719 Claims Management Jobs

We are seeking an experienced RCM Manager to oversee end-to-end processes in US healthcare, including Payment Posting, Charge Entry, and AR Denials. Must have strong knowledge of billing, coding, and claim management. Leadership skills required.

We are seeking an experienced RCM Specialist with expertise in EBO Reporting within eCW. Ideal candidates will have a strong understanding of claims management, payment posting, and revenue cycle optimization in the US healthcare setting.

We are seeking an experienced RCM Specialist with expertise in EBO Reporting within eCW. Ideal candidates will have a strong understanding of claims management, payment posting, and revenue cycle optimization in the US healthcare setting.

About The Role Skill required: Retirement Solutions - Claims Case Mgmt - Claims Processing Designation: Claims Management Associate Qualifications: Any Graduation Years of Experience: 1 to 3 years What would you do? Tower:UK Life and Pensions-Claims Processing What are we looking for? Skillset:Graduate in any stream.Open to flexible shifts based on business requirements.Good verbal & written communication skillsGood typing skill and attention to detail.Good time management skills. Ability work independentlyMust have/ minimum requirementMinimum of 2 years experience in the UK Life, Pensions and Investment domain, specifically Claims processing with equivalent experience in U.S. retirement services will also be considered.Strong analytical and comprehension skills with the ability to interpret information accurately and draw meaningful insights.Proficient in Microsoft Office tools, including Excel, Word, and Outlook, for reporting, documentation, and daily operations. Roles and Responsibilities: Roles & Responsibilities:Assess claims to determine coverage eligibility and benefit entitlements in line with policy terms and regulatory guidelines.Conduct thorough research to validate policy details, support documentation, and calculate the correct benefit amount.Identify and confirm the appropriate payee or beneficiary before initiating claims payment.Ensure accurate eligibility verification and payment processing in compliance with organizational policies and regulatory requirements (including UK-specific and applicable local laws).Review the proof of employment, salary history and other information needed to calculate benefits for Pensions claims.Verify the information and eligibility for the benefits of Pensions claims.Complies with all regulatory requirements, procedures, and State/Local regulations.Researching on any queries/ requests sent by the Business Partners/Client Support Teams and replying the same with minimum response time.Taking active participation in process improvements and automation.Ensure Quality Control standards that have been set are adhered to.Excellent organizational skills with ability identify and prioritize high value transactions.Completing assigned responsibilities and projects within timelines apart from managing daily BAU. Qualification Any Graduation

Handling warranty claims and documentation Coordinating with service and technical teams Maintaining warranty records and DMS entries Reporting to backend systems Required Candidate profile Manage and process warranty claims efficiently Ensure compliance with warranty policies and procedures Communicate with customers, dealers, and manufacturers regarding warranty claims

Hiring for US Healthcare - Claims & Premium Billing Education: BE/B.Tech/MCA/M.Tech/MSc./MS ,Bcom Responsibilities A day in the life of an Infoscion As part of the Infosys consulting team, your primary role would be to actively aid the consulting team in different phases of the project including problem definition, effort estimation, diagnosis, solution generation and design and deployment You will explore the alternatives to the recommended solutions based on research that includes literature surveys, information available in public domains, vendor evaluation information, etc. and build POCs You will create requirement specifications from the business needs, define the to-be-processes and detailed functional designs based on requirements. You will support configuring solution requirements on the products; understand if any issues, diagnose the root-cause of such issues, seek clarifications, and then identify and shortlist solution alternatives You will also contribute to unit-level and organizational initiatives with an objective of providing high quality value adding solutions to customers. If you think you fit right in to help our clients navigate their next in their digital transformation journey, this is the place for you!

