595 Claims Adjudication Jobs - Page 6

Aster Medcity is looking for Associate.Medical Records.MIMS Hospital Calicut to join our dynamic team and embark on a rewarding career journey Processing requisition and other business forms, checking account balances, and approving purchases. Advising other departments on best practices related to fiscal procedures. Managing account records, issuing invoices, and handling payments. Collaborating with internal departments to reconcile any accounting discrepancies. Analyzing financial data and assisting with audits, reviews, and tax preparations. Updating financial spreadsheets and reports with the latest available data. Preparation of operating budgets, financial statements, and reports. Reviewing existing financial policies and procedures to ensure regulatory compliance. Providing assistance with payroll administration. Keeping records and documenting financial processe

Closing Ratio/Meeting all KPI of team member& Self Negotiate with dealers Large Value Claims handling Avoid cost wastage Workshops Regular training of claims policies Faster settlements Settlement Ratio-97% Investment Ratio-3% Key Accountabilities/ Responsibilities Stakeholder interfaces Experience 3-5 years of experience in Motor Claims & Body paint Workshop. Education Preferably Diploma in Automobile, Graduate from MechanicalEngineer Graduate from Any discipline with prior experience in Claims

Role Description: As a Revenue Cycle Management (RCM) Associate / Senior Associate at PDA E-Services Pvt Ltd , you will be an integral part of our US healthcare operations team, responsible for managing the end-to-end revenue cycle process for dental practices in the United States. Your primary focus will be to ensure accurate billing, efficient payment processing, timely insurance follow-ups, and effective resolution of revenue-related discrepancies. Company Profile: PDA E-Services Pvt Ltd is a dynamic and fast-growing Global Capability Centre (GCC) for Piccadilly Dental Alliance (PDA) , a leading dental healthcare organization in the United States. Established in 2022 , we provide operational, administrative, and practice management support to US-based dental practices, enabling them to focus on delivering exceptional patient care. As PDAs exclusive India-based outsourcing partner, we are expanding rapidly with a strong emphasis on operational excellence and healthcare service expertise. Roles & Responsibilities: Ensure accurate and timely generation of patient bills. Support insurance-related pre-processing and post-processing requirements. Conduct payment reconciliation processes to ensure completeness of receivables. Identify and resolve billing and audit issues related to the US dental healthcare system. Analyse revenue trends and claims performance for efficient payment processing and insurance follow-ups. Demonstrate an end-to-end understanding of the US dental insurance clearance and claim management process. Maintain high attention to detail, strong organizational skills, and effective coordination and communication abilities. Regularly interact with the senior leadership team based in the United States for operational updates and issue resolutions. Qualifications: Education: Graduate in any discipline (B.Com / BBA / B.Sc / B.A / or equivalent preferred). Experience: Associate: 0-2 years of experience in RCM / medical billing / US healthcare process. Senior Associate: 2- 4 years of relevant RCM or US healthcare billing experience preferred. Strong verbal and written communication skills in English. Proficiency in Microsoft Office applications (especially Excel and Outlook). Good analytical and problem-solving abilities. Prior experience in US dental or healthcare RCM processes is an added advantage. Benefits Offered: Fixed weekend off (Saturday & Sunday) Opportunity to work with an expanding US healthcare organization. Professional growth and internal career advancement opportunities. Exposure to international healthcare operations and leadership interaction. Comfortable, collaborative, and inclusive work environment. Paid leaves and holiday benefits as per company policy. Job Details: Job Title: Associate / Senior Associate RCM Working Days: Monday to Friday (Saturday and Sunday fixed off) Location: PDA E-Services Pvt Ltd 405, Fourth Floor, PT Gera Centre, Dhole Patil Road, Bund Garden Road, Pune 411001.

