181 Claims Handling Jobs

Review and analyze denied or underpaid dental claims from insurance companies Ensure all appeals meet timely filing deadlines and are supported by appropriate documentation Follow-up on unpaid and underpaid claim through payer portals calls or email

Role & responsibilities We are looking for an accomplished Doctors with significant ICU experience and a strong ability to manage both clinical and non-clinical responsibilities. The ideal candidate will excel in patient care, clinical documentation, and possess in-depth knowledge of medical documentation essential for insurance claims processing. Key Responsibilities: Patient Documentation: Manage patient medical history and progress notes with precision. Claims Processing: Handle preauthorization and reimbursement claims, including validation and processing. Clinical Records: Maintain accurate clinical documentation in compliance with healthcare standards. Collaboration: Work closely with consultant surgeons and physicians on treatment management. Diagnostic Insights: Provide valuable insights on diagnostic tests, laboratory results, and imaging to support treatment decisions. Real-Time Support: Collaborate with bedside teams to offer real-time critical care expertise. Regulatory Updates: Stay informed on the latest medical guidelines, insurance policies, and healthcare regulations. TPA experience is a plus Preferred candidate profile

Roles & Responsibilities: Manage inbound & outbound calls from US providers, pharmacies, and members regarding benefits or claim denials. Handle US Medical/PBM denied claims and Utilization Management (PA, Appeals, etc.). Manage RCM cycle for patient financial encounters. Evaluate documents to ensure accurate claim information. Resolve customer queries and complaints professionally. Adhere to call center scripts, maintain quality standards, and prepare reports. Requirements: 23 years of US Healthcare voice process experience. Excellent communication skills. Comfortable with rotational shifts (247) and working on Indian holidays. Strong knowledge of claims handling and CRM systems . Customer-focused, adaptable, with good problem-solving skills. Must be willing to work in a voice process .

Roles and Responsibilities * Assist customers in assessing vehicle damage and estimating repairs. * Prepare job cards, process insurance claims, and handle claims from start to finish. * Provide technical knowledge of automobiles and accident repair processes to customers. * Handle customer queries and concerns with empathy and professionalism.

Dear Candidates, Greetings from HealthIndia Insurance TPA Service Pvt. Ltd. Company Profile - We are provide highest level of quality health care by creating a platform which is entirely dedicated to service excellence, patient care and health education to the members. For more details kindly go through company website: https://www.healthindiatpa.com Currently we have an opening in Customer Relationship Management Department for Executive Role . Location: HEALTHINDIA INSURANCE TPA SERVICES PVT LTD. PLOT NO 312 ,2ND FLOOR, PHASE 2, UDYOG VIHAR-OPPOSITE TO ICICI BANK UDYOG VIHAR, GURUGRAM, HARYANA -122016 Roles & Responsibilities: Handling Major Corporate Group. Solving Customer/Broker's queries related to claims and other issues. Following up with Insurance Company for endorsement and getting the same updated in system. Guiding customers to apply for claims and with policy Terms & Conditions. Register claims in system. Grievance resolution by taking follow from the operation team. Tracking up the claims file for & updating to the corporate client till the claim get settled. Following up for cheque dispatch details and NEFT details with backend and banks. Maintaining day to day activities on the worksheet. Preparing & Sending Monthly MIS to Corporate. Good Communication skills (written & verbal) and attitude is mandatory. Salary no match for the right candidate. If Interested, Kindly share updated resume on email id - roshni.rajbhar@healthindiatpa.com or contact us at - 8976760612 Roshni Rajbhar, HR Team, roshni.rajbhar@healthindiatpa.com 8976760612

Job Description Position: Auto Claim Adjuster Job Title: Auto Claims Adjuster Department: Claims Reports to: Claims Manager Location: Bangalore Employment Type: Full-time Roles & Responsibilities : Dealing with Insurance Companies for Auto claims only Dealing with Location Managers for paper formalities Maintaining In-House location, Insurance companies etc. Coordinating with parent company representatives Skills & Qualifications : 1 - 3 years SOLID experience with insurance company Claims Dept or Brokerage dealing with AUTO claims / Auto Insurance only Knowledge of LOCAL Auto insurance regulatory laws Good Communication & Negotiation Skills (writing and speaking) Time flexibility requirement, and should be self-motivated Hands-on capabilities Room to Grow Bachelors degree in a related field or equivalent work experience Compensation: Fixed Salary + Incentive - 2 Rounds of interviews and joining would be immediately after the 2nd round of interviews. - Background check and verification is required. Shift - Night shift ( Canadian Timings ) 6 Days working - Sunday Off Location - Serene Building No.106, 4th Floor, 4th C Cross Rd, 5th block, Koramangala Industrial Layout, S.G. Palya, Bengaluru, Karnataka 560095 If Interested directly visit to our office location for F2F Interview Notes: If interested in auto claims then only Please apply - US/Canada process Open to freshers with strong English communication skills. Notes: If interested in auto claims then only Please apply If You have Auto claims experience, Apply Please Can attach resume to Shankar@caledontechnologies.com

