71 Claims Handling Jobs - Page 2

Roles and Responsibilities Manage accounts receivable calls to resolve customer queries related to medical billing, claims processing, and revenue cycle management. Handle denial management by identifying and resolving issues with insurance companies, patients, or other stakeholders. Process patient statements, verify demographic information, and update records as needed. Collaborate with internal teams to resolve complex billing issues and ensure timely resolution of customer complaints. Maintain accurate records of all interactions with customers using our CRM system. Desired Candidate Profile 1-5 years of experience in AR calling, denial handling, or similar roles in US healthcare industry. Strong knowledge of medical billing processes, including claims handling and revenue cycle management. Excellent communication skills for effective interaction with customers over phone calls. Ability to work independently in a fast-paced environment while maintaining attention to detail. Interested relevant experienced candidates can share your updated resume to 7339474094 or Vaibavalakshmi.Balaji@Calpion.com

Walk-In Interview registration will end by 11:00AM Job responsibilities : Processing of Health Claims. Claim Registration and Claim Adjudication. Identifying the Frauds. Adhering to SLAs and processing the claims with in the TAT as per policy terms and conditions. Supporting CRM, Provider, sales and grievance teams Office Address: Tata AIG General Insurance Company Limited, C/o Imperial Towers, Floor-5, Landmark - Next to Metro (Ameerpet) Station, Ameerpet, Hyderabad

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 Hindi & Malayalam. CTC – Upto 3.5 LPA.

Job Title : Marine | End-to-end Claims Insurance Qualification : Any Graduate and Above Relevant Experience : 3 7 years Must Have Skills : 1.Insurance regulations and laws 2.Claims handling procedures 3.Risk management principles 4.Industry standards 5.Maritime law and regulations 6.Investigate and analyze claims documentation 7.Determine coverage and liability 8.Negotiate settlements and resolve disputes 9.Communicate effectively with insureds, claimants, suppliers and brokers 10.Apply industry-standard claims handling procedures. 11.Collaboration and teamwork Good Have Skills : Experience in Marine Adjuster Roles and Responsibilities : 1.Investigate the circumstances surrounding marine incidents, such as collisions, groundings, or cargo damage. 2.Assess the extent of damage to vessels, cargo, or freight, and estimate the cost of repairs or replacement. 3.Appropriately document information on claim file Maintain effective and ongoing communication with various internal and external contact. 4.Learn and follow best practices of clients as well as claims requirements, standards and practices as required by applicable state statutes. 5.Ensure compliance with relevant maritime law and regulations Ensure adherence to regulatory requirements, industry standards, and company policies. 6.Mitigate organizational risk, maintaining compliance and reputation Location : Kochi, Pune CTC Range : 4.5 7.5 LPA (Lakhs Per Annum) Notice Period : Immediate Mode of Interview : Virtual Shift Timing : Night Shift Mode of Work : Hybrid Thanks & Regards, Amulya G Senior HR Analyst Black and White Business Solutions Pvt Ltd Bangalore, Karnataka, INDIA. Direct Number: 080-67432435/Whatsapp @6366979339 amulya.g@blackwhite.in | www.blackwhite.in ****************************** DO REFER YOUR FRIENDS**********************************

