595 Claims Adjudication Jobs - Page 5

Eurofins Assurance India Pvt Ltd is a leading certification body providing Audit & Certification , Inspections , and other services covering the broad spectrum of sustainable supply chain. Eurofins will help the customers to mitigate risks in their supply chain and to ensure the benchmarking performance with operations, processes, systems, people or capabilities. Whether you are in Food, Cosmetics, Consumer products or Health care sector, our global auditor and technical expert network will help to mitigate/eliminate your risks against supply chain and distribution flows: Regulatory and Industrial standards . We have accreditations for a number of different industry standards/memberships to ensure we service the entire supply chain. Responsible for local sales for assurance business for products like (SMETA, BSCI, HIGG "“ FEM, SLCP, WRAP, GOTS, etc.) "¢ Responsible for achieving targeted revenue for North region as defined by Eurofins Management. "¢ Prepare and present sales quotations and proposals to current and prospective clients. "¢ Maintain accurate customer and sales information in CRM. "¢ Provide Monthly Sales reports to Management. "¢ Responsible for supporting marketing activities in region. "¢ Assist in payment collection for region. "¢ Assist in Scheduling the audit. "¢ Commitment to providing a consistently high standard of customer service. "¢ Demonstrable record of success in sales, product or service marketing and sales management Additional Information Good written and verbal communication skills Operational Excellence and demonstrated ability to deliver results in multiple challenging situations. Team-focused with the ability to achieve or exceed objectives while working collaboratively with other team members to achieve mutual success. Good at Presentations High leadership and supervisory skills Result oriented Problem solving Good at Retention

Key Responsibilities : Lead Generation & Sales: Proactively identify and engage potential members through various channels, including walk-ins, inbound inquiries, and outbound outreach Membership Sales & Conversions: Present and sell membership options, upsell additional services such as personal training, and close sales to meet or exceed monthly targets Customer Engagement & Retention: Provide personalized tours, address member inquiries, and ensure a welcoming environment to enhance member satisfaction and retention CRM Management: Utilize CRM tools to track leads, manage follow-ups, and update member records to maintain accurate and up-to-date information Community Outreach: Build relationships with local businesses, organizations, and influencers to drive group memberships and increase brand visibility Event Management: Organize and participate in events to engage the community and generate interest in membership offerings

Aster Medcity is looking for Deputy Manager Revenue Cycle Managementto join our dynamic team and embark on a rewarding career journey Developing and implementing revenue cycle management policies and procedures that ensure accurate billing, timely collections, and compliance with regulatory requirements Monitoring and analyzing revenue cycle data to identify areas for improvement and implement process improvements Collaborating with other departments to ensure that revenue cycle activities are aligned with organizational goals and objectives Managing the accounts receivable to ensure timely and accurate billing and collections Ensuring compliance with regulatory requirements related to revenue cycle management Managing relationships with payers and negotiating contracts and reimbursement rates Developing and maintaining relationships with key stakeholders, including patients, providers, and payers Managing budgets and financial performance for revenue cycle management and preparing reports and presentations to senior management on revenue cycle performance Excellent leadership and communication skills, with the ability to motivate and manage teams effectively Strong analytical and problem-solving skills

Prepare ILAs, Final Survey Reports, and requirement letters. Maintain records of claim intimation, surveyor visits, document status, and report. Follow up with insured and internal teams to minimize TAT Update data in CMS software Health insurance Provident fund

