9289544594/Keshav Kaushal-9205669978/ Nasar Arshi 9266377969/Arpita Mishra-8840294345 Desired Candidate Profile Candidate must possess good communication skills. Only Immediate Joiners can apply. Only Candidate with relevant experience in AR/Denial Management can apply Provident Fund (PF) Deduction is mandatory from the organization worked. B.Tech/B.E/LLB/B.SC Biotech aren't eligible for the Interview. Undergraduate with Min. 12 Months Exp is mandatory. Benefits and Amenities: 5 days working. Both Side Transport Facility and Meal. Apart from development, and engagement programs, R1 offers transportation facility to all its employees. There is specific focus on female security who work round-the-clock, be it in office premises or transport/ cab services. There is 24x7 medical support available at all office locations and R1 provides Mediclaim insurance for you and your dependents. All R1 employees are covered under term-life insurance and personal accidental insurance.

We are Hiring hybrid wfh Back office Process Backoffice Marine/Motor Claims Insurance (Min 3yr To 9yrs BPO),Sal 10.00 LPA ( Pune / Mumbai Location) Process : Back office Process /UK Insurance Process Min 1yr to 4yrs exp. International BPO !!!Easy Selection and Spot Offer!!! Salary upto 4.5 Lacs + Incentives. Walk in at Infinites HR Services, Cerebrum IT Park, B3, 1st Floor, Kalyani Nagar Pune 411014. Call : Call : WhatsApp call only Dipika- 9623462146 / 7391077623 / 7391077624 Fenkin Empire off no 404, 4th Floor, Thane West, 400601. Land Mark: Bhanushali Hospital, Station Road. Walkin Distance from Thane Railway Station. Meet Ali : 8888850831 / 8888850831 Regards Dipika 9623462146

Role Objective:To bill out medical accounts with accuracy within defined timelines and reduce rejections for payers. Essential Duties and Responsibilities: Process Accounts accurately basis US medical billing within defined TAT Able to process payer rejection with accuracy within defined TAT. 24*7 Environment, Open for night shifts Good analytical skills and proficiency with MS Word, Excel, and PowerPoint Qualifications: Graduate in any discipline from a recognized educational institute. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Good communication Skills (both written & verbal) Skill Set: Candidate should have good healthcare knowledge. Candidate should have knowledge of Medicare and Medicaid. Ability to interact positively with team members, peer group and seniors.

We are committed to transform the healthcare industry with our innovative revenue cycle management services. Our goal is to make healthcare simpler and enable efficiency for healthcare systems, hospitals, and physician practices. With over 30,000 employees globally, we are about 14,000 strong in India with offices in Delhi NCR, Hyderabad, Bangalore, and Chennai. Our inclusive culture ensures that every employee feels valued, respected, and appreciated with a robust set of employee benefits and engagement activities. Role Objective:To bill out medical accounts with accuracy within defined timelines and reduce rejections for payers.Essential Duties and Responsibilities: Process Accounts accurately basis US medical billing within defined TAT Able to process payer rejection with accuracy within defined TAT. 24*7 Environment, Open for night shifts Good analytical skills and proficiency with MS Word, Excel, and PowerPoint Qualifications: Graduate in any discipline from a recognized educational institute. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Good communication Skills (both written & verbal)Skill Set: Candidate should have good healthcare knowledge. Candidate should have knowledge of Medicare and Medicaid. Ability to interact positively with team members, peer group and seniors.

Role & responsibilities Oversee and manage the end-to-end claims process, ensuring timely processing and adherence to internal policies Analyze claims data to identify trends, assess process gaps, and evaluate financial impact Prepare and present reports including claim status, pending settlements, and loss projections to senior management Collaborate with internal teams and external partners to resolve operational challenges and enhance efficiency Act as the primary point of contact for claim-related insights, fostering clear communication among stakeholders Identify and implement best practices to improve claim management accuracy and efficiency

Job TitleINSURANCE EXECUTIVE Job Code HREQ2017/12/66 --> Job Location Kolkata Experience 1YR -5YRS Gender Male/ Female Job Details URGENTLY LOOKING FOR A CANDIDATE WHO HAVE KNOWLEDGE ABOUT Quotation and issuence of general insurance, claim processing. ELIGIBILITY CRITERIA- ANY GRADUATE. Salary Per Year 1-2.5 LPA Apply Now