Airbnb was born in 2007 when two hosts welcomed three guests to their San Francisco home, and has since grown to over 5 million hosts who have welcomed over 2 billion guest arrivals in almost every country across the globe Every day, hosts offer unique stays and experiences that make it possible for guests to connect with communities in a more authentic way, The Community You Will Join The AirCover team is charged with ideating, building, launching, and managing the AirCover business inside of Airbnb We have a huge responsibility to our community of Hosts and guests to be there when things dont go exactly as planned with their reservations We have a lot of work to do in the coming years and we are looking for someone who will help us manage all of the things that need to be done to deliver best-in-class services to our community, The Claims Experience team is responsible for providing Community Delight to our users by tailoring the experience and services we offer to their own specific needs so that everyone can host and travel with confidence We will develop a deep empathy and understanding of each of our customers desires, and will go above and beyond to ensure we create personalized interactions that leave lasting impressions throughout the end-to-end claims process, The team will drive operational success across each of the Aircover products, delivering Seamless Execution through the quality and speed of our interactions, whilst focusing on customer retention and the continued growth of our Airbnb community, The Difference You Will Make As the Claims Operations Manager, you will lead a team that helps drive the success of our vision to deliver unmatched products and services so everyone can host and travel with confidence, Deliver community delight to our users by tailoring experiences and the services we offer to their unique and specific needs In this role, youll help create and influence the direction we wish to take the AirCover organization, You will touch all three areas of our AirCover brand; AirCover for Hosts, AirCover for Guests and Guest Travel Insurance, You will also develop a deep understanding of each of our customers desires, and will go above and beyond to ensure we create personalized interactions that leave a lasting impression, By leading a team of Claims Specialists you will be responsible for overseeing the end-to-end claims processes at a strategic level, making fast data driven decisions and ensuring we create a deep and ongoing empathy for our customers whilst providing clear guidance on helping them navigate the claims process You'll also advance team engagement through people and culture initiatives, and focus on their growth to nurture and develop world class talent, You will work as part of a cross-functional team to drive the success of the company's products and services You will be responsible for driving and executing strategies that also improve community engagement, and community protection, while ensuring operational excellence across the Aircover suite of products and services, A Typical Day Bring and share strategic vision for the end-to-end customer claims handling experience, including dispute resolution and feedback management Collaborate on the development and implementation of new policies and procedures to ensure our service delivery is effective and delivers a seamless experience for our community Manage and lead the Claims operations team in ACC Gurgaon, ensuring optimal delivery of performance and productivity Support and work with senior leadership to develop and execute on our one-company roadmap and Aircover strategic pillars, Develop and maintain relationships with external partners, such as insurance carriers and claims adjusters, to ensure that claims are handled efficiently and effectively, Inform the business on team performance metrics and quality, identifying opportunities to improve the customer experience, and driving upstream changes with operations and product leaders, Partner closely with cross-functional teams to deliver a scale-first organization by aligning on key metrics, goals & deliverables Strive for the continuous improvement of our operational workflows and processes Analyze performance data to identify opportunities for process improvements and optimization of the customer experience Collaborate to design strategies to improve customer engagement, community building, and community protection Ensure the operations team is fully aligned with the company's mission, values and roadmap Drive key initiatives to improve growth, engagement and belonging within the team You will be responsible for reporting at Weekly, Monthly, Quarterly and Annual Business Reviews for your area, You will build, foster and support your team, while holding team members accountable to expectations and performance, You will serve as a thought leader with stakeholders such as Trust, Legal, Privacy, CS Safety, Product Management, Policy, and understand how the policy/product roadmap impacts risk mitigation of emerging threats, Your Expertise 10+ yearsexperience in customer experience management and operational excellence, preferably in high tech and/or insurance organizations, Strong track record (> 5 years) of leading, recruiting, and coaching high performing teams at a global level, Insurance experience preferred In depth understanding of claims handling processes and regulations, Knowledge of customer experience best practices and trends Open, collaborative style with a Airbnb-first mentality, Proven track record of developing and executing successful strategies tailored to specific customer experience groups Ability to operate within a constantly changing environment with strong bias for action, including the ability to juggle multiple priorities and effectively deliver in a fast-paced, dynamic environment, Demonstrated ability to identify and resolve issues through effective problem solving skills, Proven ability to negotiate skilfully in difficult situations with both internal and external groups, Hybrid Work Requirements & Expectations: To support productivity and maintain a professional hybrid work environment, employees are expected to adhere to the following: Workspace: A dedicated, quiet, and private workspace free from interruptions and external noise Internet Connectivity: During the working hours, maintain a minimum and consistent internet speed of 10 Mbps on your official devices to ensure reliability for work-related tasks, including calls and virtual meetings Professionalism: Employees must remain fully engaged, respectful, and maintain a professional presence during virtual meetings, with video participation required unless otherwise approved, Confidentiality & Security: Employees are responsible for protecting Airbnbs Intellectual Property and Confidential Information Work-related activities, including calls and meetings, must not be conducted in public places, while traveling, or in any setting that may compromise confidentiality or work quality, Our Commitment To Inclusion & Belonging Airbnb is committed to working with the broadest talent pool possible We believe diverse ideas foster innovation and engagement, and allow us to attract creatively-led people, and to develop the best products, services and solutions All qualified individuals are encouraged to apply,