We are Hiring Candidates who are experienced in AR Calling specialized in end to end RCM (International Voice only) for Medical Billing in US Healthcare Industry. *Roles and Responsibilities* Reviews the work order. must have work experience in worker compensation or auto insurance or claim adjudication Follow-up with insurance carriers for claim status. Follow-up with insurance carriers to check status of outstanding claims. Receive payment information if the claims has been processed. Analyze claims in-case of rejections. Ensure deliverables adhere to quality standards. *Candidates with excellent communication and strong knowledge in end to end RCM can apply.* ONLY IMMEDIATE JOINERS PREFERRED. Ability to work in night shift - US shift Cab provided (both pick up and drop) 5 days work (Weekend fixed OFF) Job location : Chennai Share your updated resume and photograph to Shobana K - 8248223875 Contact Shobana K - 8248223875

Review the claim allocated and check status by calling the payer or through IVRWeb Portal Ask a series of relevant questions depending on the issue with the claim and record the responses Prepare call notes, initiate or execute the corrective measures by sending necessary documents to Payers Record the actions and post the notes on the clients revenue cycle platform Us e appropriate client specific call note standards for documentation Adhere to Companys information, HIPAA and security guidelines Be in the center of ethical behavior and never on the sidelines Job Profile: Should have worked as an AR Caller for at least 2 years to 4 years with medical billing service providers Good knowledge of Revenue Cycle and Denial Management concept Positive attitude to solve problems Ability to absorb clients business rules Strong communication skills with a neutral accent Graduate degree in any field Note- Immediate Joiners preferred. Schedule: Night shift Experience: AR Caller: 1 year (Preferred)

• 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 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. Interested candidate can share your resume to varsha.kumari@mediassist.in

Experience in BPO Industry- International Voice only Team Leader - Healthcare process voice (MUST) Medical billing AR Excellent Comms

About The Role Vault functionEnsure timely opening of vault and availability of cash to cash van officers.To ensure Proper cash dispensing branch wise with no errors. Adjudication of Notes as per RBI norms & Rules-Updation of bin register and card on time and ensuring proper signatures.-Managing cash inflows and out flows from chest vault and periodical balancing during the day. -Ensuring constant supply of ATM Counter issuable cash. Ensure enough fresh cash availability in all denominations.-To keep the vault clean of any un wanted stuff.Must have knowledge to pass notes as per RBI refund rules and to get full value during RBI inspections. -Proper scrutiny and upkeep of key registers and keys.Identify potential with other CC banks for offloading excess cash through diversion orders , maintain relationship with other banks & regulatorsSecurity and house keeping-To ensure 24 hours vigil in chest area by attentive guards.-Ensure proper checks and frisking by guard during movement in chest area.-To conduct surprise checks specially on holidays and nights to see guards on duty. -To ensure duty of one person to keep vigil in chest area all the time.Proper functioning of all security equipment and their regular checking and servicing. Maintaining CCTV Backups and recordings -To ensure proper upkeep and cleaning of all the areas in the chest.Audit-To ensure absolutely clean audit report with no adverse comments in any area.-Constant review of process and controls to ensure complete controls.-Timely submission of all demanded records to audit for scrutiny.-To keep good relation with them and timely resolution to the queries. -RBI audit has to be exceptionally good with no adverse remarks.Should have knowledge of RBI guidelines , procedure & controls for better cash management in the unit, and achieve good audit rating-To regularly check all areas especially critical ones from process as well as audit point of view.Floor Manager-To observe the sorting and counting activities.To observe the cash movements from the vault and vice versa.Stationery control-To keep optimum level of stationary required in chest.-To stop leakage in stationary use and device ways to reduce cost.

About The Role Vault functionEnsure timely opening of vault and availability of cash to cash van officers.To ensure Proper cash dispensing branch wise with no errors. Adjudication of Notes as per RBI norms & Rules-Updation of bin register and card on time and ensuring proper signatures. -Managing cash inflows and out flows from chest vault and periodical balancing during the day. -Ensuring constant supply of ATM Counter issuable cash. Ensure enough fresh cash availability in all denominations.-To keep the vault clean of any un wanted stuff.Must have knowledge to pass notes as per RBI refund rules and to get full value during RBI inspections. -Proper scrutiny and upkeep of key registers and keys.Identify potential with other CC banks for offloading excess cash through diversion orders , maintain relationship with other banks & regulatorsSecurity and house keeping-To ensure 24 hours vigil in chest area by attentive guards.-Ensure proper checks and frisking by guard during movement in chest area. -To conduct surprise checks specially on holidays and nights to see guards on duty.-To ensure duty of one person to keep vigil in chest area all the time.Proper functioning of all security equipment and their regular checking and servicing. Maintaining CCTV Backups and recordings -To ensure proper upkeep and cleaning of all the areas in the chest.Audit-To ensure absolutely clean audit report with no adverse comments in any area.-Constant review of process and controls to ensure complete controls.-Timely submission of all demanded records to audit for scrutiny. -To keep good relation with them and timely resolution to the queries.-RBI audit has to be exceptionally good with no adverse remarks.Should have knowledge of RBI guidelines , procedure & controls for better cash management in the unit, and achieve good audit rating -To regularly check all areas especially critical ones from process as well as audit point of view.Floor Manager-To observe the sorting and counting activities.To observe the cash movements from the vault and vice versa.Stationery control-To keep optimum level of stationary required in chest.-To stop leakage in stationary use and device ways to reduce cost.