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Associate Manager Qualifications: Any Graduation Years of Experience: 10 to 14 years About Accenture 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. Visit us at www.accenture.com What would you do "As a Travel Claims Team Manager, you will be responsible for managing a team of Travel Claims adjusters, this might also involve investigating, evaluating, and processing travel insurance claims. Your role will involve assessing the validity of claims, ensuring timely and accurate resolution, and providing outstanding customer service throughout the process.Review and process travel insurance claims, including medical, trip cancellation, and baggage loss claims. Investigate claims by gathering and analyzing relevant information and documentation. Communicate with policyholders, healthcare providers, and other stakeholders to obtain necessary information. Evaluate claims to determine coverage, validity, and appropriate compensation. Resolve disputes and provide clear explanations of claim decisions to policyholders. Maintain accurate and detailed records of claim activities and decisions. Stay updated on industry trends, regulations, and best practices.Review and process travel insurance claims, including medical, trip cancellation, and baggage loss claims. Investigate claims by gathering and analyzing relevant information and documentation. Communicate with policyholders, healthcare providers, and other stakeholders to obtain necessary information. Evaluate claims to determine coverage, validity, and appropriate compensation. Resolve disputes and provide clear explanations of claim decisions to policyholders. Maintain accurate and detailed records of claim activities and decisions. Stay updated on industry trends, regulations, and best practices." What are we looking for " - Bachelors degree in Business, Insurance, or related field preferred. Proven minimum 7 years of experience in claims adjusting or a similar role, ideally within the travel insurance sector. Strong analytical skills and attention to detail. Excellent communication and interpersonal skills. Ability to handle multiple claims simultaneously in a fast-paced environment. Proficiency in claims management software and Microsoft Office Suite. Bachelors degree in Business, Insurance, or related field preferred. Proven minimum 7 years of experience in claims adjusting or a similar role, ideally within the travel insurance sector. Strong analytical skills and attention to detail. Excellent communication and interpersonal skills. Ability to handle multiple claims simultaneously in a fast-paced environment. Proficiency in claims management software and Microsoft Office Suite." Roles and Responsibilities: "In this role you are required to do analysis and solving of moderately complex problems Typically creates new solutions, leveraging and, where needed, adapting existing methods and procedures The person requires understanding of the strategic direction set by senior management as it relates to team goals Primary upward interaction is with direct supervisor or team leads Generally interacts with peers and/or management levels at a client and/or within Accenture The person should require minimal guidance when determining methods and procedures on new assignments Decisions often impact the team in which they reside and occasionally impact other teams Individual would manage medium-small sized teams and/or work efforts (if in an individual contributor role) at a client or within Accenture Please note that this role may require you to work in rotational shifts" Qualification Any Graduation

Skill required: Reinsurance - Collections Processing Designation: Claims Management Senior Analyst Qualifications: Any Graduation Years of Experience: 7 to 11 years Language - Ability: English(International) - Intermediate About Accenture 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. Visit us at www.accenture.com What would you do You will be aligned with our Risk and Compliance vertical and help us perform compliance reviews, publish reports with actions and provide closure guidance as needed. We design & recommend effective controls to mitigate risks and help service delivery team prepare for upcoming client / external audits.You will be working as a part of the Risk & compliance team which is responsible for helping clients and organizations identify risks and create mitigation plans.The Operational Audit & Compliance team focuses on auditing and managing effective implementation and delivery of functional processes within operations to mitigate risks. The role may require for you to have a good understanding of anti-corruption, BCM and infosec policies, records management and contractor controls. The team is responsible for establishing processes to validate the effectiveness and drive improvements wherever required. What are we looking for 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.Canceling and rewriting insurance policies and endorsementsManage OTC collection/disputes such as debt collection, reporting on aged debt, dunning process, bad debt provisioning etc. Perform Cash Reconciliations and follow up for missing remittances, prepare refund package with accuracy and supply to clients, record all collections activities in a consistent manner as per client process (tool), delivery of process requirements to achieve key performance targets, ensure compliance to internal controls, standards, and regulations (Restricted countries) Roles and Responsibilities: In this role you are required to do analysis and solving of moderately complex problems May create new solutions, leveraging and, where needed, adapting existing methods and procedures The person would require understanding of the strategic direction set by senior management as it relates to team goals Primary upward interaction is with direct supervisor May interact with peers and/or management levels at a client and/or within Accenture Guidance would be provided when determining methods and procedures on new assignments Decisions made by you will often impact the team in which they reside Individual would manage small teams and/or work efforts (if in an individual contributor role) at a client or within Accenture Please note that this role may require you to work in rotational shifts Qualification Any Graduation