Job Summary: We are seeking a dedicated and detail-oriented professional to manage insurance claims on behalf of clients across various lines of business. The ideal candidate will ensure accurate documentation, effective coordination with insurers, and timely settlement of claims, while maintaining high standards of service and compliance. Key Responsibilities: Register and manage claims across multiple insurance segments (e.g., Health, Motor, Property, Marine, etc.) Liaise with clients and insurance companies to collect required claim documents and provide status updates Monitor and ensure timely follow-ups to drive claim resolution and settlements Maintain accurate claim records and prepare regular MIS reports for internal and client use Ensure adherence to regulatory requirements and internal company standards throughout the claims process Proactively follow up with insurers to expedite claim approvals and settlements Escalate delays, disputes, or complex claims to senior management or resolve through effective negotiation Candidate Requirements: Graduate degree (preferably in Commerce, Insurance, or a related field) Minimum 2 years of experience in claims handling within a broking firm or insurance company Strong knowledge of insurance products and end-to-end claim processes Effective communication and interpersonal skills, with a focus on client servicing and coordination High attention to detail and the ability to manage multiple claims simultaneously

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

Role & responsibilities Impact the Bottom Line: Drive the performance of a team of Consultants, meeting and exceeding all KPI targets. Strengthen Relationships: Manage attrition, shrinkage, and other critical metrics of the team. Influence the Lives of Others: Coach and mentor Consultants, providing feedback and performance management. Keep Management Updated: Inform leadership on the latest trends of end-user customers and provide feedback to Ops Managers. Define Sutherland's Reputation: Drive organizational initiatives within the team from time to time. Preferred candidate profile Minimum 5 years experience in the field of Property & Casualty Insurance, specifically handling claims. Minimum 2 years experience in team handling. Open to rotational shifts and working from office 5 days a week.

Job Title: MBBS Medical expert- Claim & Insurance (Claim Adjudication & Medical Auditor) Location: Delhi/NCR Key Responsibilities Review and adjudicate medical claims for accuracy, completeness, and compliance with established guidelines and protocols. Evaluate clinical documentation and medical necessity to ensure appropriate utilization and minimize fraudulent claims. Support the development and implementation of medical audit frameworks and tools. Collaborate with internal teams, insurers, and government stakeholders for scheme design and policy formulation. Analyze claim trends, identify irregularities, and propose corrective and preventive actions. Provide expert insights and recommendations on complex medical claims and health benefits adjudication. Contribute to the design and delivery of training programs related to claims processing, auditing, and compliance. Assist in drafting SOPs, process manuals, and operational guidelines for public health insurance schemes. Participate in healthcare policy evaluation, scheme monitoring, and audit assignments for state and national-level projects. Required Qualifications & Skills Essential: MBBS from a recognized university. Minimum 3 years and 7 years of post-qualification experience in the healthcare or health insurance sector. Health insurance or underwriting. Healthcare practice or claim processing/medical insurance services. Healthcare schemes or claims management/medical auditing. Strong analytical skills with an investigative approach to claim validation. Knowledge of ICD codes, medical billing, and healthcare regulations. Desirable: MD from a recognized university or institute. Proven experience in health insurance, medical underwriting, claims adjudication, or medical audit. Familiarity with government-sponsored health schemes (e.g., PM-JAY, state insurance programs). Strong analytical mindset with attention to detail and a structured investigative approach. Proficiency in using health claims management systems and audit tools. Excellent written and verbal communication skills. KPMG India has a policy of providing equal opportunity for all applicants and employees regardless of their color, caste, religion, age, sex or gender, national origin, citizenship, sexual orientation, gender identity or expression, disability, or other legally protected status. As an equal opportunity employer, KPMG is committed to fostering a culture where everyone feels welcomed and is treated fairly. If you have any reasonable accessibility or accommodation requirement that will make you more comfortable during the assessment and recruitment process, please let us know and our Talent Acquisition colleague will connect with you

Job Summary: We are seeking a dedicated and detail-oriented professional to manage insurance claims on behalf of clients across various lines of business. The ideal candidate will ensure accurate documentation, effective coordination with insurers, and timely settlement of claims, while maintaining high standards of service and compliance. Key Responsibilities: Register and manage claims across multiple insurance segments (e.g., Health, Motor, Property, Marine, etc.) Liaise with clients and insurance companies to collect required claim documents and provide status updates Monitor and ensure timely follow-ups to drive claim resolution and settlements Maintain accurate claim records and prepare regular MIS reports for internal and client use Ensure adherence to regulatory requirements and internal company standards throughout the claims process Proactively follow up with insurers to expedite claim approvals and settlements Escalate delays, disputes, or complex claims to senior management or resolve through effective negotiation Candidate Requirements: Graduate degree (preferably in Commerce, Insurance, or a related field) 25 years of experience in claims handling within a broking firm or insurance company Strong knowledge of insurance products and end-to-end claim processes Effective communication and interpersonal skills, with a focus on client servicing and coordination High attention to detail and the ability to manage multiple claims simultaneously