Role Overview: You will be joining EY as a Senior Developer or Staff Developer to contribute to shaping a better working world by leveraging your expertise in Majesco toolkits and domain-specific knowledge. Key Responsibilities: - Lend Majesco specific toolkit and Domain subject matter expertise throughout design and development phases of the project. - Lead development activities end-to-end, including coordinating, developing, reviewing code, and debugging complex issues. - Coordinate implementation of all types of development activities across client interfaces (Java, etc.) and Configuration flows. - Work with Analysts/Customers to design, develop, program, and configure changes and maintain complex integration software. - Create/change Data-object modeling, customer interface, and integrations based on requirements. - Create/maintain SOAP/REST based services. - Work in an agile environment. - Clearly articulate configuration rationale, conduct and participate in design and reviews. - Leading communication with internal and external stakeholders. Qualifications: - Bachelor's degree (computer science, engineering, or related field) or a graduate degree. - Overall Experience range: 3 - 7 years. - Hands-on experience with various Majesco toolkits like dev-studio, ICD/ICM, Digital 1st, EDW. - At least 3 years of Majesco Policy/Billing/Claims experience required. - Experience working on UI designs and integrations. - Experience working with configuration-driven tools/platforms/framework. - Experience in Insurance - P&C - Knowledge across several of the following focus areas: Policy Administration, Billing & Commissions, Claims Management. - Good to have experience in developing front end and microservices backend. - Willingness to travel. Additional Details of the Company: EY is committed to building a better working world by creating new value for clients, people, society, and the planet. Using data, AI, and advanced technology, EY teams help clients shape the future with confidence and tackle the most pressing issues of today and tomorrow. EY teams operate across assurance, consulting, tax, strategy, and transactions, utilizing sector insights, a globally connected network, and diverse ecosystem partners to provide services in more than 150 countries and territories.,

Job Title: TPA Manager Location: Miri Piri Institute of Medical Science & Research, Shahabad Markanda, Kurukshetra (Haryana) Hospital Strength: 420+ bedded upcoming super-specialty hospital & upcoming medical college (100 MBBS seats) Position Overview We are seeking an experienced and detail-oriented TPA Manager to lead and manage all Third-Party Administrator (TPA), insurance, CGHS, ECHS, and Ayushman cases. The role involves overseeing pre-authorization, billing, claims settlement, and ensuring smooth coordination between patients, TPAs, and hospital departments while maintaining compliance and accuracy. Key Responsibilities Handle end-to-end TPA, Insurance, Ayushman, CGHS, and ECHS cases. Coordinate with patients, TPA representatives, and consultants for pre-authorization approvals. Monitor real-time admission intimation, approval status, and treatment cost estimates. Ensure accurate preparation and timely submission of claims to TPAs/Insurance companies. Follow up on pending claims, resolve queries, and minimize claim rejections. Maintain updated records of approvals, discharges, and settlement status. Collaborate with billing, finance, and medical teams for seamless case management. Train and guide TPA executives in documentation and claim processing. Ensure compliance with NABH requirements, audit standards, and hospital policies. Generate MIS reports on approvals, rejections, pending claims, and revenue flow. Eligibility Qualification: Graduate/Postgraduate in Healthcare Administration, Finance, or related field. Experience: Minimum 5 years of experience in TPA/Insurance management in a multi-specialty hospital. Skills: Strong knowledge of insurance/TPA processes, claim settlement, negotiation, MIS reporting, patient handling, and excellent communication. Why Join Us? Be part of an upcoming medical college with 100 MBBS seats backed by the credibility of SGPC . Opportunity to work in a 420+ bedded super-specialty hospital with advanced facilities. Supportive work culture, timely salary , and ethical governance. Significant scope to grow in hospital operations and insurance management. Contact for Queries: +91 9650779097 Email: miripirihr@gmail.com

Contracts Handled from Govt Projects Like Railways, Airports, Medical , PWD Buildings, Maintain Tender & contracts documents ,sub contractor prequalification, templates, forms, procedures. Providing support to project management on contractual issues

