6244 Claims Jobs - Page 10

Skill Set: Strong knowledge on motor insurance. Knowledge of the insurance process (quote, policy issuance, finance, claims). Expertise in any one of the processes is a must. Hands-on exp. with SQL and API Integration. A Good Understanding of Java, microservices, and web services is an added advantage. Good communication/interpersonal skills. Job Requirements: Liaise with the internal business team (Sales, Underwriting, Actuary, Operations, Claims and Finance) and external partners to ensure a mutual understanding of processes and applications. Requirements elicitation and System solution designing. Define the customer journey. Coordination with development team on project planning & deliver...

Current Designation: Sr Executive Fire General Insurance Department/Group: General Insurance Location: Mumbai Kandivali Position Type: Full-Time Reporting Relationship Reports to: Operations Manager Positions Supervised Runner Boys Internal Relation: Customer Service, Sales External Relation: Insurance Companies, Customers Required Skills Behavioral Functional 1. Customer Driven Should be concerned that the customer does not miss the deadline and effectively guide themwith the rightsolutions 2. Effective Communicator - As much as you might prefer email and text messaging, insurance business still gets done over the phone. 3. Time Management - A renewal is late if all renewal requirements are...

Cognizant Walk-in drive for US Healthcare -Claims Process at Chennai location. Interview Date : 8th Nov 2025 (Saturday) Interview Time : 10:00 AM to 1:00 PM Venue - Cognizant CKC - SEZ Ave, Elcot Sez, Sholinganallur, Chennai, Tamil Nadu 600119 Building Details: Cafeteria - 1st floor, Wing - B. POC: Babu/Aswini Preferred candidates Profile: Overall experience required - 2 to 5 years Minimum 2 years of experience in US Healthcare Claims adjudication, Grievance and Appeal, PDM, Credentialing. Prior experience in claims/knowledge preferred Notice Period : Immediate to 30 days Preferred Education: Graduation is must Must have good communication skills Should be ready to work in Night shift (US Sh...

Role & responsibilities Property and Casualty Insurance International domain Should have experience in Claims or Underwriting Should have experience in client handling Good Communication Should be flexible working in US Shift Should be ready to work in Work from Office Preferred candidate profile Graduate

Claims Processing Dr Job Qualifications and Requirements: Required : BDS, BHMS, BAMS, MD, Pharm D Graduates. Job Description: 1. Along with the medical expertise, need to master the various products ( Policies) and to apply the terms and conditions during claim processing. 2. Claims processors process any claim payments when applicable and must ensure they comply with federal, state, and company regulations and policies. 3. To coordinate with various persons (Claimant, Treating Physician, Hospital insurance desk, Field Visit Drs, Investigation officers)for hassle-free claim processing 4. Medical claims processor will have to look into claims where payment was denied. Commonly due to issues o...

Roles and Responsibilities Manage accounts receivable calls to resolve customer queries, disputes, and issues related to medical billing. Identify and address denials by investigating root causes, appealing denied claims, and ensuring timely resolution. Collaborate with internal teams such as revenue cycle management (RCM) staff to resolve complex billing issues. Maintain accurate records of all interactions with patients, providers, and insurance companies. Utilize strong communication skills to effectively communicate with customers over the phone or through email correspondence. Desired Candidate Profile 2-4 years of experience in AR calling, US healthcare medical billing, claims processi...

Job Description: 4+ years of experience with Guidewire BillingCenter development. Strong proficiency of Guidewire Data Model, Gosu programming & BillingCenter configuration. Solid understanding of Billing processes in the P&C insurance domain. Excellent problem-solving & communication skills. Familiarity with SOAP/REST APIs, integration tools & DevOps practices. Guidewire Certification (BillingCenter Developer or Architect). Experience with other Guidewire modules (PolicyCenter, ClaimCenter) a plus. Familiarity to Scrum methodologies. Experience with CI/CD pipelines & DevOps Tools. Configure and customize Guidewire BillingCenter modules. Knowledge of insurance domain & business processes. Co...

Department : Health Claims Medical Position Overview Looking to leverage your medical expertise in a dynamic insurance environment As a Claims Associate Medical, you will play a key role in ensuring the accuracy, quality, and integrity of health claims decisions by applying clinical knowledge, regulatory awareness, and strong attention to detail. This role demands a balance of technical understanding and operational execution. Key Responsibilities Claims Processing: Review, analyze, and process health claims accurately and within turnaround time (TAT) as per internal SOPs and regulatory norms. Medical Review: Assess the clinical validity of diagnoses, treatments, and procedures in submitted ...

