6255 Claims Jobs - Page 49

Role Overview: As a QNXT Configuration and SI professional, your responsibilities will include analyzing and understanding requirements, designing, developing, unit testing, and documenting test results for Facets/FACETS interfaces development tasks. Your expertise in QNXT data model, QNXT core batches, SQL, and .Net skills will be essential for this role. Your hands-on experience in QNXT claims and Enrolment will play a crucial role in the successful implementation of QNXT system. Additionally, you will be involved in analyzing requirements, designing, developing, unit testing, and documenting test results for QNXT interfaces and reports development tasks. Effective coordination and communi...

Minimum Mandatory Skill Set Knowledge of Processing of claims, quality check and adherence to TAT, computer skills, excel. Candidate should be open to work in 24X7X365 shifts Brief Job Profile Claims adjudication, Fraud and leakage control, Client/provider feedback, Team training and retention, Investigation Desired Competencies/ Skill Set MS Excel and MIS skills, Candidate having work experience of claim processing, Investigation, computer skills. Preferred Industry Health Insurance, TPA, Hospitals, Healthcare

Minimum Mandatory Skill Set Knowledge of Processing of claims, quality check and adherence to TAT, computer skills, excel. Candidate should be open to work in 24X7X365 shifts Brief Job Profile Claims adjudication, Fraud and leakage control, Client/provider feedback, Team training and retention, Investigation Desired Competencies/ Skill Set MS Excel and MIS skills, Candidate having work experience of claim processing, Investigation, computer skills. Preferred Industry Health Insurance, TPA, Hospitals, Healthcare

Role Overview: You will be responsible for utilizing your experience in US Healthcare to handle claims and configuration tasks. Your role will involve enrolling, designing, and implementing customer-specific solutions with accuracy during coding. Additionally, you will be involved in the reinstatement of medical codes, as well as the addition and deletion of codes on a frequent basis. Your ability to identify gaps between external expectations and system limitations will be crucial as you suggest configuration improvements. Moreover, writing SQL queries and performing data validation to identify test cases will also be part of your responsibilities. Key Responsibilities: - Utilize your exper...

Develops, recommends, and implements policies and procedures for investigating and evaluating new and existing customer creditworthiness and extending or revoking credit lines/limits Coordinates with internal departments to resolve billing disputes that may affect the ability to collect receivables Reviews and makes recommendations regarding bad debt or write-offs Investigates and analyzes credit risks, using available internet and credit agency tools and information Recommends and implements credit extensions/revocations, and/or legal action where necessary Develops and maintains relationships with outside credit agencies Ensures procedures and internal controls are followed in compliance w...

Develops, recommends, and implements policies and procedures for investigating and evaluating new and existing customer credit-worthiness and extending or revoking credit lines/limits. Coordinates with internal departments to resolve billing disputes that may affect the ability to collect receivables. Reviews and makes recommendations regarding bad debt or write-offs. Investigates and analyzes credit risks, using available internet and credit agency tools and information. Recommends and implements credit extensions/revocations, and/or legal action where necessary. Develops and maintains relationships with outside credit agencies. Ensures procedures and internal controls are followed in compl...

In the above context, the ASMrole is responsible to supervise the business delivery under Banca team and Tie Ups& primarily grow the business with profits, Channel Management Managing Banks, NBFCs and other Micro Finance companies. Also liaising with Operations & Product tower, Process Excellence group, Claims,Finance,legal, Business Intelligence, marketing & Human Resource teams for the process. Ensuring that we deliver best of our services to client as well as to banks. Key Accountabilities/ Responsibilities Responsible for achieving overall Gross Written Premium Team Management. Channel Relationship. Plan and make Strategies. Workshops, Camps. Regular training of Bank employees regarding ...

Role Summary In the above context, the ASM role is responsible to supervise the business delivery under Agency travel team and Tie Ups & primarily grow the business with profits, Channel Management Agents. Also liaising with Operations & Product tower, Process Excellence group, Claims, Finance, legal, Business Intelligence, marketing & Human Resource teams for the process. Ensuring that we deliver best of our services to client as well as to banks. Key Accountabilities/ Responsibilities Responsible for Achieving overall Gross Written Premium Responsible for sustainable Profitability Responsible to maintain COR at budgeted levels To maintain the Hygiene Responsible for Activation Stakeholder ...

As a Junior Analyst you will triage incoming reports, complete structured reviews, action accounts under established guidelines, and maintain crisp documentation so partner teams (Global Customer Operations Programs, Community Management, Testing Services, InfoSec/Legal, Product) can move fast with confidence. This role is ideal for an early-career analyst who is rigorous with checklists and SLAs, comfortable in ticketing systems, and eager to learn fraud/risk patterns in a unique business model. Key Responsibilities: 1. Triage & enforcement: Work tickets from our Report a Tester and related support queues; validate claims against community guidelines and available signals; document decision...