Responsibilities: * Prepare ILAs, survey reports & letters * Maintain claim records * Update CMS follow up with insured & teams to reduce TAT * Manage back-office claim tasks reports preparation efficiently to support smooth claims processing. Health insurance Provident fund

To contact the insured for Underwriting referred proposals to procure the complete medical history using Audio and/or Video tools. To Follow up with customer for past medical records and/or relevant health documents Maintain end to end TAT / SLAs. Required Candidate profile Location – Bangalore Candidate must know to speak excellent English. CTC – Upto 3.5 LPA

Job Description: 1. Conduct insurance claim & valuation surveys of industrial, commercial & residential properties, prepare reports, handle correspondence, and assess losses as per policy coverage. Education: B.Tech (Civil/Mech/Elec), Freshers. Health insurance Provident fund

As a team member in this role, your primary responsibility will be to meet all Key Performance Indicators (KPIs) and achieve a high closing ratio. You will be required to negotiate with dealers, handle large value claims, and ensure that cost wastage is avoided. Regular workshops and training sessions on claims policies will be conducted to enhance your skills. Faster settlements with a settlement ratio of 97% and an investment ratio of 3% are expected from you. You will also be accountable for the re-open ratio and segmentation of vehicles, ensuring that claims are separated according to vehicles. Conducting team meetings with both internal and external surveyors will be part of your routine to minimize the re-open of claims to less than 2%. Your key accountabilities will involve effectively managing stakeholder interfaces, utilizing your 3-5 years of experience in Motor Claims & Body Paint Workshop. The ideal candidate for this position should hold a Diploma in Automobile, be a graduate in Mechanical Engineering, or have prior experience in claims with a graduate degree in any discipline.,

Our Client is hiring for Claim Handler at Mumbai Location. Role type - Dedicated claims handler Work location - Work from office Mumbai, Vikhroli. Timings - 10 am - 7 pm. Monday to Saturday - Acko, Digit, Care TPA - Medi assist, Vidal Health, FHPL Required Candidate profile Preferred roles - Client Servicing, CRM, Claims handler, Customer support (If they understand claims terminology. Comms expectation - Interaction with Customers and Partners TPA/insurers

Our Client is hiring for Claim Handler at Mumbai Location. Role type - Dedicated claims handler Work location - Work from office Mumbai, Vikhroli. Timings - 10 am - 7 pm. Monday to Saturday - Acko, Digit, Care TPA - Medi assist, Vidal Health, FHPL Required Candidate profile Preferred roles - Client Servicing, CRM, Claims handler, Customer support (If they understand claims terminology. Comms expectation - Interaction with Customers and Partners TPA/insurers

Our Client is hiring for Claim Handler at Mumbai Location. Role type - Dedicated claims handler Work location - Work from office Mumbai, Vikhroli. Timings - 10 am - 7 pm. Monday to Saturday - Acko, Digit, Care TPA - Medi assist, Vidal Health, FHPL Required Candidate profile Preferred roles - Client Servicing, CRM, Claims handler, Customer support (If they understand claims terminology. Comms expectation - Interaction with Customers and Partners TPA/insurers

Our Client is hiring for Claim Handler at Mumbai Location. Role type - Dedicated claims handler Work location - Work from office Mumbai, Vikhroli. Timings - 10 am - 7 pm. Monday to Saturday - Acko, Digit, Care TPA - Medi assist, Vidal Health, FHPL Required Candidate profile Preferred roles - Client Servicing, CRM, Claims handler, Customer support (If they understand claims terminology. Comms expectation - Interaction with Customers and Partners TPA/insurers

