7662 Claims Jobs - Page 27

We are looking for a skilled Insurance Benefits Specialist to join our team at Multiplier. The ideal candidate will have a strong background in insurance benefits and excellent analytical skills. Roles and Responsibility Analyze and interpret complex insurance policies to determine benefit eligibility and coverage. Develop and implement effective claims strategies to maximize benefit payments. Collaborate with cross-functional teams to resolve customer complaints and issues. Conduct thorough research on new insurance products and services to stay updated on industry trends. Provide expert guidance on insurance benefits to internal stakeholders. Identify areas for process improvement and impl...

We are looking for a skilled Senior AirCover Specialist to join our team, with a strong background in handling complex air coverage cases. The ideal candidate will have excellent analytical and problem-solving skills, with the ability to work independently and as part of a team. Roles and Responsibility Handle complex air coverage cases with precision and accuracy. Analyze data to identify trends and patterns in air coverage performance. Develop and implement strategies to improve air coverage quality. Collaborate with cross-functional teams to resolve issues and enhance processes. Provide expert guidance on air coverage-related matters to stakeholders. Identify areas for process improvement...

Role & responsibilities Insurance Back-End Operations Handle insurance-related back-end operations . Ensure data accuracy , process claims, and update policy details. Support compliance and documentation tasks. Non-voice (mostly) role within BPO operations. Key Responsibilities Process insurance claims and policy applications . Update/validate ESI (Employee State Insurance) and other health insurance records . Manage policy renewals , premium payments , and perform data corrections . Verify employee details , eligibility , and coverage information . Work on Excel , internal ERP/CRM tools , and client-specific software . Maintain high data accuracy and meet daily SLAs (Service Level Agreement...

Level : 5A Location : India / GGN or BLR Reports to : OTC GPL Purpose of the role : The Business Analyst supports OTC foundation program by capturing, documenting, and analyzing business processes, data, policies and controls. The role ensures clarity and consistency in documenting the as-is” and “to-be” states, supporting process simplification and standardization efforts through structured analysis Key Responsibilities Develop project charters and value case for the projects assigned Lead and manage projects aligned Work closely with SMEs to gather, analyze, and document current process flows, controls, and pain points Partner with external vendors, governance SME’s, Service delivery, and ...

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Key Responsibilities: - Evaluate and process insurance claims to determine validity and payment eligibility. - Review documentation including claim forms, bills, and related records for accuracy and completeness. - Interpret policy terms to determine coverage and liability. - Detect and investigate potential fraudulent or suspicious claims. - Coordinate with internal teams and external stakeholders to resolve claim-related disputes. - Maintain proper documentation and ensure compliance with regulatory guidelines. - Support continuous process improvements to enhance claims operations efficiency. Requirements: - Bachelor's degree in Insurance, Healthcare Management, B.Pharma/ M.Pharma/ Pharm.D...

Openings for Executive - Freshers Key Responsibilities: Data Validation and KYC Validation Candidate can join immediate Job Location - Kilpauk,Chennai Working days - Monday to Saturday Interested Candidate can Directly Walkin tothe below venue. Vidal Health Insurance TPA Pvt.Ltd., Om sakthi Plaza, 2nd floor, Kilpauk Garden Road, Kilpauk,Chennai-600010. Regards Uday HR Vidal Health Insurance TPA Pvt Ltd.,

Job description Team Executive - Claims Adjudication(Prepay/Postpay) Location : Hyderabad Roles & Responsibilities: In-depth Knowledge and Experience in the US Health Care Payer System. 4 - 9 years of experience in Claims Adjudication(PrePay audit, Postpay audit) . With over 1 year of experience as a Team leader Proven track record in managing processes, streamlining workflows and excellent people management skills. Need to be a people centric manager who could articulate the employee challenges to the management as well as motivate the team towards desired project goals. Circulate quality dashboards at agreed periodic intervals to all relevant stake holders Adhering to various regulatory an...

Responsible for handling government/PSU/corporate empanelment's, coordinating with external authorities, managing billing follow-ups, ensuring compliance, and maintaining strong stakeholder relationships. Key Responsibilities Identify, submit, and renew empanelment's with government agencies, PSUs, and corporates. Act as the primary liaison for audits, inspections, and official communications. Ensure timely claim submission, track pending payments, and follow up for settlements. Maintain documentation, agreements, renewals, and compliance records. Coordinate internally for authorizations, approvals, and beneficiary support. Prepare weekly/monthly MIS on empanelments, claims, and payments. KP...