Overview Roles & Responsibilities: 1) Candidates Should have worked in hospital Insurance desk 2) Provide Medical opinion for health Insurance claims 3) Processing of cashless requests & Health Insurance claims document 4) Proficient with medical terms & system 5) Understanding of policy terms & system. 6) Understanding of Claims adjudication/ Claims Processing Tagged as: insurance Before applying for this position you need to submit your online resume . Click the button below to continue. Related Jobs RELATIONSHIP OFFICER IN BANK Bank Jorhat Full Time 2024-01-19

Claims Executive Responsibilities: Receiving and answering emails, telephone calls related to claims Advice policyholders on claim procedure Ensure fair settlement of a claim with TAT Manage all administration aspects of the claim Adhere to legal requirements, industry regulations and customer quality standards set by the company. Handle any complaints associated with a claim Claims Executive Requirements: A bachelor's degree in any discipline. At least 2-4 years' experience as a claims handler or a similar role. Excellent time management skills and organizational abilities. Top-notch client interaction skills. Ability to work in a high-pressure environment. A general understanding of insurance terminology and abbreviations. Attention to detail and process-orientated thinking. The ability to work independently and multitask. Proficient in basic computer handling.

We are looking for an experienced CGHS Billing Executive with a minimum of 2 years of experience in hospital billing, specifically handling CGHS (Central Government Health Scheme) processes.

Job Title: Sr Manager Health Insurance Claims Location: Bangalore (Hybrid) Company: Pazcare Type: Full-time About Pazcare Pazcare is transforming employee healthcare and wellness for 2000+ companies including Mamaearth, Chaayos, Mindtickle, and more. We simplify health insurance and wellness benefits, giving HR teams superpowers through real-time claim tracking, analytics, and stellar employee experiences. Role Overview As a Claims Manager, you will be the frontline owner of ensuring claims are settled within the agreed turnaround time (TAT) across TPAs. You will play a critical role in driving TPA performance, resolving escalations, and advocating on behalf of our clients to ensure no valid claim is wrongly repudiated. Key Responsibilities Ensure all reimbursement and cashless claims are processed within the committed TAT across clients. Track, analyze, and manage TAT performance of multiple TPAs; escalate and hold them accountable for delays or service gaps. Reopen wrongly repudiated claims with TPAs/insurers and fight for fair resolution on behalf of clients. Collaborate closely with the customer success and insurance teams to address claim escalations proactively. Drive continuous process improvement in claims handling and communication workflows. Maintain internal dashboards and reports to track SLAs and spot trends. Requirements 3+ years of experience in health insurance claims (TPA/insurance broker/insurer preferred). Strong understanding of reimbursement, cashless claim processes, and IRDAI guidelines. Assertive communicator with negotiation skills to handle TPAs and insurers. Analytical mindset with ability to identify patterns in delays or rejections. Empathy for the end user the employee or HR dealing with a health issue. Why Join Pazcare? Work with a mission-driven, fast-growing team redefining how India experiences employee health benefits. Ownership of high-impact outcomes and the opportunity to shape the future of claims at scale. Be part of a culture that values transparency, speed, and customer-first thinking.