As an IND Sr Manager - Business Service Support at Aon, you will play a crucial role in providing expert advice and high-quality service to clients within the UK retail business. Your responsibilities will include managing a team of Business Service Support to ensure the highest level of service delivery to Client Service Advisors based in the UK. Your strong interpersonal skills, attention to detail, and deep understanding of insurance procedures will be essential for this role. You will be responsible for building effective relationships with Client Service Teams in the UK and India to ensure the best service is provided to each assigned Client Service Advisor. Your experience in team management will be valuable as you lead a team of subject matter experts, aligning their objectives with the overall business strategy and developing their capabilities as future leaders. Collaboration with other support functions such as Quality, IT, HR, and Admin will be necessary for operational stabilization and delivery results. Additionally, you will coach and mentor direct reports to support their personal and professional development, contributing to retention, engagement, and succession planning goals. The ideal candidate will have a strong background in the insurance and/or financial services industry, with experience in broking, claims handling, or underwriting. Excellent communication skills, organizational abilities, and problem-solving mindset are crucial for success in this role. You should also possess analytical skills, attention to detail, and the ability to work both independently and as part of a team. At Aon, we value diversity and believe in creating an inclusive environment where colleagues can thrive. Our commitment to sustainability drives us to integrate responsible practices into our core business operations, ensuring a sustainable future for our clients and communities. Join us at Aon and be part of a team that is dedicated to shaping decisions for the better, protecting and enriching lives worldwide.,

Job Description Acts as an interface between the TPA, Insurance Company and the hospital. Responsible for investigation of suspicious claims. Effective usage of Fraud control measures. Act as a backend support to the TPA. Responsible for data mining and analytics related to Fraud and Investigation (IFD) Field visit for investigation purpose. Open to travel. Desired Candidates Profile Qualification Any Graduate Experience Fresher - 2 Years Exp. Profile Executive If interested kindly share your resume to recruitment1@mdindia.com

Title: Assistant Vice President Grade: L6 Location: Goregaon East Sub Department: Claims Department Operations Job Description: 1.Claims Investigation management for all category of Claims - Death, Health and Critical illness/Health 2.Analysis and assessment of Investigation report , documents and information received from Investigator and move quality closure within stipulated timelines 3.Responsible for accurate claim assessment and speedy decision 4.Vendor management- maintain good numbers of quality investigator as per requirement , fresh on-boarding, elimination/dis-empanelment of poor performer, monitor timely payment to all vendors (Investigation billing) 5.Monthly Investigator performance review, integrity check, industry feedback, liaising with Legal and Risk team for action 6.Responsible for Vendor / Investigator related communication, Regular engagements with Investigator and industry peers to build relations 7.Responsible for Claims investigation data management for all reports, MIS, Internal and external audits 8.Responsible for any system enhancements/Automation 9.Fraud detection ability, trend analysis and suggestion to put mitigation plan

Position : AM/Executive Claims Experience: Min 6 – 8 years Industry preferred: FMCG Location: Paradise, Hyderabad Job Summary: We are seeking a detail-oriented Claims Processor to review and process sales claims, tour claims, and travel claims. The successful candidate will ensure accurate and timely processing of claims, adhering to company policies and procedures. Key Responsibilities: - Review and process claims (sales, tour, travel) for accuracy and completeness - Verify claim documentation and supporting materials - Apply company policies and procedures to claims processing - Communicate with claimants, agents, or internal teams to resolve issues or request additional information - Maintain accurate records and databases - Meet productivity and quality standards Requirements: - Strong attention to detail and analytical skills - Excellent communication and interpersonal skills - Ability to work in a fast-paced environment - Proficiency in MS Office and claims processing systems (if applicable) Preferred Qualifications: - Bcom Computers - Experience in claims processing or customer service - Knowledge of insurance, travel, or sales industry Interested candidates can apply on talent@bambinoagro.com

Job Title: AM/Executive Sales Admin Experience: Min 6 plus years Industry preferred: FMCG Location: Secunderabad/ Hyderabad Job Summary: We are seeking a detail-oriented Claims Processor to review and process sales claims, tour claims, and travel claims & Tracking of GPRS location & Settlement of Travelling Expenses for Sales Team, Also candidate will ensure accurate and timely processing of claims, adhering to company policies and procedures. Key Responsibilities: - Review and process of claims related to Sales Department (sales, tour, travel) for accuracy and completeness - Verify claim documentation and supporting materials. - Apply company policies and procedures to claims processing - Tracking of GPRS location & Settlement of travelling expenses for Sales team - Maintain accurate records and databases - Meet productivity and quality standards Requirements: - Strong attention to detail and analytical skills - Excellent communication and interpersonal skills - Ability to work in a fast-paced environment - Proficiency in MS Office and claims processing systems (if applicable) Preferred Qualifications: - Bcom - Experience in claims processing - Knowledge of travel, or sales industry Interested candidates can apply on talent@bambinoagro.com