Be the voice and bridge of Digits health claims teamdeliveringexceptional service and communication to clients, partners, and internalstakeholders. Youll manage end-to-end claim servicing and play a key role inrelationship building and process awareness. Key Responsibilities Manage inbound and outbound calls/emails , resolving queries related tohealth claims swiftly and empathetically. Provide end-to-end service to clients , ensuring all touchpointsSales, HR, Brokers, Agentsare engagedand informed. Act as the central coordinator for query resolution by working closely withinternal teams (processing, tech, product, etc.). Conduct interactive sessions with employees/HR to explain coverage, pro...

SUMMARY About The Client : A Fortune 500 global leader in technology services and digital business solutions, this company delivers comprehensive Business Process Services (BPS) and IT-enabled solutions. With a worldwide presence, it serves diverse industries including banking, healthcare, retail, manufacturing, and communications. The firm's expertise spans a broad spectrum of critical processes from finance and accounting to human resources, customer service, and supply chain management - enabling clients to enhance efficiency, drive innovation, and achieve business agility on a massive scale. Job Title: Senior Process Executive (SPE) Domain : P & C Insuranc e operations ( Guidewire with c...

JOB DETAILS 1.Direct and coordinate the activities of all security personnel. 2.Ensure that all security staff provides services that are above and beyond for customer satisfaction and retention. 3.Ensure the safety and security of guest, staff, visitors and contractors at all times. 4.Responsible to manage all safety & security, Fire Life Safety and food hygiene risks faced by the hotel. 5.Liaise with all department heads to ensure hotel employees are adhering to established security procedures. 6.Record and notify all risks, deviations from hotels safety standards and any untoward incidents. 7.Track departmental safety record and document medically treated and non-treated injuries. 8.Overs...

JOB DETAILS 1.Direct and coordinate the activities of all security personnel. 2.Ensure that all security staff provides services that are above and beyond for customer satisfaction and retention. 3.Ensure the safety and security of guest, staff, visitors and contractors at all times. 4.Responsible to manage all safety & security, Fire Life Safety and food hygiene risks faced by the hotel. 5.Liaise with all department heads to ensure hotel employees are adhering to established security procedures. 6.Record and notify all risks, deviations from hotels safety standards and any untoward incidents. 7.Track departmental safety record and document medically treated and non-treated injuries. 8.Overs...

JOB DETAILS 1.Direct and coordinate the activities of all security personnel. 2.Ensure that all security staff provides services that are above and beyond for customer satisfaction and retention. 3.Ensure the safety and security of guest, staff, visitors and contractors at all times. 4.Responsible to manage all safety & security, Fire Life Safety and food hygiene risks faced by the hotel. 5.Liaise with all department heads to ensure hotel employees are adhering to established security procedures. 6.Record and notify all risks, deviations from hotels safety standards and any untoward incidents. 7.Track departmental safety record and document medically treated and non-treated injuries. 8.Overs...

JOB DETAILS 1.Direct and coordinate the activities of all security personnel. 2.Ensure that all security staff provides services that are above and beyond for customer satisfaction and retention. 3.Ensure the safety and security of guest, staff, visitors and contractors at all times. 4.Responsible to manage all safety & security, Fire Life Safety and food hygiene risks faced by the hotel. 5.Liaise with all department heads to ensure hotel employees are adhering to established security procedures. 6.Record and notify all risks, deviations from hotels safety standards and any untoward incidents. 7.Track departmental safety record and document medically treated and non-treated injuries. 8.Overs...

Daily retrieval of bank activity (ACH, wire, lockbox and credit card) and ERP receipt activity and post payments to customer accounts Daily posting of cash receipts as well as SAP coding of deductions taken, by customer, as per remittance detail provided by customer/collections team Review of customer portal for remittance advice Processing of clearing and offsets as approved by management Review of accounts and presentation of offset proposals for Deductions Specialist review and approval Follow up, with deductions Specialist, as necessary on unapplied cash Requesting of Proof of Delivery (POD) from logistics partner(s) Filing of initial claims with carriers when PODs do not support deliver...

ERP: Workday Work on Vendor Master Data Management (Onboarding new suppliers and Modifications if any) Processing invoices and handling exceptions if any Payment batch creation and daily bank reconciliation activity (Payments pertaining to Employee expense payments and supplier payments) Amex administration Activity (Creation of new employee s credit card and regular reconciliation of outstanding credit card activities) Verifying and processing of employee expense claims (T&E Activity) Work with client contacts/vendors for timely resolution of pricing and quantity discrepancies on invoices and invoice exceptions Regular reporting involves daily/weekly/monthly reports (viz regular production ...