About Navi Navi is one of the fastest-growing financial services companies in India providing Personal & Home Loans, UPI, Insurance, Mutual Funds, and Gold. Navi's mission is to deliver digital-first financial products that are simple, accessible, and affordable. Drawing on our in-house AI/ML capabilities, technology, and product expertise, Navi is dedicated to building delightful customer experiences. Founders: Sachin Bansal & Ankit Agarwal Know what makes you a Navi ite : 1. Perseverance, Passion and Commitment Passionate about Navis mission and vision Demonstrates dedication, perseverance, and high ownership Goes above and beyond by taking on additional responsibilities 2. Obsession with high-quality results Consistently creates value for the customers and stakeholders through high-quality outcomes Ensuring excellence in all aspects of work Efficiently manages time, prioritizes tasks, and achieves higher standards 3. Resilience and Adaptability Adapts quickly to new roles, responsibilities, and changing circumstances, showing resilience and agility Key Responsibilities: Review submitted health claims for accuracy, completeness, and compliance with insurance policies and applicable regulations. Identify any inconsistencies, overbilling, or discrepancies between services provided and the claims submitted Detect potential fraudulent claims by analyzing patterns and identifying suspicious activities or behaviors Providing detailed reports on audit findings, Decision accuracy, including identifying overpayments, underpayments, or fraudulent activities Recommend actions based on findings, such as denying, reducing, or adjusting claims Communicate audit results and findings to management and external stakeholders Suggest process improvements to enhance the efficiency and accuracy of the claims audit process. Stay updated with industry trends, regulations, and changes in healthcare policies that may impact claims auditing Provide guidance and training to claims team members or other related stakeholders Investigating medical claims to identify fraud Automate system and bring in improvements on claims processes Team Management- Build and manage the team of doctors supporting the function The role involves identifying discrepancies, fraud, or errors in claims to ensure compliance with health insurance policies and regulatory requirements What are some of the good to have skills for this role? Medical Graduate in any stream (MBBS/BHMS/BAMS/BUMS/BDS) Experience in handling audit Background in claims processing with clinical experience in a hospital setting Data analytics experience would be an added advantage Knowledge of different languages would be an added advantage. Proficiency in Hindi and English is mandatory. Knowledge of health insurance policies and regulations, IRDAI circulars is must Strong analytical and problem-solving skills. Excellent attention to detail and ability to spot discrepancies Ability to anticipate potential problems and take appropriate corrective action Effective communication skills for working with different stakeholders Time management skills to meet deadlines. Should have a broad understanding of Claims Practice Sharp business acumen to understand health insurance claim servicing needs Excellent communication skills, including writing reports and presentations

Primary Responsibilities Team Handling Handle a team of 3050-member team, including SMEs and leads Effectively monitor the team's performance Track team's performance through intelligent reporting Conduct one-o-ones with team in timely manner Resolve team’s issues in a timely manner and motivate team to deliver in a highly complex and dynamic environment Should be able to convey leadership messaging Able to work in complex environments and should be able to multitask Prepare weekly and monthly reports/dashboards Be able to prepare and run client weekly/monthly presentations Track and report Risk and Compliance matters promptly Excellent understanding of P&C Auto Insurance processes Good skills and knowledge of leadership, facilitation, conflict resolution Excellent in logical and reasoning skills, ability to analyse the requirements Be innovative, open minded and progressive in thinking Can coordinate and do follow ups with stakeholders Excellent communication skills, both written and verbal - should be able to interact with client partners independently. Be open to work with other peers and team members as required by the Management Should be a competent user of MS Office including Word, Excel, PowerPoint, SharePoint, Teams and Outlook