Dear Candidate, Greetings from NTT DATA. We are happy to take your profile for a wonderful career with NTT DATA. Job Title: HC & Insurance Senior Associate (Claims Adjudication/Processing) Experience: 3 - 5 Years of relevant experience in Claims adjudication Skillset: HIPAA. ICD, CPT Codes, Medicare, Medicaid, Copay & Coinsurance Shift: Night Shift Work Location: Chennai - DLF Cybercity Mode of Work: Work From Office Positions General Duties and Tasks: • Process Insurance Claims timely and qualitatively • Meet & Exceed Production, Productivity and Quality goals • Review medical documents, policy documents, policy history, Claims history, system notes and apply the trained client level business rules to make appropriate Claims decisions, call out claims trends and flag fraud activities • Analyze customer queries to provide timely response that are detailed and ordered in logical sequencing • Cognitive Skills include language, basic math skills, reasoning ability with excellent written and verbal communication skills • Stay up to date on new policies, processes, and procedures impacting the outcome of Claims processing • Continuous learning to ramp up on the knowledge curve to be the SME and to be compliant with any certification as required to perform the job • Be a team player and work seamlessly with other team members on meeting customer goals • Developing and maintaining a solid working knowledge of the insurance industry and of all products, services and processes performed by Claims function • Handle reporting duties as identified by the team manager • Handle claims processing across multiple products/accounts as per the needs of the business Requirements for this role include: • Both Under Graduates and Post Graduates can apply. • Excellent communication (verbal and written) and customer service skills. • Able 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. • Demonstrate strong reading comprehension and writing skills. Cognitive Skills include language, basic math skills, reasoning ability and verbal communication skills. • Ability to work in a team environment. • Handling different Reports - IGO/NIGO and Production/Quality. • To be in a position to handle training for new hires • Work together with the team to come up with process improvements • Strictly monitor the performance of all team members and ensure to report in case of any defaulters. • Encourage the team to exceed their assigned targets. • Candidate should be flexible & support team during crisis period • Should be confident, highly committed and result oriented • Experience on working in an office environment set up utilizing Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools • Experience in a professional/office related role that required you to communicate (oral/written) effectively with internal team members and external customers • Experience in a role that required a focus on quality including attention to detail, accuracy, and accountability for your work product • Candidate should be flexible to work from home and office environment. Broadband connection is must while working from home. Preferences for this role include: • 5+ years of experience processing insurance claims in the health, life, or disability disciplines that required knowledge of CPT, HCPCS, ICD9/10, CDT. • 2+ year(s) of experience in role that required understanding and interpreting complex documents such as medical records and legal contracts. ***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.

Positions General Duties and Tasks: Process Insurance Claims timely and qualitatively Meet & Exceed Production, Productivity and Quality goals Review medical documents, policy documents, policy history, Claims history, system notes and apply the trained client level business rules to make appropriate Claims decisions, call out claims trends and flag fraud activities Analyze customer queries to provide timely response that are detailed and ordered in logical sequencing Cognitive Skills include language, basic math skills, reasoning ability with excellent written and verbal communication skills Stay up to date on new policies, processes, and procedures impacting the outcome of Claims processing Continuous learning to ramp up on the knowledge curve to be the SME and to be compliant with any certification as required to perform the job Be a team player and work seamlessly with other team members on meeting customer goals Developing and maintaining a solid working knowledge of the insurance industry and of all products, services and processes performed by Claims function Handle reporting duties as identified by the team manager Handle claims processing across multiple products/accounts as per the needs of the business Requirements for this role include: Both Under Graduates and Postgraduates can apply. Excellent communication (verbal and written) and customer service skills. Able 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. Demonstrate strong reading comprehension and writing skills. Cognitive Skills include language, basic math skills, reasoning ability and verbal communication skills. Ability to work in a team environment. Handling different Reports - IGO/NIGO and Production/Quality. To be in a position to handle training for new hires Work together with the team to come up with process improvements Strictly monitor the performance of all team members and ensure to report in case of any defaulters. Encourage the team to exceed their assigned targets. Candidate should be flexible & support team during crisis period Should be confident, highly committed and result oriented Experience on working in an office environment set up utilizing Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools Experience in a professional/office related role that required you to communicate (oral/written) effectively with internal team members and external customers Experience in a role that required a focus on quality including attention to detail, accuracy, and accountability for your work product Candidate should be flexible to work from home and office environment. Broadband connection is must while working from home. Preferences for this role include: 3+ years of experience processing insurance claims in the health, life, or disability disciplines that required knowledge of CPT, HCPCS, ICD9/10, CDT. 2+ year(s) of experience in role that required understanding and interpreting complex documents such as medical records and legal contracts. ***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

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/Bangalore 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

Davies is seeking a highly organised and self-motivated professional to join our Life & Health team as an Administrator Team Leader. In this role, you will provide leadership, guidance, and direction to a dedicated team, ensuring the achievement of key results and operational excellence. Your responsibilities will include overseeing document indexing, imaging, quality audits, data entry and the review of Proof of Loss (POL), as well as processing policy documents and claims. You will play a critical role in handling sensitive files and processing essential documents to support our US operations. This is an excellent opportunity for a proactive and detail-oriented individual looking to make an impact within a dynamic and collaborative environment.