Clients business problem to resolve : At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees are key factors in our companys growth, market presence and our ability to help our clients stay a step ahead of the competition. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here.Clients Business problem to solve?Our Client is one of Leading Health Plan in US providing services in Florida state , NTT are getting into contract with Client to manage End to End Claims Administration services. Our NTT Business Process Outsourcing (BPO) team has implemented the processes and technologies for our clients bring about real transformation for customers of all sizes. Our end-to-end administrative services help streamline operations, improve productivity and strengthen cash flow to help our customers stay competitive and improve member satisfaction.Positions General Duties and Tasks:NTT are getting into contract with Client to manage End to End Health Claims Administration services. Our NTT Business Process Outsourcing (BPO) team has implemented the processes and technologies for our clients bring about real transformation for customers of all sizes. Our end-to-end administrative services help streamline operations, improve productivity and strengthen cash flow to help our customers stay competitive and improve member satisfaction. Requirements for this role include: Must have strong Health Claims End to End Domain Knowledge. Must have 8+ years experience in Claims Adjudication Minimum 2+ years as Team lead/Asst.Manager Both Under Graduates and Post Graduates can apply. Excellent communication (verbal and written) and customer service skills. Ability to work independently; strong analytic skills. Detail-oriented, ability to organize and multi-task. Ability to make decisions. Required computer skills: Must have experience with data entry and word processing, possess a working knowledge of MS Office applications, and understand how to navigate through web-based applications. Cognitive Skills include language, basic math skills, reasoning ability and verbal communication skills. Ability to work in a team environment.Problem SolvingReviews structured problems.Selects and applies appropriate standards/guidelines.Probes beyond the stated situation.Identifies underlying issues and consider possible alternatives. Job Duty Differentiators: Supervises processes and/or claims processing teams ensuring highest quality of service is provided. Includes the distribution of work, calculation and communication of productivity and quality results and review of audit appeals. Monitors production goals of team and reports results and issues to higher-level leadership. Assists team with escalated claims processing issues. **Required schedule availability for this position is Monday-Friday 6PM/4AM IST The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekends basis business requirement.

POSITION: MEDICAL OFFICER/CONSULTANT PA/RI APPROVER PURPOSE OF ROLE: To scrutinize and process the claims within the agreed TAT by having an understanding of the policy terms & conditions while applying their domain medical knowledge. Designation Function Medical Officer/Consultant Claims PA/RI Approver Reporting to Location Assistant Manager Claims Mumbai Educational Qualification Shift BHMS, , BAMS, MBBS(Indian registration Required) Rotational Shift (for female employee shift ends at 8:30 PM) 6 rotational week offs Provided per month Week offs Related courses attended None Management Level Junior Management Level Industry Type Hospital/TPA/Healthcare/Insurance Roles and 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. • • • Responsibilities Understand the process difference between 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 terms and conditions within the TAT. • Handle escalations and responding to mails accordingly. • • • • Error-free processing (100% Accuracy) Maintaining TAT Productivity (Achieve the daily targets) Key Results and Outcomes driven by this role: 0- 5 years Relevant Experience No of years of experience 0-5 years None Demonstrated abilities if any Technical Competencies • Analytical Skills • • Basic Computer knowledge Type writing skills • • Communication skills Decision Making Behavioral competencies

Role & responsibilities : Claims Processing: Managing and processing insurance claims, including verifying patient information, coding procedures accurately, and submitting claims to insurance companies. Follow-up on Unpaid Claims: Monitoring the status of submitted claims, identifying unpaid or denied claims, and following up with insurance companies to resolve issues and ensure timely payments. Appeals and Disputes : Handling claim denials and rejections by preparing and submitting appeals to insurance companies and resolving billing disputes. AR Aging Management : Managing accounts receivable aging reports and actively working to reduce outstanding balances. Preferred candidate profile: Experience: A minimum of 1-5 years of experience in medical billing and insurance claims processing. Previous experience in a senior or leadership role within a medical billing department is highly desirable. Knowledge: Strong understanding of medical billing procedures, healthcare reimbursement, and insurance claim processes. Proficiency in medical coding (ICD-10, CPT, HCPCS) and knowledge of billing software and electronic health records (EHR) systems. Familiarity with healthcare regulations, including HIPAA, and the ability to maintain compliance.