Job description: We are hiring Claims Adjudication! HR SPOC (Reference): Sam Jeshurin Position: CSA/Sr.CSA Division: Healthcare International Business Job Location: Firstsource Solution Limited, 5th floor ETA Techno Park, Block 4, 33 OMR Navalur, 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: Minimum 1 year experienced in Claims Adjudication!!!! Interested candidates Kindly share your resumes to Mobile (Whatsapp): 8825506927 Email: sam.jeshurin@firstsource.com Join us to be part of a dynamic team with career grow...

Role: AM IBA Specialty Claims Experience : 6-10 years Location : Pune Education : Any Finance Graduate (B Com , M Com, MBA- Finance, BBA) Work Mode : Hybrid Experience : Any Finance Graduate with 7 years of relevant experience in UK insurance domain, AP/AR and Claims Payment . Position Summary Team Manager with sound experience in Insurance Claim Payments / Insurer Payments (UK Insurance experience is mandatory) Primary Responsibilities Manage a team working on claims payments for UK region People management & client management experience is a must Conduct one on one sessions with team members Ability to analyze and prepare daily/weekly/monthly reports Communicate with onshore and offshore t...

Lead all contract management activities for metro rail projects, ensuring compliance with legal, regulatory, and project-specific requirements. Draft, review, and negotiate contracts with clients, contractors, consultants, and suppliers. Advise senior management and project teams on contractual matters, risk mitigation, claims, and dispute resolution. Monitor contract performance, variations, amendments, and close-outs to ensure project objectives are met. Coordinate with multidisciplinary teams to align technical, commercial, and legal contract terms. Manage contract documentation, records, and reporting for all project phases. Job Requirements Graduate in Civil or Electrical Engineering. M...

Communicate with insurance companies and other payers regarding unpaid claims and follow-up on outstanding Accounts Receivables. Verify the accuracy of patient-provided insurance information and prepare call notes. Initiate or execute corrective measures by sending necessary documents to Payers. Examine and sort unpaid insurance claims, and request an Explanation of Benefits (EOB) from the insurance provider if the claim has already been paid. Ensure timely resolution of claims by calling insurance companies and following up on outstanding accounts. Maintain accurate records of calls made, claims resolved, and follow-ups initiated. Job Requirements Graduate degree in any field. Sound knowled...

We are looking for a highly skilled and experienced Accounts Payable Associate to join our team in Chennai/Trivandrum. The ideal candidate will have 1-4 years of experience ensuring timely and accurate processing, payment, and reconciliation of creditor invoices, investigator payment requests, and employee expense claims. Roles and Responsibility Process accounts payable vouchers accurately and on time. Manage documentation in line with statutory requirements. Reconcile creditor accounts and assist in the month-end close process. Resolve issues with suppliers, investigators, and employees. Participate in AP re-engineering projects as needed. Ensure compliance with company policies and proced...

Hiring for Under writing ---- US - Process only Roles and Responsibilities' SHIFT TIMINGS - 6:30 PM - 3:30 AM KEY SKILLS Underwriting Insurance Underwriting New business Insurance Renewal Hiring for claims processing ! 1. Document Indexing Printing documents into Image Right folders and labeling the pages 2. Medicare Compliance Verifying Medicare status of claimants and reporting of claims 3. Deductible Reimbursement Invoicing Track and manage collection of delinquent deductible payments from members.

Primary Details Time Type: Full time Worker Type: Employee Delivering exceptional customer service and resolving customer enquiries to assist in the profitable growth of the direct business portfolio by performing quotes, renewals, policy maintenance and problem solving and relationship building with direct customers Primary Responsibilities Strategy and Planning Nil Policy, Process and Procedures Monitor and manage monthly budget are met Identify and implement best practice risk control and process improvements Attend relevant product and skill course, maintain product, system and process knowledge and pass on relevant points to other employees Monitor, review and maintain underwriting guid...

About Cognida.ai Our Purpose is to boost your competitive advantage using AI and Analytics. We Deliver tangible business impact with data-driven insights powered by AI. Drive revenue growth, increase profitability and improve operational efficiencies. We Are technologists with keen business acumen - Forever curious, always on the front lines of technological advancements. Applying our latest learnings, and tools to solve your everyday business challenges. We Believe the power of AI should not be the exclusive preserve of the few. Every business, regardless of its size or sector deserves the opportunity to harness the power of AI to make better decisions and drive business value. We See a wor...