I am hiring for this position for one of our Life Insurance clients. Role & responsibilities Prudent claim Assessment and management of end-to-end claim settlement /repudiations, including Life, Group claims Coordinate with Reinsurers /sales/customers for closure of claims within the regulatory framework and timelines Direct and oversee the maintenance of complete and accurate claim management records. Managing the claim teams on day-to-day claims transactions, guidance on claims philosophy, regulatory, and audit procedures Ensuring daily claim deliverables are met and claims decisions within prescribed SLA with quality Ensure customer centric approach while delivering sensitive area of death claims. Accuracy and Speed in delivery Customer satisfaction Quality in claims assessment/approvals Preferred candidate profile Graduate with required communication skills, A minimum of five to seven years progressively responsible previous insurance industry experience. Life Insurance domain knowledge Decision-making skills. MIS, MS Excel, Workflows , Group Asia and Life Asia system knowledge

Finance Analyst Accounts Receivable Client Finance - JLL Business Service (Gurugram) What this job involves: Analysing cash/amount received in the bank deposits and making the application against the tenant accounts Analyse and research tenant ledgers history against the over/short payments. Query handling working on all queries received and keeping a close tab on any pending queries that could be resolved and following up on the rest. Contact accountants and Property teams whenever necessary to determine the proper payment application. Research and analyse duplicate and erroneous payments. Escalate unresolved issues/concerns. Assist in training new employees as needed. Working on different process-related and ad-hoc reports Keeping all the process-related documents intact on a real-time basis Sounds like you To apply, you need to have the following: Employee Specifications Strong Finance background, Commerce graduate or Post Graduate is preferred. Minimum 0-2 years of experience in Order to Cash, specifically Cash Application role is preferable. Strong analytical skills with attention to detail and logical thinking and carry a positive attitude to develop solutions quickly Strong interpersonal skills Demonstrated consistency in values, principles, and work ethics Working knowledge of MS Office (MS Word, Excel, PowerPoint, Outlook) required Performance Objectives Works within established procedures with a moderate degree of supervision Identifies the problem and all relevant issues in straightforward situations, assesses each using standard procedures, and makes sound decisions

Job description: We are hiring Claims Adjudication Experienced HR Recruiter (Reference): Sam Jeshurin Job Location: Firstsource Solution Limited, 5th floor ETA Techno Park, Block 4, 33 OMR Navallur, Chennai, Tamil Nadu 603103. Landmark: Near Vivira Mall. Shift Details: Night shift / Flexible to work in any shift and timing Cab Boundary Limit: We provide cab Up to 30 km (One way drop cab | Doorstep only) Minimum Eligibility: 1. Minimum 1 year experience in Claims Adjudication Process. Note: This is not for Freshers and Direct walk-in interview (No Virtual) Walk-In Details: Walk-In Days: Monday To Friday Walk-In Time: 10:30 AM - 2:00 PM Documents to carry: 1. Updated resume 2. Aadhar card 3. Pan card 4. Educational Certificates (1st to 6th marksheet, Provisional marksheet) Note: Mention Sam(HR) in top of your resume when attending the walk-in interview. Ensure that you check your eligibility criteria before appearing for the interview, as this helps in a smooth screening process. Contact: Sam Jeshurin (sam.jeshurin@firstsource.com or What's app: 8825506927) Join us to be part of a dynamic team with career growth opportunities. We look forward to seeing you at the interview! You can refer your friends as well! 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 sam.jeshurin@firstsource.com

Understand the US P&C Insurance / Claims function end to end. FNOL Pre-Adjudication like Coverage Verification, Indexing Subrogation and Salvage Document Management Loss Run Should have a basic understanding of the insurance policy and Claim life cycle. Good to have knowledge of end-to-end Claims function/Insurance life cycle Must have good knowledge of insurance terms premium, deductibles, claim etc Good written and verbal communication, and a team player Strong analytical skills Analyses and synthesizes information/makes decisions based on policies. Responsible and dedicated to meet the clients expectations. Prioritizes tasks in order of importance. Key Responsibilities: › Review requests of FNOL thoroughly of different LOB’s receives from client › Verify coverage and other details from policy document if the received claims is a legitimate one › Highlighting data concerns like missing/incomplete data to the claim examiners › Record claim information in system and generate unique claim no. for future related communication › Process the claim payments › Do a deep quality check of team members’ work › Knowledge of detailed end to end claim lifecycle › Create loss run report as requested by UW, insured & brokers etc. › Closing claims as requested by claim examiners › Work on client ad-hoc request › Support on MIS/data reporting activities Qualifications: Graduates Any P&C Insurance certificate from reputed institute is an added advantage Proficiency in Microsoft Office (Word, Excel, and Outlook) Role & responsibilities Preferred candidate profile