Job description Team Executive - Claims Adjudication Location : Chennai, Navalur Roles & Responsibilities: In-depth Knowledge and Experience in the US Health Care Payer System. 4 - 9 years of experience in Claims Adjudication . With over 1 year of experience as a Team leader Proven track record in managing processes, streamlining workflows and excellent people management skills. Need to be a people centric manager who could articulate the employee challenges to the management as well as motivate the team towards desired project goals. Circulate quality dashboards at agreed periodic intervals to all relevant stake holders Adhering to various regulatory and compliance practices. Maintaining and Ownership of reports both internal as well as for the clients. Presenting the data and provide deep insights about the process to the clients as well as Internal Management. Managing and co- ordinating training programs. Excellent in Coaching and providing feedback to the team. Take necessary HR actions as part of the Performance Improvement Process Key Performance Indicators Ensuring that the key Service Level Agreements are met consistently without any exceptions. Leverage all Operational metrices to ensure that the Revenue and Profitability targets are met and exceeded . Work in tandem with all Business functions to ensure smooth business process. Retention of key team members Interested Candidates share your CV - deepalakshmi.rrr@firstsource.com / 8637451071 Disclaimer: Firstsource follows a fair, transparent, and merit-based hiring process. We never ask for money at any stage. Beware of fraudulent offers and always verify through our official channels or deepalakshmi.rrr@firstsource.com

Key Responsibilities: Should manage a large team and coordinate with other functions Floor walk regularly to supervise, coordinate and monitor day-to-day operations & metrics Should lead a team of associates and motivate them to achieve the team SLA. Should consistently achieve all SLAs set by the client Manages inventories and Reports. Provides encouragement to team members, including communicating team goals and identifying areas for new training or skill checks. Answers team member questions, helps with team member problems, and oversees team member work for quality and guideline compliance Communicates deadlines and goals to team members Develops strategies to promote team member adherence to company regulations and performance goals Conducts team meetings to update members on best practices and continuing expectations. Provides quality client handling, including interacting with clients, answering queries, and effectively handling customer complaints Organize daily/ weekly /monthly team meetings to update the associates on any process changes, quality issues , production details and team SLA Preparing and sharing of various day-to-day operations reports Should handle Change Request and coordinate with various teams to bring it to a completion Required Skills: Team handling skills Willingness to work in rotational shifts/night shift/ permanent shift Knowledge of basic quality tools. Proficiency in MS Office (PowerPoint, Excel & Outlook) Good communication skills Highly focused and energetic Problem solving & result oriented skills Job Description Interested Candidates share your CV - deepalakshmi.rrr@firstsource.com / 8637451071 Disclaimer: Firstsource follows a fair, transparent, and merit-based hiring process. We never ask for money at any stage. Beware of fraudulent offers and always verify through our official channels or deepalakshmi.rrr@firstsource.com

Role & responsibilities 1) Preparing and submitting billing data and medical claims to insurance companies 2) Generate revenue by making payment arrangements, collecting accounts and monitoring and pursuing delinquent accounts 3) Collect delinquent accounts by establishing payment arrangements with patients, monitoring payments and following up with patients when payment lapses occur 4) Utilize collection agencies and small claims courts to collect accounts by evaluating and selecting collection agencies, determining the appropriateness of pursuing legal remedies and testifying in court cases, when necessary 5) Ensuring each patients medical information is accurate and up-to-date 6) Preparing bills and invoices and document amounts due to medical procedures and services 7) Good expertise in AR Aging 8) Doing charge and Payment Posting 9) All the End to End process of Medical Billing

Job Summary Join our dynamic team as a PE-Claims HC specialist where you will play a crucial role in processing and adjudicating claims with precision and efficiency. This hybrid role requires a keen understanding of Medicare and Medicaid claims ensuring compliance and accuracy. With a focus on night shifts you will contribute to our mission of delivering exceptional healthcare solutions without the need for travel. Responsibilities Process claims with a high degree of accuracy ensuring compliance with Medicare and Medicaid regulations. Analyze claims data to identify discrepancies and resolve issues promptly. Collaborate with team members to streamline claims adjudication processes. Maintain up-to-date knowledge of industry standards and regulatory changes. Utilize technical skills to enhance claims processing efficiency. Communicate effectively with stakeholders to ensure clarity and understanding of claims processes. Implement best practices to improve overall claims management. Monitor claims processing metrics to ensure timely and accurate adjudication. Provide feedback and suggestions for process improvements. Support the team in achieving departmental goals and objectives. Ensure all claims are processed within established timelines. Assist in the development of training materials for new team members. Contribute to a positive work environment by fostering collaboration and teamwork. Qualifications Possess strong analytical skills to assess and adjudicate claims accurately. Demonstrate proficiency in claims adjudication processes and tools. Exhibit a solid understanding of Medicare and Medicaid claims requirements. Show excellent communication skills to interact with various stakeholders. Have the ability to work effectively in a hybrid work model. Display a keen attention to detail to ensure compliance and accuracy. Certifications Required N / A