Role: Closed file review & audit 1-Handling closed / open file review for third party administrator & inhouse claims 2-Recoveries from third party administrator for claims processed with errors 3-Highlight areas of improvement 4-Monthly reports to be published Candidate must have: 1-In-depth knowledge of medical cases with exposure to ailment treatments, policy coverages for OPD/hospitalization/personal accident/ travel claims 2-Good interpersonal skills 3-Must be proactive & effective learner 4- Must have previous experience of Audit 5- Good Analytical, Communication and Negotiation skills 6- Familiar with Basic Microsoft Excel and regulatory changes 7- Minimum 7 years of experience in general insurance Accident & Health claims Qualifications Degree in medicine (BHMS/BAMS/MBBS) At Liberty General Insurance , we create an inspired, collaborative environment, where people can take ownership of their work; push breakthrough ideas; and feel confident that their contributions will be valued, and their growth championed. We have an employee strength of 1200+ spread over a network of 116+ offices in 95+ cities, across 29 states. Our partner network consists of about 5000+ hospitals and more than 4000+ auto service centers. We believe and live by our values every day - Act Responsibly, Be Open, Keep it Simple, Make things better and Put People First. For learning about our key USPs, you can go visit our website. Working with Liberty also provides you an opportunity to experience One Liberty Experience . We create the One Liberty experience through Providing Global exposure to employees by including them in cross country projects that gives them opportunities to work with diverse teams within & outside India. Fosters Diversity, Equity & Inclusion (DEI) to create equitable career opportunities Flexi Working arrangements. If you aspire to grow & build your capabilities to work in a global environment, Liberty is the place for you!

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Analyst Qualifications: Any Graduation Years of Experience: 3 to 5 years Language - Ability: English(International) - Intermediate 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.Claim processing team collects end-end data dataDevelop and deliver business solutions that support the claims process across its lifecycle, including first notice of loss, claims investigation, payment administration or adjudication, provider reimbursement (health care), subrogation and recovery. What are we looking for? Property and Casualty Insurance Ability to establish strong client relationship Ability to meet deadlines Ability to perform under pressure Ability to work well in a team Prioritization of workload Claims Processing 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

Skill required: Delivery - Financial Management Designation: I&F Decision Sci Practitioner Sr Analyst Qualifications: Bachelor's in actuarial science/Master's in actuarial science Years of Experience: 5 to 8 years What would you do? Data & AIDesign and implement the org structure, responsibilities, procedures and supporting technology to ensure finance and accounting operations run effectively and efficiently. Ability to perform day-to-day management of financial accounts, provide financial assistance for decision making in timely manner, apply accounting principles, prepare accurate and timely financial management reports and statements and ensure accurate recording and analysis of revenues and expenses. What are we looking for? Insurance Claims Financial Reporting Ability to work well in a team Adaptable and flexible Agility for quick learning Commitment to quality Ability to manage multiple stakeholders Roles and Responsibilities: In this role you are required to do analysis and solving of increasingly complex problems Your day-to-day interactions are with peers within Accenture You are likely to have some interaction with clients and/or Accenture management You will be given minimal instruction on daily work/tasks and a moderate level of instruction on new assignments Decisions that are made by you impact your own work and may impact the work of others In this role you would be an individual contributor and/or oversee a small work effort and/or team Qualification Bachelor’s in actuarial science,Master’s in actuarial science

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Senior Analyst Qualifications: Any Graduation Years of Experience: 5 to 8 years Language - Ability: English(International) - Intermediate 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.Claim processing team collects end-end data dataDevelop and deliver business solutions that support the claims process across its lifecycle, including first notice of loss, claims investigation, payment administration or adjudication, provider reimbursement (health care), subrogation and recovery. What are we looking for? Property and Casualty Insurance Ability to establish strong client relationship Ability to manage multiple stakeholders Ability to perform under pressure Process-orientation Written and verbal communication Payment Processing Operations Roles and Responsibilities: In this role you are required to do analysis and solving of increasingly complex problems Your day to day interactions are with peers within Accenture You are likely to have some interaction with clients and/or Accenture management You will be given minimal instruction on daily work/tasks and a moderate level of instruction on new assignments Decisions that are made by you impact your own work and may impact the work of others In this role you would be an individual contributor and/or oversee a small work effort and/or team Please note that this role may require you to work in rotational shifts Qualification Any Graduation