Mega Walk-in Drive US Healthcare (Claims Adjudication) Date: 19th & 20th September 2025 Time: 11:30 AM 4:00 PM Venue: Sagility, KCT Tech Park, Thudiyalur Rd, Saravanampatti, Coimbatore, Tamil Nadu 641049 We Are Hiring Experienced Professionals! Join our growing team in US Healthcare Claims Adjudication Minimum Requirement 3.6+ years of experience in US Healthcare (Claims Processing & Adjudication) Additional Opportunities in Sagility : We have openings for WFM & Training functions Also for Internal Contact Center Operations (Inbound calls) Open Positions Team Leader Operations Quality Specialist Subject Matter Expert (SME) Process Trainer Quality Team Leader Assistant Manager Operations Deputy Manager Operations Senior Manager Operation Documents to Carry: Updated Resume (2 copies) Govt. ID Proof (Aadhar/PAN/Passport) Recent Passport-size Photographs Why Join Us? Work with a leading US Healthcare brand Fast-track career growth across leadership roles Attractive benefits & rewards Interested folks please Walkin directly to Sagility office and connect with our recruitment team on : 9597910418 / 8309217838

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

Assistant Manager / Deputy Manager - Claims -2+ Years - Pune Are you a highly motivated claims professional looking to make an impact in the insurance industry? We are seeking an experienced Assistant Manager / Deputy Manager - Claims with over 2 years of expertise in managing and processing claims. This is your chance to work in a role where you can bring value, drive process improvements, and enhance customer satisfaction. If you are ready to embark on an exciting journey of professional growth, this is the perfect opportunity for you! Location:- Pune Your Future Employer A leading organization in the insurance domain, known for its dynamic work environment and commitment to professional excellence. The company consistently values employee development and fosters inclusivity, diversity, and innovation across all levels. Working with this employer promises a fulfilling career with ample growth opportunities. Responsibilities As the Assistant Manager / Deputy Manager - Claims, your primary responsibilities will include: Reviewing and processing insurance claims with precision, ensuring compliance with company policies and regulations. Investigating claim discrepancies and coordinating with stakeholders for resolution. Managing a team to assess loss and mitigate risks effectively. Working closely with internal teams to ensure smooth claim adjudication and timely settlements. Maintaining relevant documentation and claim process records. Delivering quality customer service to ensure client satisfaction and retention. Analyzing claim trends to provide valuable insights for process improvement. Requirements Experience : Minimum of 2+ years in insurance claims handling, investigations, or related functions. Education : Bachelors degree in any field. A certification or training in insurance will be an added advantage. Skills : Strong analytical and problem-solving skills. Excellent communication and interpersonal abilities. Expertise in working with claim management systems and tools. Knowledge of insurance policies, procedures, and regulatory compliance. A keen eye for detail and a customer-centric mindset. Ability to work collaboratively and lead a team effectively. Proactive and goal-oriented approach to tasks. Whats in it for you? Opportunity to work with a highly reputed organization in the insurance sector. Ample avenues for professional learning and career advancement. Inclusive and diverse work culture that promotes work-life balance. Competitive salary with employee benefits and perks. Recognition and rewards for exceptional performance. Reach Us If you feel this opportunity is well-aligned with your career progression plans, please feel free to reach us with your updated profile at prachi.gupta@crescendogroup.in Disclaimer Crescendo Global specializes in Senior to C-level niche recruitment. We are passionate about empowering job seekers and employers with an engaging and memorable job search and leadership hiring experience. Crescendo Global does not discriminate on the basis of race, religion, color, origin, gender, sexual orientation, age, marital status, veteran status, or disability status. Note We receive a lot of applications on a daily basis, so it becomes a bit difficult for us to get back to each candidate. Please assume that your profile has not been shortlisted in case you don't hear back from us in 1 week. Your patience is highly appreciated. Profile Keywords Insurance, Claims Management, Assistant Manager, Deputy Manager, Insurance Claims, Compliance, Client Servicing, Risk Mitigation, Claim Investigations, Pune Jobs, Insurance Domain, Claims Processing, Leadership in Insurance, Insurance Regulatory Compliance.

Exotica is seeking an experienced Contracts & Cost Control Manager to lead cost management, contracts administration, and vendor negotiations for our landmark projects. The candidate must have strong exposure to large-scale commercial/high-rise real estate projects and ensure cost efficiency, timely procurement, and contract compliance. Key Responsibilities Prepare and verify rate analysis, BOQs, and cost benchmarking for all project works. Review contractor/subcontractor quotations, negotiate and finalize contracts. Monitor budget vs. actual costs, highlight deviations, and recommend corrective action. Manage work orders, variations, claims, and contractor billing. Coordinate with Purchase, Planning, and Accounts for financial control. Maintain and update vendor/contractor performance database. Desired Candidate Profile B.E./B.Tech in Civil Engineering, with MBA (Contracts/Construction Management) preferred. 1218 years’ experience in Contracts & Cost Control for Grade-A commercial/residential projects. Strong knowledge of rate analysis, QS, cost estimation, and contracts law. Expertise in MS Excel, ERP (SAP/Oracle/Odoo), and cost management tools. Excellent negotiation and communication skills.