Job Summary We are seeking a dedicated Senior Process Executive for our B&L team with 2 to 4 years of experience. The ideal candidate will have strong technical skills in MS Excel and preferably domain experience in Frclsr Claim File&srv(MortgLn) and Default Report&Analytic-MortLn. This is a night shift role based in our office with no travel required. Responsibilities Senior Process associate is expected to meet or exceed the set agreed target both during the training period and in the period following training. The productivity targets will be revised based on the tenure and any such changes will be made known to the associate. Quality Process associate is expected to meet and exceed the minimum quality benchmark according to the guidelines specified. The quality targets will be revised based on the tenure and any such changes will be made known to the associate. Process associate is expected to be open and receptive to feedback and should view the feedback mechanism as a tool for constant self improvement and process development. Essential Functions Basic knowledge of Mortgage industry and ability to recognize various mortgage documents (example Deed Appraisal Invoices Payoff letters etc) File claims for reimbursement of expenses. Reconcile claim proceeds. File supplemental claims as needed. Ensure data accuracy. Ability to review and gauge any red flags in the document and information provided in client system. Perform other related duties as required and assigned. Qualification (Process Associate) Graduate in any discipline 2 to 4 year of Experience in BPO Transaction Data Processing background. Qualification (Sr. Process Associate) Graduate in any discipline 2 Plus year of experience in Mortgage BPO Transaction Data Processing background. Skill Sets Good analytical skills research knowledge and decision making. Knowledge of MS office (Excel) Good written and spoken communication skills. Ability to work in shifts (preferably night) Willing to work 6 days a week. Certifications Required Certification in Advanced Excel or Data Analysis is preferred.

Job Description: Medical Record Retrieval and Release of Information Specialist Position Overview: We are seeking dedicated and detail-oriented Medical Record Retrieval and Release of Information (ROI) Specialists to join our healthcare team. The position is responsible for efficiently and accurately retrieving, processing, and releasing medical records in accordance with healthcare regulations and policies. This is a hybrid role with both calling and non-calling responsibilities. Key Responsibilities: Retrieve medical records from healthcare facilities, ensuring accuracy and completeness of records. Ensure compliance with HIPAA and other regulatory standards regarding the privacy and security of medical records. Process release of information requests for authorized parties such as patients, legal entities, insurance companies, and other healthcare providers. Organize and maintain medical records in both paper and electronic formats, ensuring they are accessible and easily retrievable. Coordinate with other departments (e.g., billing, insurance) to provide requested information while safeguarding patient confidentiality. Review and verify records for completeness and accuracy before releasing them. Perform audits of medical records to ensure accuracy and compliance with regulatory standards. Skills & Qualifications: Experience in healthcare administration or medical records management (preferred). Knowledge of HIPAA regulations and patient confidentiality. Strong communication skills (for calling positions). Excellent attention to detail and organizational skills. Ability to work efficiently and accurately in a fast-paced environment. Experience with medical records systems and software (e.g., Epic, Cerner, etc.) preferred. Ability to handle sensitive information with professionalism and discretion. Comfortable with night shift. Salary & Benefits: Competitive salary based on experience Health and Accidental insurance Call or WhatsApp -9311316017 (HR Manish Singh)