Role & responsibilities: Handle and process insurance claims (Property, Casualty, Motor, Liability, or Employee Benefits) as assigned. Serve as the primary point of contact for clients, insurers, and third parties regarding claim status and inquiries. Perform claim intakes , document claim details, and validate policy coverage. Work independently (or with the AM / CSA) to manage and resolve queries from Clients and Claims adjusters / Reinsurers, seeking assistance as required ensuring escalation where necessary and resolution with minimum delay. Evaluate and negotiate settlements , ensuring fair and timely resolution. Maintain accurate and up-to-date claim records in the system. Prepare claim reports, summaries , and assist with trend analysis. Ensure compliance with regulatory standards , internal policies, and service level agreements (SLAs) . Escalate complex or fraudulent claims appropriately. Contribute to process improvements and client retention efforts. Preferred candidate profile: Minimum 5 years of experience in claims handling , insurance operations, or related fields (freshers with strong internships may be considered for junior roles). Understanding of insurance products and claims procedures . Excellent communication and customer service skills. Strong attention to detail, organizational, and time-management abilities. Proficiency with claims management software (e.g., Guidewire, Claim Center, or similar) and MS Office tools. Interested candidates can share their cv on below mentioned mail id: sonaly.sharma@crescendogroup.in References are highly appreciated.

CVminimizationrisk Join Hella Infra Market Limited as an Insurance Specialist Are you an expert in handling trade credit and corporate insurance policies? We're looking for a skilled professional to manage end-to-end insurance operations and ensure minimised across our diverse business operations. Key Responsibilities: Manage and oversee Trade Credit Insurance and ensure full compliance. Handle a broad range of corporate insurance products such as Fire, Electronic Equipment, PII, Machinery Breakdown, Liability, Contractor's Plant and Machinery, Transit, and D&O policies. Process claims and coordinate with insurers and brokers to ensure timely settlements. Draft, renew, and manage proposals, endorsements, and policy modifications . Communicate effectively with internal and external stakeholders. Negotiate coverage, premiums, and discounts to secure optimal insurance terms. Prepare and manage insurance MIS and reports for leadership review. Key Skills & Competencies: Strong understanding of corporate/general insurance and claims processing . Effective negotiation and analytical skills . Excellent verbal and written communication . Proficient in MIS/reporting . Ability to juggle multiple policies and ensure seamless execution. Share your cv at sahil.sangurdekar@infra.market Why Hella Infra Market Limited? Join one of the leading names in infrastructure, known for innovation, scale, and impact. If you thrive in high-performance environments and are ready to take ownership of critical insurance functions, this is the place for you.

Opening with a leading Insurance Industry for their office in Hyderabad. Role: Claims Processing-Life Insurance Location: Hyderabad Experience: 3-4Years+ Qualifications: Graduation/Postgraduation (Any) Roles & Responsibilities: Team Leadership: Supervise and motivate a team of claims professionals. Provide guidance, training, and support to ensure optimal performance. Foster a positive and collaborative team culture. Claims Processing: Oversee the end-to-end life insurance claims process. Review and assess claim documentation for accuracy and completeness. Ensure adherence to company policies and regulatory requirements. Beneficiary Communication: Communicate with beneficiaries in a compassionate and understanding manner. Address inquiries and provide clear explanations of the claims process. Collaboration: Liaise with other departments, such as underwriting and legal, to resolve complex claims. Collaborate with external partners, such as medical professionals or investigators, when necessary. Quality Assurance: Implement quality control measures to maintain accuracy in claims processing. Regularly review and update departmental procedures to enhance efficiency. Reporting: Prepare and present regular reports on claims processing metrics and team performance. Provide insights to senior management for continuous improvement/New Trends etc. Authority Reports such as BAP, Monthly/Quarterly/Annually statistics by reconciliation with accounts. Qualifications : Bachelor's degree in business, finance, or a related field. Proven experience in life insurance claims processing, with at least 5-7 years in a managerial role.In-depth knowledge of insurance regulations and industry best practices. Strong leadership, communication, and interpersonal skills. Interested Candidates can share their CV's at afreen@topgearconsultants.com

Role: Claims Associate - P&C, Insurance, Healthcare, claims processing, claims adjudication Voice Process (WFO) Qualification: Graduates only Shifts: 24/7 rotational shifts Week Offs: 2 rotational week offs Notice Period- immediate joiners Salary: Hike on last Transport: Two-way cab with 25 km radius (no transport allowance will be provided) You should have voice or semi-voice claims experience, knowledge of property and casualty claims with a minimum of 12 months experience. • Agent will be supporting Global customers except China and Japan • No relocations • Night allowance Onsite Permanent Role Interested can contact me on 7678666623