HITACHI RAIL is looking for an enthusiastic self-motivated Project Controller who thrives in a fast-paced environment. The successful candidate is comfortable performing a wide range of tasks from administrative to strategic. The position is based in Bangalore, India. Accountabilities: In conjunction with Project Team, develop the Work Breakdown Structure and Budgets for the project Work with Work Package Leaders (WPL) to develop accurate cost to complete estimates and percent complete evaluations Track, monitor and report planned budgets/forecast vs. actual spend using project controlling tools (SAP, PCS and other tools). Provide variance explanations and possible recovery plan actions Work...

Mandatory Skills :AEM, AEM Developer, Sling, Javascript Responsibilities Migrate custom components (e.g., navigation, forms, carousel, search) to AEM Core Components for consistency and scalability. Develop and standardize front-end architecture using React, HTL (Sightly), and a component library with Storybook. Build responsive and accessible UI components, ensuring compliance with WCAG standards. Create and manage AEM templates, dialogs, and clientlibs to support content authors. Implement performance optimizations such as lazy loading, caching, and image optimization for faster page loads. Connect front-end components to Sling Models and APIs for dynamic data rendering. Collaborate with b...

Oversee and implement quality control processes for manufactured products. Conduct regular audits and inspections to ensure compliance with quality standards. Collaborate with production, RD, and supply chain teams to address quality issues. Develop and maintain quality documentation and reports. Investigate and resolve product quality complaints in a timely manner. Ensure compliance with all relevant industry regulations and standards. Train and mentor junior quality control staff. Participate in continuous improvement initiatives to enhance product quality. Qualifications Bachelors degree in Food Science, or a related field. Minimum of 3 years experience in quality assurance/control within...

Preparation of payment runs for vendors Sending remittance advice to vendors. Liaising with the Treasury team agency with regards to amendments for BACS payment files, ensuring any anomaly on the payment selections are reported to Treasury team agency to resolve within the agreed timescale. Maintain accurate and up-to-date filing. Assist with Internal and External Client Audits. Maintain the level of accuracy and meet the deadlines for manual payments Daily. Checking payment runs in line with the agreed signature Matrix. Provide holiday and sick cover as necessary. As a holiday sick cover able to take handle below tasks: Ensure all expense paperwork is date stamped on day of receipt. To proc...

In your position you will be mainly supporting the IFRS 17 related work of the global LH business. In this role you will perform various tasks to ensure the delivery of IFRS 17 results. In addition to IFRS work, there would be existing BAUs that needs to be supported as we'll. The candidate will decide and act with a degree of autonomy in practice areas within the delegated authorities. About the team: The Global Finance Operations Transformation (GFOT) in Group Finance is responsible for the close process and financial reporting of mainly - Life Health (LH) business. It covers all accounting bases - Statutory and IFRS - and consists of units taking care of Intragroup retrocessions (IGR), ex...

Bristol Myers Squibb is seeking a highly skilled and motivated Forecasting Analyst II to join our US Commercialization Analytics team in Hyderabad. This position offers an exceptional opportunity to contribute to the strategic direction of our commercial operations by leveraging advanced analytics and forecasting methodologies within the pharmaceutical sector. As a Forecasting Analyst II within US Commercialization, you will play a critical role in shaping business strategy by developing robust forecasting models and delivering actionable insights. You will leverage advanced analytics to project sales, demand, and market trends for pharmaceutical products, supporting decision-making across c...

NP - Immediate to 30 days At least 4+ years of experience in working on Guidewire ClaimCenter Configuration & Integration. Guidewire ClaimCenter configuration as well as integration developer. Must be Guidewire certified in any of the Xcenters, preferably ClaimCenter Possess good knowledge in FNOL, exposure, incidents, recoveries, payments, check/bulk invoice, assignments, activities. Possess good knowledge in Message queue, events, Batch, Web services, API. GW Cloud knowledge Experience in Agile SCRUM or SAFe methodology P & C Insurance domain knowledge Convert User Stories to code to configure the application or integrate it with other applications. Design and execute unit tests and implem...

Submit electronic claims for facilities and insurance carriers Work scrubbing/editing reports from billing systems and clearinghouses Work with other departments regarding resubmission of claims Work and track acceptance and rejection reports Research and fix system problems causing delay in claims submission Requirements EDUCATION, EXPERIENCE AND SPECIAL SKILLS: Minimum of 1 year of RCM experience, claims experience preferred High school diploma Detail oriented Organizational skills Computer knowledge Good written and oral communication skills Knowledge of commonly used insurance billing concepts Experience using Epic

Summary ofroleThe roleinvolves building robust fraud detection frameworks, managing investigationsthrough empanelled risk agencies, engaging with law enforcement and businessteams, and driving awareness across teams Key ResponsibilitiesDevelop and implement fraud risk frameworks across customer and distributors life cycle Monitor transactions, claims and sales practices to identify red flags and fraud patternsLead and manage investigations of suspected fraud cases through empanelled risk agencies, ensuring timely closure with quality reporting Evaluate and monitor performance of risk agencies to ensure adherence to defined SLAs and investigation quality standards Drive vendor staff training ...