Role & responsibilities Tariff Negotiations and cost management Conducting surprise audits and checks of the claims and case to case negotiations Manage workload of both field and office effectively Experience in dealing with providers (Hospitals/Diagnostics & OPD Clinics) Understanding of Health Claims and claim related processes Good understanding of Health Insurance and related products Managing relationship with the providers Flexible to travel across locations based on the organizational requirements Managing internal (Claims Team, Sales and Central Teams and external stakeholders (Brokers, Channel partners & Corporates) Managing and controlling of cost for the portfolio assigned Timely reporting of business MIS and reports to leadership team Analytical and data-driven approach in day to day work Lead and manage the technology & process related initiatives Complying to the audit and compliance related concerns as per organization guidelines Preferred candidate profile We are looking for a doctor profile with relevant experience in claims and willing to travel across AP & Telangana states. Ability to collaborate with various cross functional stakeholders and drive the agenda for closure Should have a good analytical mind to understand costs associated with hospital tariffs and claim cost and manage them effectively. Should have excellent communication, presentation and detailed oriented skills (MS Excel, PowerPoint)

Job description In-depth Knowledge and Experience in the US Health Care Payer System. 4-9 years of experience in Dental Claims . With over 1 year of experience as a supervisor. Proven track record in managing processes, streamlining workflows and excellent people management skills. Need to be a people centric manager who could articulate the employee challenges to the management as well as motivate the team towards desired project goals. Circulate quality dashboards at agreed periodic intervals to all relevant stake holders Adhering to various regulatory and compliance practices. Maintaining and Ownership of reports both internal as well as for the clients. Presenting the data and provide deep insights about the process to the Clients as well as Internal Management. Managing and co- ordinating training programs. Excellent in Coaching and providing feedback to the team. Take necessary HR actions as part of the Performance Improvement Process. Key Performance Indicators Ensuring that the key Service Level Agreements are met consistently without any exceptions. Leverage all Operational metrices to ensure that the Revenue and Profitability targets are met and exceeded . Work in tandem with all Business functions to ensure smooth business process. Retention of key team members Interested Candidates share your CV - deepalakshmi.rrr@firstsource.com / 8637451071 Disclaimer: Firstsource follows a fair, transparent, and merit-based hiring process. We never ask for money at any stage. Beware of fraudulent offers and always verify through our official channels or deepalakshmi.rrr@firstsource.com

====================================================================== Walk-in Details:- Job Mode:- Work from Office Interview Dates:- 16-Jul-25 (Wednesday) to 31-Jul-25 (Thursday) (Except Sundays) Interview Timings:- 03:00 PM to 08:30 PM Interview Location:- Confiance House Near Shree Punjabi Seva Samaj, Behind Navrangpura Bus Stop, Swastik Society, Navrangpura, Ahmedabad, Gujarat 380009 ====================================================================== Role & responsibilities Performing outbound calls to insurances regarding medical claims (in the US) to collect outstanding Accounts Receivables. Ensuring accurate and timely completion of transactions to meet or exceed client SLAs. Responding to customer requests by phone and/or in writing to ensure timely resolution of unpaid medical insurance claims. Resolving complex situations following pre-established guidelines. Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team. Organizing and completing tasks according to assigned priorities. Preferred candidate profile Excellent English Communication required (Oral & Verbal) Graduation or above Should be Comfortable with US Shifts Goal oriented and stable Positive attitude towards work Perks and benefits 5 working days Overtime benefits. Health Insurance. Other employee benefits. If you are not able to attend the walk-in interview or have any doubt then you can connect on 7486008424 or work@confiancebizsol.com Open Positions AR Caller:- 15

HI Warm Greetings from Rivera Manpower Services , WORK LOCATION : Bangalore /Kochi Note : Candidates who are willing to Relocate to Bangalore Can apply. Minimum 3 YEARS Experience in Property and Casualty Insurance /Motor Insurance for US market Can apply Call and book your Interview slots 9986267393 /9380300644 JD for Senior Process Analyst In this role, Underwriter Assistant assists the Branch Underwriter & plays a vital role in maintaining customer relationship through timely & accurate services. A person will act as a liaison between multiple parties including Branch Underwriter, Policy Servicing Team, Insurance Carriers, and Insurance Brokers, etc. by answering questions & providing detailed information about the accounts/policies via Phone Calls or Emails. To ensure success, Underwriter Assistant should have a friendly and professional attitude, excellent communication skills, and the ability to stay calm under pressure. Should have good understanding of Insurance Domain & minimum experience of 2 years in P&C Insurance. Must have a knowledge of Insurance Life Cycle & worked into minimum 2 different processes. Being an integral part of the production (sales) team in USA, should be ready to work in Night Shift India Time. Work experience in Surplus Lines Insurance or with Managing General Agent (MGA) or with Insurance Broker would be an added advantage. Primary Responsibilities Assist Underwriters in day-to-day duties by: 1. Co-ordinating & collecting information from different stakeholders that requires for underwriting & binding accounts/policies, 2. Binding policies in Carrier as well as Agency Management System along with Invoicing & delivering the same to the clients, 3. Follow-up with clients for bind request, pending information, inspection report recommendation implementation, 4. Ensure all documents/information available in file for policy servicing teams, 5. Handling questions & communication with stakeholders via email & inbound/outbound calls, 6. Updating & ensuring compliance to SL affidavits requirements, 7. Triaging endorsements & cancellations, 8. Facilitating & managing miscellaneous activities that do not require Underwriting decision making Excellent verbal & written communication Graduate with 3+ years of experience in an Insurance domain (P&C /BFSI) Flexible & customer focused Strong problem solving and analytical approach Proactive & accountable Skilled in multi-tasking & prioritizing Exposure to complaints & escalations management Prioritization of work received through different channels Call and book your Interview slots 9986267393 / 9380300644