As an ideal candidate for this role, you should have knowledge on advanced claims, policy, and billing management capabilities that insurers require to enhance efficiency, profitability, and customer loyalty. Your experience should include the implementation of best-in-class business processes to optimize reinsurance processes and provide functionality for statutory reporting. You should have at least 4 to 10 years of experience and have been involved in at least ONE end-to-end Implementation Project. It is essential for you to possess a valid passport. Your primary responsibilities will include providing business support and analytical applications that contribute to optimizing insurance business processes. Kindly note that there are no additional details of the company provided in the job description.,

Roles and Responsibilities: 2-3 years of experience in processing claims adjudication and adjustment process Experience in professional (HCFA) and institutional (UB) claims Knowledge in handling authorization, COB, duplicate and pricing process Knowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of pocket, maximum inside limits and exclusions, state variations Audit claims as outlined by Policies and Procedures. Utilize appropriate system-generated reports applicable for specialty claims. Document, track findings per organizational guidelines for reporting purpose. Based upon trends, determine ongoing Claims Examiner training needs and develop/implement training programs as approved by Senior Management. Conduct in-depth research of contract issues, system-related problems, claims processing Policies and Procedures, etc., to confirm cause of trends. Recommend actions/resolutions to Senior Management. Work with other organizational departments to develop corrective action plans to improve accuracy of the claims adjudication processes and assure compliance with organizational requirements and applicable regulations. Assist in the development of Claims Department Policies and Procedures. Attend organizational meetings as required Adhere to organizational Policies and Procedures. Requirements: 2-3 years of experience in processing claims adjudication and adjustment process Experience in professional (HCFA), institutional (UB) claims (optional) Both under graduates and post graduates can apply Good communication (Demonstrate strong reading comprehension and writing skills) Able to work independently, strong analytic skills Work Timings: Required schedule availability for this position is Monday-Friday 5.30PM/3.30AM IST (AR SHIFT). The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekends basis business requirement

This role will be responsible for end-to-end contract management of projects, including review of contractual terms, management of correspondence, handling deviations and variations and ensuring proper closure. The position requires managing claims, dispute resolution and providing contractual support to project teams. In addition, the role will oversee performance management, training adherence, attrition control and process improvement, with a focus on digitization initiatives. Key Responsibilities: 1. Contract Management Responsible for overall contract management of projects from award to closure. Manage contractual correspondence with clients, vendors and other stakeholders to ensure clarity and compliance. Review deviations, variations and work order amendments in line with contractual obligations. 2. Claims & Dispute Resolution Review and evaluate claims raised under contracts. Lead and support dispute resolution mechanisms to safeguard company interests. Ensure timely escalation and settlement of contractual issues. 3. Contract Closure Oversee final closure of contracts in compliance with company and client requirements. Ensure proper documentation, record-keeping and audit readiness. 4. MIS & Reporting Prepare MIS reports and presentations on contract status, claims, disputes and closures for senior management review. Ensure timely and accurate updates for decision-making. 5. People Management & Development Ensure adherence to performance management and appraisal processes and timelines for all direct reports. Drive adherence to the training calendar and encourage team participation in capability-building programs. Control and reduce attrition in the team through effective engagement, development and retention initiatives. 6. Process Improvement & Digitization Undertake and review process improvement initiatives in contract management. Support digitization efforts to streamline contract review, correspondence, claims and closure processes. Qualifications Graduate / Postgraduate in Law, Engineering, Management or related field. 10+ years of experience in contract management, preferably in large projects/engineering/construction sectors. Strong understanding of contract law, claims, and dispute resolution. Exposure to digitization initiatives and process improvement preferred. Key Skills: Expertise in contract drafting, review and management. Strong negotiation and dispute resolution skills. Proficiency in claims evaluation and work order amendments. Excellent MIS preparation and presentation abilities. People management skills with focus on performance, training and retention. Analytical thinking with a process improvement and digitization mindset. Effective stakeholder communication and coordination.