Role Summary 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% Re-open ratio/Segmentation of vehicles Separating the Claims according to Vehicles Conducting Team Meeting with internal and external survey. Re-open of claims should not be cross 2% 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 Summary 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% Re-open ratio/Segmentation of vehicles Separating the Claims according to Vehicles Conducting Team Meeting with internal and external survey. Re-open of claims should not be cross 2% 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

Job Description (Posting). About HCLTech HCLTech is a global technology company, spread across 60 countries, delivering industry-leading capabilities centered around digital, engineering, cloud and AI, powered by a broad portfolio of technology services and products. We work with clients across all major verticals, providing industry solutions for Financial Services, Manufacturing, Life Sciences and Healthcare, Technology and Services, Telecom and Media, Retail and CPG, and Public Services. We re powered by our people a global, diverse, multi-generational talent - representing 161 nationalities whose unique spark, perspective and boundless passion drive our culture of proactive value creation and problem-solving. Our purpose is to bring together the best of technology and our people to supercharge progress for everyone, everywhere our clients, partners, their stakeholders, communities, and the planet. As a company, we are deeply focused on accelerating our ESG agenda. We are also creating technology-enabled sustainable solutions with and for our clients and partners. We embed ESG imperatives into every aspect of our business and ensure that the progress we supercharge is responsible, inclusive and beneficial to all our stakeholders in the long term. We have committed to achieving net zero by 2040. To learn more about how we can supercharge progress for you, visit Consultant with guidewire - policycenter,guidewire - claimcenter Job Summary As a Consultant specializing in guidewire policy center and guidewire claim center, you will be responsible for implementing and providing expert consultancy on the Guidewire software solutions in the areas of policy management and claims handling. Your role will involve collaborating with clients to optimize their Guidewire systems, ensuring efficient policy and claim processes. (1.) Key Responsibilities 1. Implement and customize guidewire policy center and claim center solutions according to client requirements. 2. Provide expert consultation on best practices and solutions within the guidewire software suite. 3. Work closely with clients to understand their policy management and claim handling needs and propose appropriate solutions. 4. Conduct system testing, troubleshooting, and performance tuning related to guidewire implementations. 5. Assist in the integration of guidewire systems with other relevant technologies within the client's environment. 6. Offer training and support to client teams on the effective utilization of guidewire software solutions. Skill Requirements 1. Proficiency in guidewire policy center and guidewire claim center software platforms. 2. Strong understanding of policy management and claim handling processes in the insurance industry. 3. Experience in customizing and implementing guidewire software solutions to meet client requirements. 4. Ability to troubleshoot and optimize guidewire systems for enhanced performance. 5. Good communication skills to effectively collaborate with clients and internal teams. Certifications: Guidewire certification in PolicyCenter and ClaimCenter is preferred but not mandatory. Skill (Primary) Domain Competencies (APPS)-Insurance - Package Solution-Guidewire Policycenter

Manage the Group business with the Bank employees Liaison with different departments for closure of the cases Champion product and process to drive top line sales through business sales team and maintaining penetration levels of group insurance products with channel partner. Coordinate and train key officials (ASSL, DSA, other bank officials) to enhance their understanding of the business to increase seller activisation Provide market feedback on competition and other products in the market. Manage and strengthen relationship through engagement with Partner s Zonal Leadership team, Ops & Credit Team, DSAs, SMs, Field Sales Staff at all levels and across functions. Values add in key initiatives to enhance attachment ration & business volume through training and service. Tracking penetration performance and publishing dashboards, along with Group Operations. To measure & monitor the various metrics (Files and sum assured Penetration rates, seller activation, Claim denial rates/ pending rates, rejection ratios , medical TATs etc) , to minimize the same and adhere to TATs and contribute to product improvement. Monitoring and control process of Post Sales. Managing complete claims operation & end to end process.

Role Summary 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% Re-open ratio/Segmentation of vehicles Separating the Claims according to Vehicles Conducting Team Meeting with internal and external survey. Re-open of claims should not be cross 2% 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 Summary 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% Re-open ratio/Segmentation of vehicles Separating the Claims according to Vehicles Conducting Team Meeting with internal and external survey. Re-open of claims should not be cross 2% 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