The candidate must have completed BHMS, BAMS, or BUMS from a reputed university." Experience : 0 to 2 years Locations : Bangalore, Chennai and Mumbai / Pune Role & responsibilities To give Claims & Cashless/preauthorization, and scrutiny Medical Reimbursement Claims, and to Process Claims Third Party Administration (Health) services (TPA) Claims and Preauthorization Processing HealthCare Assistance Services High Ratio Claims Management in coordination with Networking and Empanelment Department Monitoring the overall operations of Claims and Preauthorization. Responsible for ensuring efficient response at the level of Preauthorization to maintain TAT. Ensure adherence to processes and controls. Creating the process for claim processing (Cashless and Reimbursement). Co-ordination between Network Hospitals/Preauthorization/Claims. Ensuring a high-quality patient care at customized/optimized cost. Creating the process for claim processing (Cashless and Reimbursement). Preferred candidate profile • Good Excellent oral and written communication, negotiation, and decision-making skills. • Good customer service/relationship skills and ability to work effectively in a fast-paced environment with shifting priorities . Must be willing to work in non - clinic

Designation/ Role: Trainee Department: Accounts Receivable Work Timing: Night Shift Qualifications: Minimum HSC/10+2 Equivalent (Any Graduate Preferred) Skills: Good verbal and written communication Skills. Able to build rapport over the phone. Strong analytical and problem-solving skills. Be a team player with positive approach. Good keyboard skills and well versed with MS-Office. Able to work under pressure and deliver expected daily productivity targets. Ability to work with speed and accuracy. Medical billing AR or Claims adjudication experience will be an added advantage. Experience 01-year experience US calling process will be an added advantage. Job Description The job involves an analysis of receivables due from healthcare insurance companies and initiation of necessary follow-up actions to get reimbursed. This will include a combination of voice and non-voice follow-up along with undertaking appropriate denial and appeal management protocol. Job Responsibilities 1) Analyses outstanding claims and initiates collection efforts as per aging report. So that claims get reimbursed. 2) Undertakes denial follow-up and appeals work wherever required. 3) Documents and takes appropriate action of all claims which has been analyzed and followed-up in the clients software. 4) Build good rapport with the insurance carrier representative. 5) Focuses on improving the collection percentage. Desired Qualities Behavior: Discipline, Positive Attitude & Punctuality

About The Role Project Role : Business Analyst Project Role Description : Analyze an organization and design its processes and systems, assessing the business model and its integration with technology. Assess current state, identify customer requirements, and define the future state and/or business solution. Research, gather and synthesize information. Must have skills : GuideWire Integration Good to have skills : NAMinimum 2 year(s) of experience is required Educational Qualification : 15 years full time education Summary :As a Business Analyst, you will engage in a variety of tasks that involve analyzing organizational processes and systems. Your typical day will include assessing the current state of business models, identifying customer requirements, and defining future states or business solutions. You will conduct research, gather data, and synthesize information to support decision-making and improve integration with technology, ensuring that the organization meets its strategic goals effectively. Roles & Responsibilities:- Expected to perform independently and become an SME.- Required active participation/contribution in team discussions.- Contribute in providing solutions to work related problems.- Facilitate workshops and meetings to gather requirements and feedback from stakeholders.- Document business processes and create detailed specifications for system enhancements. Professional & Technical Skills: - Must To Have Skills: Proficiency in GuideWire Integration.- Strong analytical skills to assess business processes and identify areas for improvement.- Experience with process mapping and documentation tools.- Ability to communicate effectively with both technical and non-technical stakeholders.- Familiarity with project management methodologies. Additional Information:- The candidate should have minimum 2 years of experience in GuideWire Integration.- This position is based at our Gurugram office.- A 15 years full time education is required. Qualification 15 years full time education