TATA AIG General Insurance Company Limited is looking for Senior Manager - Health Claims to join our dynamic team and embark on a rewarding career journey Analysis for the current business practice. Find out the different operational strategies. Work on developing the current operational strategy applied to the company with the most recent technology. Coordinate with the operations manager to take the required steps after brainstorming and research. Optimize the operations in the company. Put the suitable operational strategy to fit with the companys culture. Implement the operational strategy in the different departments of the company. Supervise the strategy, and make sure that all the employees respect this strategy. Work regularly in improving the companys operations performance. Also, the deputy operations manager works in certain cases in touch with the clients to make sure that they receive the required service with the highest quality. In Customer service company, the deputy operations manager works with his team to make the clients satisfied by offering to his team the required training and courses to be able to communicate correctly with the customers. Follow up with the running project daily in order to make sure that they follow the right operation process. Check the logistics operations. Monitor t Show to the employees the company strategies and regulations in order to maintain the operation process. Solve all the different problems that could face the operations, to ensure the operational strategy. Issue a weekly, and monthly report for the operations manager to see all the updates realized on Disclaimer: This job description has been sourced from a public domain and may have been modified by Naukri.com to improve clarity for our users. We encourage job seekers to verify all details directly with the employer via their official channels before applying.

TATA AIG General Insurance Company Limited is looking for Deputy Manager - Health Claims to join our dynamic team and embark on a rewarding career journey Assist the Manager in the day-to-day operations of the business, including setting goals, developing strategies, and overseeing the work of team members Take on leadership responsibilities as needed, including managing team members and making decisions in the absence of the Manager Identify and address problems or challenges within the business, and develop and implement solutions Collaborate with other departments and teams to ensure smooth and efficient operations Maintain accurate records and documentation Contribute to the development and implementation of business plans and goals Disclaimer: This job description has been sourced from a public domain and may have been modified by Naukri.com to improve clarity for our users. We encourage job seekers to verify all details directly with the employer via their official channels before applying.