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years Language - Ability: English(International) - Intermediate 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.Claim processing team collects end-end data dataDevelop and deliver business solutions that support the claims process across its lifecycle, including first notice of loss, claims investigation, payment administration or adjudication, provider reimbursement (health care), subrogation and recovery. What are we looking for? Property and Casualty Insurance Ability to establish strong client relationship Ability to meet deadlines Ability to perform under pressure Ability to work well in a team Prioritization of workload Claims Processing Roles and Responsibilities: In this role you are required to solve routine problems, largely through precedent and referral to general guidelines Your primary interaction is within your own team and your direct supervisor In this role you will be given detailed instructions on all tasks The decisions that you make impact your own work and are closely supervised You will be an individual contributor as a part of a team with a predetermined, narrow scope of work Please note that this role may require you to work in rotational shifts Qualification Any Graduation

About Navi Navi is one of the fastest-growing financial services companies in India providing Personal & Home Loans, UPI, Insurance, Mutual Funds, and Gold. Navi's mission is to deliver digital-first financial products that are simple, accessible, and affordable. Drawing on our in-house AI/ML capabilities, technology, and product expertise, Navi is dedicated to building delightful customer experiences. Founders: Sachin Bansal & Ankit Agarwal Know what makes you a Navi_ite : 1. Perseverance, Passion and Commitment Passionate about Navis mission and vision Demonstrates dedication, perseverance, and high ownership Goes above and beyond by taking on additional responsibilities 2. Obsession with high-quality results Consistently creates value for the customers and stakeholders through high-quality outcomes Ensuring excellence in all aspects of work Efficiently manages time, prioritizes tasks, and achieves higher standards 3. Resilience and Adaptability Adapts quickly to new roles, responsibilities, and changing circumstances, showing resilience and agility Key Responsibilities: Review submitted health claims for accuracy, completeness, and compliance with insurance policies and applicable regulations Reviewing and evaluating medical claims to determine their eligibility for payment Investigating medical claims to identify fraud Making decisions about medical claims, such as whether to approve or deny a claim Negotiate with the treating doctor/ hospital in reducing the un-justified hospitalization cost Automate system and bring in improvements on claims processes Monitoring systems and processes to ensure sustained levels of performance Liaison with internal stakeholder to ensure the deadline of TAT’s and SLA’s & Work towards Designated Tasks Tracking of customer communication for effective grievance resolution within TAT & SLA’s Compliance- Through knowledge of products, regulations, guidelines is must to ensure process compliance all the time. Claim Analytics- Periodical claim analysis to identify frauds, monitor claim performance metrics. Informing the customer about the rejection of their claim through call Involves identifying discrepancies, fraud, or errors in claims to ensure compliance with health insurance policies and regulatory requirements What are some of the good to have skills for this role? Medical Graduate in any stream (MBBS/BHMS/BAMS/BUMS/BDS) Experience in handling audit Background in claims processing with clinical experience in a hospital setting Data analytics experience would be an added advantage Ability to handle independent assignments & having the acumen to take logical conclusions Should have a broad understanding of Claims Practice Sharp business acumen to understand health insurance claim servicing needs Excellent communication skills, including writing reports and presentations Ability to anticipate potential problems and take appropriate corrective action Knowledge of health regulations, IRDA circulars is a must. Knowledge of different languages would be an added advantage. Proficiency in Hindi and English is mandatory.

We are Hiring hybrid wfh Back office Process Backoffice Marine/Motor Claims Insurance (Min 3yr To 9yrs BPO),Sal 8.50 LPA Process : Back office Process /UK Insurance Process Min 1yr to 4yrs exp. International BPO !!!Easy Selection and Spot Offer!!! Salary upto 4.5 Lacs + Incentives. Walk in at Infinites HR Services, Cerebrum IT Park, B3, 1st Floor, Kalyani Nagar Pune 411014. Call : Call : WhatsApp call only Dipika- 88888850831 / 7391077623 / 7391077624 Regards Dipika 9623462146