Job Description - Business Analyst- Insurance Role Overview: The Business Analyst will be at the forefront of driving customer engagement and requirement gathering for application development specifically tailored for the Insurance domain. This role not only demands a deep understanding of the Insurance sector but also an ability to travel globally at short notice, based on project requirements. Designation Business Analyst - Insurance Domain (insurance claims & underwriting, Sales) Minimum 4 years experience in insurance claims & underwriting, Sales Grade Depending on candidate profile Required Work exp 5+ years Roles and Responsibilities 1. Initiate, plan, execute, monitor and control Busi...

Project Leadership & Execution Lead multiple 220kV / 400kV / 765kV AC and HVDC transmission line projects simultaneously. Own project planning: timelines, resource allocation, budgets, and execution strategies. Solve highlevel engineering/construction issues and provide onground decision support to teams. Ensure minimum downtime and zerodelay commissioning through proactive risk mitigation. Engineering & Technical Goverce Approve route survey outcomes, design packages, tower spotting, and technical drawings. Ensure compliance with CEA, POSOCO, IS/IEC , state transmission utility norms. Drive adoption of digital tools for design & monitoring ( PLSCADD, Primavera/MSP, GIS tools ). Review vendo...

Key Responsibilities: Manage revenue recognition for modern trade customers in line with company policies. Carry out reconciliation with customers to ensure accuracy of sales, claims, and collections. Process and validate customer claims (discounts, rebates, schemes) with proper documentation. Ensure timely collection of receivables from modern trade accounts and follow up on overdue balances. Track and monitor trade spends vs. provisions to highlight variances and ensure accuracy in booking. Support in month-end closing activities , including accruals, provisions, and reporting. Collaborate with Sales, Supply Chain, and Customer Service teams to resolve disputes and improve process efficien...

About the Role As APAX continues to demonstrate growth potential and increasing importance in managing the Inforce portfolio, the L&H Operations Insights team plays a critical role in enhancing client service delivery and strengthening operational efficiency. This role contributes directly to these objectives by: Conducting detailed data analysis to support informed and timely decision making. Interpreting large and complex datasets to generate actionable insights for the business. Identifying opportunities to streamline processes and champion operational excellence across functions Key Responsibilities 1. Data Quality and Risk Management Identify risks and process gaps, recommend monitoring...

Execution Analyze the customer segmentation, sales trends in terms of demographics, geography, characteristics etc. to assess the potential for business Conduct trainings at the branch for all banking partners around regulatory guidelines and products. Plan for activation of branches through R&R activities to increase the penetration in active branches to realize full potential of the bank partner in the given geography Relationship Management Drive the campaign/contest for the Partner Bank to drive sales in profitable segments. Assist banking partners in pitching product to crucial customers & driving sales closure for the same. Identify cross sell opportunities for existing customers New A...

Execution Analyze the customer segmentation, sales trends in terms of demographics, geography, characteristics etc. to assess the potential for business Conduct trainings at the branch for all banking partners around regulatory guidelines and products. Plan for activation of branches through R&R activities to increase the penetration in active branches to realize full potential of the bank partner in the given geography Relationship Management Drive the campaign/contest for the Partner Bank to drive sales in profitable segments. Assist banking partners in pitching product to crucial customers & driving sales closure for the same. Identify cross sell opportunities for existing customers New A...

Handle inbound calls from healthcare providers regarding medical claim review inquiries, denial reasons, and claim status updates. Review claim denial explanations and communicate next steps clearly and professionally to providers. Ensure compliance with internal claims review policies, organizational guidelines, and regulatory requirements. Demonstrate strong service quality and maintain accuracy in all claim-related communication. Collaborate with global counterparts to ensure consistent process execution and issue resolution. Follow all company policies, employment contract terms, and operational directives related to shift changes, reassignment, workflow modifications, and organizational...

Validate medical record documentation and charge information for compliance with coding/billing regulations. Notify and verify changes or charges with physicians, updating records after acknowledgment. Perform accurate coding of medical records using ICD-10 and CPT codes. Review coding databases annually and re-file insurance claims while verifying coverage. Analyze and resolve insurance denials, collaborating with physicians on coding challenges and reimbursements. Submit claims with appropriate documentation such as OP notes and other required information. Job Requirements Graduates in life sciences with 1-4 years of experience in medical coding. Prior experience in E&M coding, insurance, ...