Dear Aspirant, ReSource Pro Operational Solutions Private Limited, Bangalore About ReSource Pro: About Us: ReSource Pro brings to the insurance industry tools, technology and strategic services that enable profitable growth through operations excellence. Headquartered in New York, ReSource Pros global service centers address client operational needs around the clock. Recognized as an industry thought leader and listed as one of Inc. 500/5000 Fastest Growing Private Companies annually since 2009. Over 12,500+ ReSource Pro employees provide dedicated support to more than 600+ insurance organizations, consistently achieving a 96% client retention rate for over a decade. We help you execute your most complex business objectives with solutions designed to boost performance, productivity and profitability. ReSource Pro Global Achievements: ISG Provider Lens Insurance BPO Services and Platform Solutions 2020. ReSource Pro is placed as High in Product Challenger. EVEREST PEAK Matrix P&C Insurance BPS Peak Matrix Assessment 2021. ReSource Pro is identified as a strong Market Impact in the list of Major Contenders. Contact : HR Prashanth - Whats app 9008042232 | Mail Id: Prashanth_Honnachari@resourcepro.in Job Description - Analyst, Service Delivery. Basic Information Job Title : Analyst, Service Delivery. Report to Assistant Manager - Service Delivery Department Service Delivery Unit Location Bangalore, India Purpose of the Position: Process moderately complex insurance tasks, perform auditing and trouble-shooting, deliver training, and be responsible for meeting quality, quantity, and time deadlines. Communicate with the client via email. Report operation problems and propose solutions to achieve operation optimization. Key Responsibilities: Policy Checking Skillsets Experience (2-4 years): 1. The candidate should possess experience in policy checking and be familiar with various source documents, including policies, system applications, quotes, proposals, binders, and endorsements. 2. Experience in multiple lines of business, such as General Liability, Workers Compensation, Executive Liability, Property, Auto, Inland Marine, and Package tasks, is required. 3. Use web portals to access and analyze relevant documents. 4. Maintain organized records of all reviewed documents and discrepancies noted. 5. Identify and highlight discrepancies or inconsistencies in policy details. 6. Must demonstrate strong attention to detail. 7. Familiarity with account management systems like EPIC and ImageRight etc. is a plus. 8. Conduct audits and reconcile reports to identify and correct discrepancies. 9. Maintain and update training materials, logs, and documentation. Processing - 60% 1) Operate a variety of client systems and process moderately complex tasks and activities without supervision. Follow ReSource Pros Information Security policies/guidelines, as well as the clients security requirements, policies, and practices that are provided to ReSource Pro and information security requirements. Operation Optimization - 10% 1) Report operation problems and propose solutions. 2) Optimize established procedures. 3) Assist with output conversion. Customer Experience - 10% 1) Communicate with the client via email with minimal supervision. 2) Respond to the client promptly and report issues to the supervisor in a timely manner. Auditing and Trouble-shooting - 10% 1) Implement the audit plan, run the audit report and identify the performance gap. 2) Perform timely trouble-shooting. Training - 5% 1) Set up individual training plan and deliver training. Others - 5% 1) Generate and analyze the data and report. 2) Assist with new task on-boarding. Skills: Typing skills Client System Operation skills MS Office skills Email reading and writing skills Problem solving skills Training skills Why Choose Us? Innovative Environment: Be part of a team that values creativity and innovation. Career Growth: Enjoy numerous opportunities for professional development and advancement. Collaborative Culture: Thrive in a supportive and team-oriented workplace. Ready to Make an Impact? If your skills match our needs, we would love to connect with you! Contact Scope: Send your resume to Shivaraj Patil at Prashanth_Honnachari@resourcepro.in

Claims Management: Process, submit, and follow up on insurance claims, resolving discrepancies and denials with insurance providers. Patient Assistance: Educate patients on their insurance coverage and benefits and assist them with understanding their bills and statements. Liaison with Insurers: Serve as a point of contact between the hospital and insurance companies, ensuring proper communication and adherence to policies. Data and Reporting: Maintain accurate patient insurance information in the billing system and prepare reports on billing and insurance activities. Compliance: Ensure adherence to hospital policies and insurance regulations and guidelines Skills: Excellent communication and interpersonal skills. Strong organizational and attention-to-detail skills. Proficiency in insurance billing, coding, and claims processing. Knowledge of healthcare systems, insurance regulations, and compliance. Problem-solving and conflict resolution skills. Computer proficiency and the ability to work with data entry and reporting tools.

In this Role you will be Responsible For Review and process insurance claims. Validate Member, Provider and other Claims information. Determine accurate payment criteria for clearing pending claims based on defined Policy and Procedure. Coordination of Claim Benefits based on the Policy & Procedure. Maintain productivity goals, quality standards and aging timeframes. Scrutinizing Medical Claim Documents and settlements. Organizing and completing tasks per assigned priorities. Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team Resolving complex situations following pre-established guidelines Requirements for this role include: University degree or equivalent that required formal studies of the English language and basic Math 0-1 Year of experience where you had to apply business rules to varying fact situations and make appropriate decisions 0-1 Year of data entry experience that required a focus on quality including attention to detail, accuracy, and accountability for your work product. 0-1 Year of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools. 0-1 Year of experience that required prioritizing your workload to meet deadlines **Required schedule availability for this position is Monday-Friday 6PM/4AM IST The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekends basis business requirement.