Job Profile - To Analyze the risk-based performance and strategize the premium flow to the Insurers with a goal to meet the desired bottom line of the organization. Role & responsibilities Claim ratio calculation, monitoring and publishing the claim ratio dashboard. Holding primary discussions with key stakeholders (internally) along with Insurers, Reinsurers and Brokers for sharing findings, way ahead for programs/policies and settlement. Providing insights on loss ratios, risk dynamics and their impact on business performance. Calculating in depth analysis of any anomalies observed in claim/loss ratios trends. Providing key findings for product/category in terms of data requirement from risk. Discussions with insurers/Reinsurers and brokers for regular renewal management and placement of new business. Preparing Program notes for Insurers to quote. Maintaining cordial relationships with Insurers, Reinsurers, and brokers To drive tech enabled automations with an intent for process excellence. Education & Experience Graduation required & MBA will be an added advantage 8-10 years of experience in Claims/ Underwriting. Should be working for a general insurance company or Insurance broker Skills, Abilities and Competencies Ability to engage with Employees across levels Ability to handle conflicts and grievance handling Effective Negotiation skills High level of empathy with good listening skills Strong people skills to assess behavioral & values alignment Highly skilled in process management with eye for detailing Behavioral Attributes Go-Getter, self starter Bias for action, Execution & speed Open to ideas and eager to experiment Collaborative approach with ease in dealing with multiple stakeholders and teams Task focused with Interested can share CV on given id sangeeta.rajput@techguard.in

Hiring Role: Process Specialist & Team Lead Minimum 6 to 8 yrs of Exp in Order Management and Logistic, with at least 2+year of Exp In Team Handling within a BPO/BPM environment Any Graduate Immediate joiners Only Good Communication

Job Title: Medical Claims Specialist Reports to: Mediclaim Job Type: Full-time Role & responsibilities : Review and analyze medical claims for accuracy, completeness, and compliance with insurance policies and regulations Verify patient and policyholder information, including eligibility and coverage details Examine medical records, procedures, diagnoses, and treatment codes to determine the validity of claims Investigate and resolve claim discrepancies, errors, or fraudulent activities Communicate with healthcare providers, policyholders, and other stakeholders to gather additional information and clarify claim details Evaluate medical necessity and appropriateness of treatments, procedures, and services Adjudicate claims according to established guidelines and procedures Process claim payments accurately and in a timely manner Document claim decisions, actions taken, and communication with stakeholders Stay updated on changes in medical billing codes, regulations, and industry trends

JOB PURPOSE The job holder is responsible of serving providers and insurance companies by determining requirements, answering inquiries, resolving problems, fulfilling requests and maintaining database. He/She is responsible for processing as per terms of benefits. He/She should provide accurate and relevant medical coverage details and maintain pre-approvals and claims processing as per the defined terms and policies of the organization. RESPONSIBILITIES AND DUTIES Processes claims from members and providers. Assists queries from providers and payers via phone calls or e-mails. Maintains files for authorizations and other reports. Assesses and processes claims in line with the policy coverage and medical necessity. Be fully versed with medical insurance policies for various groups / beneficiaries. May assist in training colleagues and asked to share knowledge. Accurately assesses eligibility within the policy boundaries. Monitors and maintains the claims processing as per the defined terms and policy of the organization. Achieves required processing targets assigned by the team leader on daily, weekly and monthly basis. Monitors the qualitative and quantitative measures for claims & pre-approvals. Ensures compliance to any changes in terms of system parameters or process. Maintains quality as per framework for accuracy. Maintains productivity and responsiveness to the work allocated. Collaborate with other stakeholders / teams to resolve queries including complex queries. Actively support all team members to enable operational goals to be achieved. Meet or exceed Service Level Agreement requirements, team KPI(s), monthly quality audit scores and NPS (Net Promoter Score). Assessing and processing claims for medical expenses while always bearing in mind the importance of medical confidentiality. Accurate data input to the system applications. Positioning him/herself analytically and critically in the context of cost management and in respect of existing working methods. Following up own workload (volume and timing): keeping an eye on chronology and processing time of the work volume and taking suitable actions. Participate efficiently in processing the flow of claims: inform the supervisor about claims lacking clarity and about possible ways of optimizing the processes. A sustained effort towards high-quality claims handling, accurate reimbursements and fast transactions are important motivators. Monitor and highlight high-cost claims and ensure relevant parties are aware. Follow Claim Manual and SOP strictly, adjudicate claims according to benefit policies, and meet both financial/procedure accuracy and TAT target on claims adjudication. Adjust error claims according to actual situation. Well handle recoupment and reconciliation work, communicate with providers and members via call and email for collection and explanation. Work with cross function teams, such as Finance, CSR, Eligibility, Network, Client Management, etc. Ensure recoupment work go smoothly. Actively support Team Leader and work with claim colleagues to enable all operational goals to be achieved KNOWLEDGE, SKILLS AND EXPERIENCE At least 1-2 years of experience performing a similar role. Experience of working for an international company, preferred but not essential. Claims processing or insurance experience, preferred but not essential. Broad awareness of medical terminology, advantageous. Excellent organizational skills, capable of following and contributing to agreed procedure. Strong administration awareness and experience, essential. Strong skills in Microsoft Office applications, essential. First class written and verbal communication skills, essential. Ability to communicate across a diverse population, essential. Capable of working independently, or as part of a team. Good time management, ability to work to tight deadlines. Flexible and adaptable approach, sometimes working in a fast-paced environment. Passion for achieving agreed objectives. Confident in calling out when facing issues. Should be flexible to work in shifts and on staggered weekends for overtime. COMMUNICATIONS AND WORKING RELATIONSHIPS The job holder must ensure building strong effective relationships with all his matrix partners and demonstrating approachability and openness. He/ She must be able to foster strong internal and external communication standards. Education * : Graduate (Any) - medical, Paramedical, Commerce, Statistics, Mathematics, Economics or Science. Experience Range * : Minimum 1-2 years and up to 3 years of experience in processing of healthcare insurance claims. Foundational Skills * Expertise in internati claims processing Work Timings * : 7:30AM to 4:30PM IST(Flexible shift) Job Location * : Bengaluru (Bangalore)