RCM AR Caller with 2-4 years exp in US healthcare AR medical billing, claim process, claim settlement Night shift good in English communication

Graduate Medical background, MR (B pharma), BHMS, BAMS/ MBA in Hospital Adminstration 2+ Years working experience in health insurance/health insurance TPA at Hospital handling/audit Candidate must have excellent knowledge of health insurance / Health TPA domain. Candidate must have excellent bill/medical negotiation skills & customer handling skills. Good communication skills in Hindi/English and regional language of the state/region. Ready to relocate himself/herself at location within India as may be required according to the job requirement Candidate must own vehicle to travel in various hospital assigned to him Candidate must be computer literate and shall possess skills including but not limited to Microsoft Office Suite and navigating through internet Portals Candidate will be mapped with minimum 20 hospitals for physical visit based on the location and city. Additionally 20-25 Hospitals for Case Audit and Management Proficient in handling complex situations and customers. Candidate must possess clinical knowledge for evaluation of medical files Sound knowledge of surgical procedures and disease cure management

About the work - Member Services for Seniors: Medicare and Retiree programs serve a vulnerable demographic, seniors who often have complex health conditions, limited digital literacy, and require extra care and patience over the phone. Segments we will support (Phase 1) : Medicare Advantage (Part C) : End-to-end plans covering hospitalization, medical services, and prescriptions. Group Retiree Plans : Tailored benefits for retired employees of corporations, government, or unions, often with layered entitlements and detailed queries. D-SNP (Dual-Eligible) : For members eligible for both Medicare and Medicaid. These are low-income or disabled seniors, requiring high sensitivity and multi-agency coordination. Call types expected : Plan eligibility, enrollment, and disenrollment Co-pay and deductible clarifications Benefit explanations (vision, dental, OTC) Provider and PCP changes Claims, EOBs, and billing support Pharmacy exceptions and drug tier clarifications Appeals, grievances, and service denials Hospice and long-term care coordination Medicaid coordination Skill requirements : Deep understanding of CMS (Centers for Medicare & Medicaid Services) guidelines Familiarity with Medicaid programs by state Strong listening and verbal communication Patience and empathy for cognitive or hearing impairments Proficiency in navigating multiple systems and tools Why this matters : Customer satisfaction directly impacts Medicare Star Ratings, which drive UHGs CMS reimbursements First 90-day retention is critical to reduce member churn Supporting D-SNP and retiree populations reinforces UHG’s mission of healthcare equity and access This is a defining opportunity, let’s come together to exceed expectations, build client trust, and establish ourselves as a long-term strategic partner for UHG. Looking forward to your thoughts and functional readiness in our upcoming working session. Regards Trapti Singh 9911397154