About Affinity Affinity is pioneering new frontiers in AdTech: developing solutions that push past today s limits and open up new opportunities. We are a global AdTech company helping publishers discover better ways to monetize and enabling advertisers to reach the right audiences through new touchpoints. Operating across 10+ markets in Asia, the US, and Europe with a team of over 500 experts, we are building privacy-first ad infrastructure that opens up opportunities beyond the walled gardens. Role: Sr. Specialist, HR Operations Work Location: Mumbai (Malad) Scope: Global Cross-Collaboration: Talent Acquisition, L&D, Finance, Admin, Legal. About Role: The Sr. Specialist HR Operations will p...

Assists the Director of Human Resources in executing strategies that serve to attract, retain, and develop diverse premiere talent. Position directs and works with human resource employees to carry out the daily activities of the Human Resource Department, including recruitment, total compensation, employee relations, and training and development. Executes against objectives outlined in the Human Resources Business Plan and delivers services that meet or exceed the needs of employees and enable business success. Ensures compliance with applicable regulations and Standard Operating Procedures. CANDIDATE PROFILE Education and Experience High school diploma or GED; 4 years experience in the hum...

Job Description What are the Key Deliverables in this role Financial Outcomes Primary Sales - Develop the channel partner network and implement the distribution objectives to drive reach penetration across the territory Secondary sales (Retail Distribution) - Increase number of retail outlets, maintain high service level, drive visibility of all categories of products and ensure commercial hygiene (usage of technology while placing retail orders) in the territory Customer Service Provide ground-level inputs for promotions, local activations demand forecasting exercise Ensuring timely submission of stockiest claim along with supporting documents adhering to the company s guidelines Internal P...

Territory Sales Executive - II Job Details | Tata Consumer Products Limited Search by Keyword Search by Location Select how often (in days) to receive an alert: Select how often (in days) to receive an alert: Territory Sales Executive - II Mumbai, MH, IN, 400093 Tata Consumer Products Limited Job Description What are the Key Deliverables in this role Financial Outcomes Primary Sales - Develop the channel partner network and implement the distribution objectives to drive reach penetration across the territory Secondary sales (Retail Distribution) - Increase number of retail outlets, maintain high service level, drive visibility of all categories of products and ensure commercial hygiene (usag...

About Affinity Affinity is pioneering new frontiers in AdTech: developing solutions that push past today s limits and open up new opportunities. We are a global AdTech company helping publishers discover better ways to monetize and enabling advertisers to reach the right audiences through new touchpoints. Operating across 10+ markets in Asia, the US, and Europe with a team of over 500 experts, we are building privacy-first ad infrastructure that opens up opportunities beyond the walled gardens. Role: Sr. Specialist, HR Operations Work Location: Mumbai (Malad) Scope: Global Cross-Collaboration: Talent Acquisition, LD, Finance, Admin, Legal. About Role: The Sr. Specialist HR Operations will pl...

About Affinity Affinity is pioneering new frontiers in AdTech: developing solutions that push past today s limits and open up new opportunities. We are a global AdTech company helping publishers discover better ways to monetize and enabling advertisers to reach the right audiences through new touchpoints. Operating across 10+ markets in Asia, the US, and Europe with a team of over 500 experts, we are building privacy-first ad infrastructure that opens up opportunities beyond the walled gardens. Role: Sr. Specialist, HR Operations Work Location: Mumbai (Malad) Scope: Global Cross-Collaboration: Talent Acquisition, LD, Finance, Admin, Legal. About Role: The Sr. Specialist HR Operations will pl...

Associate Director - Marketing Innovation - Packaged Foods Job Details | Tata Consumer Products Limited Search by Keyword Search by Location Select how often (in days) to receive an alert: Select how often (in days) to receive an alert: Associate Director - Marketing Innovation - Packaged Foods Mumbai, MH, IN, 400093 Tata Consumer Products Limited [[Associate Director Innovation Packaged Foods]] Job Description What are the Key Deliverables in this role Build an innovation roadmap for developing a strong foods portfolio to deliver business ambitions Build an innovation funnel and mid-term plan to deliver i2S of 5% to 7% over the mid term plan Work across salt, spices, staples, RTC, RTE 5 cat...