Job Opening: Claims Associate International Voice Process Location: Bangalore Salary: 2 LPA to 4.5 LPA Working Days: 5 days a week Week Off: 2 rotational offs Key Skills: Excellent English communication Ability to handle customer queries professionally Good problem-solving skills Willingness to work in night shifts & rotational offs Prior experience in international voice process preferred (optional) How to Apply: Contact HR Aradhna 8209505273

!!HELLO JOB SEEKERS!! !!GREETING FROM SHINING STARS!! INVITING APPLICATIONS FOR CLAIMS PROFILE BANGLORE LOCATION. SO WHO ARE LOOKING FOR A CHANGE INTO THE SAME DOMAIN CAN APPLY. LANGUAGES REQUIRED - English + Kannada LOCATION - Bangalore ( Kundan Halli ) Only Graduates are welcomed. 1 year Experience in voice. PROFILE - CLAIMS ASSOSSIATE. SALARY - UP TO 4.5 LPA 5 days Working Both side Cabs Shifts - 24/7 rotational shifts WORK FROM OFFICE INTERVIEW MODE: WALK-IN Role & responsibilities- Review insurance claims forms and related documents to determine eligibility and coverage. Verify the validity of claims and ensure all necessary documentation is complete. Enter claim data into the insurance company's management system and maintain accurate records. Update claim files and track progress to ensure timely resolution. Preferred candidate profile Only Graduate can apply. Minimum 1year Experience can apply. Should be comfortable in English and Kannada language. Should be comfortable with working from office. INTERESTED CANDIDATES CAN APPLY THROUGH THIS POST, CONNECT VIA CALL OR CAN DROP CV's ON THE NUMBERS MENTIONED BELOW Alok - `9792779366 Regards, Alok Srivastava HR executive Shining Stars ITPL #claims #voiceprocess #claimsprocess #claimsassociate #insuranceclaims #healthinsuranceclaims #propertyandcasualty #casualtyinsuranceclaims #usprocess #USCLAIMS #healthcare #bangalore #bangalorelocation #bangalorejobs