Collect, cleanse, and validate healthcare data that are not machine-readable. Maintain consistency and accuracy across datasets through regular validation and updates. Evaluate data outputs and flag inconsistencies or inaccuracies. Analyze datasets to identify anomalies, trends, and potential errors. Conduct detailed online research to gather, verify, and update data relevant to our product. Monitor real-time organizational changes by tracking Merger & Acquisition activities and updating relevant data accordingly. Contribute to building a linked dataset of the US healthcare ecosystem by mapping complex affiliation relationships among IDNs, hospitals, and providers using diverse data sources ...

o Develop In vitro capabilities & Technology pipeline to deliver consumer benefit through Sustainable materials & mechanistic insights o Drive Design of Experiments to strengthen expertise area through proof of science. o Build, learn and apply skills in cheminformatics skill to led technology funnel. o Build IP funnel for differentiated & exclusive consumer benefits o Delivers effective reporting of scientific data, including peer-reviewed publications o Communicate and work closely with global team to incorporate new technologies into product o Apply Growth Mind set through speed & teamwork Direct Reports Key Interfaces o S&T Scientists (cross functional expertise) o Design platform leader...

o Develop Multi-scale, modelling, Digital Material design capabilities to deliver materials to product and substrate insights o Validate Digital insights through In vitro protocols and proof of science. o Build pipeline of computational proof of principles based on Material, Product and Substrate o Build IP funnel for differentiated & exclusive consumer benefits o Delivers effective reporting of scientific data, including peer-reviewed publications o Communicate and work closely with global team to incorporate new technologies into product o Apply Thought leadership through speed & teamwork Direct Reports Key Interfaces o S&T Scientists (cross functional expertise) o Design platform leaders ...

12 -15+ years of experience as a Lead Consultant/Business Architect/Program Manager/ Product Manager with Healthcare Payer domain. Excellent Communication Skill and managing client stakeholders Experience in creating Business solutions . Worked on consulting presales activities Experience in executing Consulting Assessment programs Ability Gather, analyse, and document business and technical requirements for healthcare Programs Experience on core business applications in Enrolment, Claims. Payment areas (Facets, QNXT , NASCO etc ) Knowledge of CMS rating standards (STAR) and quality measures reporting Ability to Interpret and map HIPAA X12 EDI transaction sets (e.g., 270/271, 837, 835, 999) ...

We are seeking a dynamic IT Helpdesk Executive (Store InCharge ) to lead our comprehensive IT Asset Management operations while overseeing traditional store management functions. This hybrid role combines strategic asset lifecycle management with hands-on operational excellence, requiring a professional who can seamlessly manage technology assets from procurement through disposal while maintaining exceptional inventory control and vendor relationships. The ideal candidate will serve as the cornerstone of our IT asset ecosystem, ensuring optimal utilization, security, and compliance across all technology resources. Department & Reporting Structure Department: Information Technology Reports To...

Basic Function To ensure Preparation, assessment, monitoring and analysis of actuarial reservesUndertake or assist with assurance reviewsReport drafting and presentations and Report valuation results and quality assurance for central reserving teams Essential FunctionsCalculation of the quarterly best estimate reserves (including further design, refinement and modification of the current process)Support Capital and Reporting Requirements through: Calculation of the technical provisions and the ongoing maintenance and Standard Formula SCR models in line with updates to the directives from EIOPA and CAA (Luxembourg)Preparation of the QRTsClear communication of results, including key sensitivit...

Identification of process gaps / Data analysis Building network of vendor to support the activities Coordination with internal customers for smooth operation of the activity Compliance of define process Field verification / hospital / vendors / spot Safeguarding the interest of the Royal Sundaram GIC, Identification and Execution of projects to minimize /mitigate losses Identification & Eradication of fraud of any form Filing of police Complaint Complaint conversion to FIRs Venue Contact Royal Sundaram has published a position Investigation Lead at Ahmedabad Qualification-Medica Graduate

Should have experience with risk inspections/ technical presentations/ technical articles preparation/EML assessments for large risks Job Description Carry out inspections as per underwriting guidelines Carry out inspections for existing and prospective clients as the need arises Risk profiling of specific industry segment Bulletins/ Presentations on risk mgmt practices with strong hold on MS office Technical meetings with external customers Carry out EML assessments Value added services like safety audits, risk management programmes etc Support to marketing, underwriting and claims team Controlling costs on risk management services Ensure compliance of TAT for inspections Contribution of ar...

Nature of role Contracts Manager provides commercial service by managing complex, major systems prime contracts and where required; related sub-contracts. Together with the Project Management Team, the Senior Contract Manager proactively anticipates, identifies, analyses and informs management of the financial, legal and performance risks that can impact success. The role continues to manage its contractual obligations (internal and external) and keep management informed regarding performance under the assigned contracts/sub-contracts. Job Profile Conducts contract and sub-contract formation and administration activities on complex, major contracts for transit systems consisting of hardware,...