Greetings from Firstsource Solution!!! We have an exciting opportunity for experienced candidates for with good communication skills for claims adjudication process. Walk-in Time : 11:30 AM to 2:00 PM Mode of Interview: 1. F2F HR round 2. Assessments 3. Live chat 4. Operations manager round. Eligibility Criteria: Minimum 6 months experience is required in Claims/ Insurance or healthcare. Processing and data entry for routine types of physician and contract linkage transactions such as: Load new physician demographics and contract linkage using the appropriate loading instruction guidelines (i.e. Managed Care Forms, Provider Data Loading Templates, etc.) Perform physician demographics and contract linkage data using the appropriate loading instruction guidelines (i.e. Managed Care Forms, Provider Data Loading Templates, etc.) Responsible for ensuring all data elements necessary to complete the request are provided and responds to the submitter with a detailed outline if additional information is needed Use desk-top macros whenever possible to ensure data loading accuracy and efficiency Send large requests capable of being automated as defined by management to the AST Provide excellent customer service to customers (physician, health plans, affiliates, delegates, insured, and all associated business partners) by: Quickly and accurately identifying and assessing customer needs and taking appropriate action steps to satisfy those needs Solve problems systematically using sound business judgment and following through on commitments using an automated approach whenever possible Respond to customers in a polite and professional manner Complete assigned work within established TAT and Quality metrics while remaining within downtime parameters to ensure customer satisfaction. Interested candidates must directly walk-in to Firstsource office for the interview process. Please carry updated resume and Govt. photo ID proof Point of contact: N ithra-HR [Write on top of your resume] Contact no: 9502212950 Venue Details: Firstsource Solutions Limited 5th Floor, BSR Tech Park, Near Wipro Circle, Nanakramguda Financial District. Disclaimer: Firstsource follows a fair, transparent, and merit-based hiring process. We never ask for money at any stage. Beware of fraudulent offers and always verify through our official channels or @firstsource.com email addresses.

Paytm is India's leading mobile payments and financial services distribution company. Pioneer of the mobile QR payments revolution in India, Paytm builds technologies that help small businesses with payments and commerce. Paytm’s mission is to serve half a billion Indians and bring them to the mainstream economy with the help of technology. About the teamQR & Soundbox is one of Paytm‘s business tools to help merchants grow and manage their business through simplicity and data driven technology. Expectations/ Requirements 1. Must have Smart Phone, Bike & Helmet 2. Candidate must have a zeal for Growth 3. Candidate should have good market knowledge 4. Must have done a Channel Sales Role before with 5 Member Sales Team handled before 5. Must understand concepts of distribution, expansion, metrics 6. Must have experience in getting team earn Lucrative Incentives Education Graduate or above / Post Graduation preferred. s- Responsible for the Sales enrollments/Sales in the city. Do the market race and prepare the list of prospective customers , Handle the Team Members and motivate them for better sales , Ensure the team members are in market where enrollments & usage are done regularly. Should have good networking capabilities and be willing to travel extensively throughout their specified areas Key Role: Manage an assigned geographic sales area to maximize sales target and meet corporate. Objectives Build Database of key contact persons in the assigned geography. Build and maintain relationships with key client personnel Manage Category leads from qualification to closure!

Job TitleFinance reporting (Refund Claims and analysis) Location[Bangalore] Experience RequiredMinimum 3–4 years Employment Type[Full-time] Job SummaryWe are looking for a detail-oriented and proactive Refund Claims & Collections Executive with prior experience in the travel industry, who has knowledge in airline refund collections. The ideal candidate will have a strong understanding of industry practices, familiarity with GDS tools, MS office and the ability to manage the refund claim transaction volume on a daily basis. Key Responsibilities: Handle refund processes related to bookings and transactions within the travel domain. Manage end-to-end claims processing, ensuring timely validation, documentation, and closure. Coordinate with internal teams and external partners (airlines, GDS, vendors) to resolve refund claim-related issues. Maintain accurate records and logs of claims and collections activities. Use GDS software for information retrieval and resolution (As applicable). Generate basic reports and summaries using MS Excel and other MS Office tools. Ensure compliance with company policies and service level agreements (SLAs). Required Qualifications & Skills: 3–4 years of relevant experience in GDS and airline refund claims and collections within the travel industry. Exposure to GDS software such as Amadeus, Sabre, or Galileo (preferred). Strong analytical and problem-solving skills. Proficiency in MS Office, especially Excel. Ability to communicate clearly and professionally across teams and with external partners. Attention to detail, time management, and organizational abilities. Preferred Attributes: Prior experience working with travel agencies, airlines, or B2B travel platforms. Understanding of ticketing and refund processes.