Job Description!!!!!!!!!!! Greetings from Sutherland! Currently we are hiring for International Claims Associate!!! Role & responsibilities An Voice Job is a job where the executives are assigned to handle the voice process from clients in different countries, particularly the U.S., Dubai etc. These jobs include product and service support or technical support in which the customer is calling to solve an issue. Preferred candidate profile: *Must be fluent in English *Excellent Communication can Apply *Only for experience candidate *Only Graduate can apply. *24/7 shifts and rotational week offs (5 days working a week) *ROI - JAM, Assessment & Operations Round *Two-way cab facility only in night shift within 25Kms only from office premises *Candidate who is comfortable working from office can apply ,Needed Immediate Joiners only. *Virtual Interview is available *Out of station candidates are Strictly not eligible *Pursuing education candidates are strictly not eligible Perks and benefits You'll develop your emotional intelligence. You'll learn your product or service, inside and out you'll build transferable Skills. you can educate customers without selling. you can develop a side project. you'll learn how to effectively solve problems. ONLY FOR THE CANDIDATES WHO ARE GOOD AT ENGLISH COMMUNICATIONS CAN APPLY FOR THE OPPORTUNITY. * Interview Rounds 1. HR 2. Assessment 3. Operations Note: Virtual interview & Immediate joiners only . Address: Unit no 202,2nd floor,Campus D, Centennial Business park, kundan Halli main road, EPIP Area, Bang,karnataka India 560066 Interested candidates please share resume on the below mentioned contact and do not contact after 6pm Timings to contact HR : 11am to 5pm Nandini 7569452008

JOB PURPOSE The job holder is responsible of serving providers and insurance companies by determining requirements, answering inquiries, resolving problems, fulfilling requests and maintaining database. He/She is responsible for processing as per terms of benefits. He/She should provide accurate and relevant medical coverage details and maintain pre-approvals and claims processing as per the defined terms and policies of the organization. RESPONSIBILITIES AND DUTIES Follow Claim Manual and SOP strictly, adjudicate claims according to benefit policies, and meet both financial/procedure accuracy and TAT target on claims adjudication. Adjust error claims according to actual situation. Monitor and highlight high-cost claims and ensure relevant parties are aware. Well handle recoupment and reconciliation work, communicate with providers and members via call and email for collection and explanation. Processes claims from members and providers. Assists queries from providers and payers via phone calls or e-mails. Maintains files for authorizations and other reports. Assesses and processes claims in line with the policy coverage and medical necessity. Be fully versed with medical insurance policies for various groups / beneficiaries. May assist in training colleagues and asked to share knowledge. Accurately assesses eligibility within the policy boundaries. Monitors and maintains the claims processing as per the defined terms and policy of the organization. Achieves required processing targets assigned by the team leader on daily, weekly and monthly basis. Monitors the qualitative and quantitative measures for claims & pre-approvals. Ensures compliance to any changes in terms of system parameters or process. Maintains quality as per framework for accuracy. Maintains productivity and responsiveness to the work allocated. Collaborate with other stakeholders / teams to resolve queries including complex queries. Actively support all team members to enable operational goals to be achieved. Meet or exceed Service Level Agreement requirements, team KPI(s), monthly quality audit scores and NPS (Net Promoter Score). Assessing and processing claims for medical expenses while always bearing in mind the importance of medical confidentiality. Accurate data input to the system applications. Positioning him/herself analytically and critically in the context of cost management and in respect of existing working methods. Following up own workload (volume and timing): keeping an eye on chronology and processing time of the work volume and taking suitable actions. Participate efficiently in processing the flow of claims: inform the supervisor about claims lacking clarity and about possible ways of optimizing the processes. A sustained effort towards high-quality claims handling, accurate reimbursements and fast transactions are important motivators. Monitor and highlight high-cost claims and ensure relevant parties are aware. Follow Claim Manual and SOP strictly, adjudicate claims according to benefit policies, and meet both financial/procedure accuracy and TAT target on claims adjudication. Adjust error claims according to actual situation. Well handle recoupment and reconciliation work, communicate with providers and members via call and email for collection and explanation. Work with cross function teams, such as Finance, CSR, Eligibility, Network, Client Management, etc. Ensure recoupment work go smoothly. Actively support Team Leader and work with claim colleagues to enable all operational goals to be achieved KNOWLEDGE, SKILLS AND EXPERIENCE At least 3-4 years of experience performing a similar role. Experience of working for an international company, preferred but not essential. Claims processing or insurance experience, preferred but not essential. Broad awareness of medical terminology, advantageous. Excellent organizational skills, capable of following and contributing to agreed procedure. Strong administration awareness and experience, essential. Strong skills in Microsoft Office applications, essential. First class written and verbal communication skills, essential. Ability to communicate across a diverse population, essential. Capable of working independently, or as part of a team. Good time management, ability to work to tight deadlines. Flexible and adaptable approach, sometimes working in a fast-paced environment. Passion for achieving agreed objectives. Confident in calling out when facing issues. Should be flexible to work in shifts and on staggered weekends

1 To investigate and verify insurance health claims 2 Required to work on computers and make calls to our clients 3 discuss cases with patients and doctors. We provide full training