We are looking for a seasoned professional with deep expertise in Production Support for General Insurance systems , including: Motor Insurance Health Insurance Fire Insurance Claims Management Core Policy Issuance Platforms The ideal candidate will be responsible for ensuring high availability, stability, and performance of insurance applications and platforms, while collaborating with business and technical teams to resolve incidents and implement preventive measures. Key Responsibilities: Provide L2/L3 production support for insurance applications across Motor, Health, Fire, and Claims domains. Monitor system performance, troubleshoot issues, and ensure timely resolution of incidents. Collaborate with development, QA, and infrastructure teams for root cause analysis and permanent fixes. Maintain and enhance core policy issuance systems and workflows. Ensure compliance with SLAs, audit requirements, and data security standards. Document support processes, incident logs, and knowledge base articles. Participate in release management, UAT support, and post-deployment validations. Desired Candidate Profile: Minimum 7 years of experience in Production Support within the General Insurance domain . Strong functional knowledge of Motor, Health, Fire Insurance , and Claims workflows . Hands-on experience with policy issuance systems and insurance platforms (e.g., Guidewire, TCS BaNCS, or similar). Proficiency in incident management tools (e.g., ServiceNow, JIRA) and monitoring solutions. Excellent problem-solving, communication, and stakeholder management skills. Ability to work in a high-pressure environment and manage multiple priorities. Education: Bachelors degree in Engineering, IT, or related field. Insurance certifications (e.g., III, CII) are a plus.(Not mandatory)

About Us: Medi Assist is India's leading Health Tech and Insure Tech company focused on administering health benefits across employers, retail members, and public health schemes. We consistently strive to drive innovation and participate in such initiatives, to lower health care costs. Our Health Benefits: Administration model is designed to deliver the tools necessary for a health plan to succeed, whether its our modular claims management system, our technology that unveils data to make important decisions, or our service solutions built around the voice of the customer. In short, our goal is to link our success to that of our members Roles and Responsibilities: Check the medical admissibility of a claim by confirming the diagnosis and treatment details. Scrutinize the claims, as per the terms and conditions of the insurance policy. Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiation of open billing and package etc. Understand the process difference between PA and an RI claim and verify the necessary details accordingly. Verify the required documents for processing claims and raise an IR in case of an insufficiency. Coordinate with the LCM team in case of higher billing and with the provider team in case of non-availability of tariff. Approve or deny the claims as per the terms and conditions within the TAT. Handle escalations and responding to mails accordingly. Work from Office only 4th floor, AARPEE Chambers, Off Andheri-Kurla Road Industrail Estate Marol, Andheri East, , Marol Cooperative Next To Times Square, Shagbaug, Gamdevi, Marol, Mumbai, Maharashtra 400059 Interested candidates can share their resumes to abhilasha.dutta@mediassist.in Whatsapp : 8050700698.

Roles and Responsibilities: 2-3 years of experience in processing claims adjudication and adjustment process Experience in professional (HCFA) and institutional (UB) claims Knowledge in handling authorization, COB, duplicate and pricing process Knowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of pocket, maximum inside limits and exclusions, state variations Audit claims as outlined by Policies and Procedures. Utilize appropriate system-generated reports applicable for specialty claims. Document, track findings per organizational guidelines for reporting purpose. Based upon trends, determine ongoing Claims Examiner training needs and develop/implement training programs as approved by Senior Management. Conduct in-depth research of contract issues, system-related problems, claims processing Policies and Procedures, etc., to confirm cause of trends. Recommend actions/resolutions to Senior Management. Work with other organizational departments to develop corrective action plans to improve accuracy of the claims adjudication processes and assure compliance with organizational requirements and applicable regulations. Assist in the development of Claims Department Policies and Procedures. Attend organizational meetings as required Adhere to organizational Policies and Procedures. Requirements: 2-3 years of experience in processing claims adjudication and adjustment process Experience in professional (HCFA), institutional (UB) claims (optional) Both under graduates and post graduates can apply Good communication (Demonstrate strong reading comprehension and writing skills) Able to work independently, strong analytic skills

Dear Candidate Greetings from Technogen !!! We thank you for taking time about your competencies and skills, while allowing us an opportunity to explain about us and our Technogen, we understand that your experience and expertise are relevant the current open with our clients. About Technogen : https://technogenindia.com/ Technogen India Pvt. Ltd. is a boutique Talent & IT Solutions company, founded in 2008, has been serving global customers for over last 2 decades,. Talent Solutions: We assist several GCCs, Global MNCs and IT majors on their critical and unique IT talent needs through our services around Recruitment Process Outsourcing (RPO), contract staffing, permanent hiring, Hire-Train-Deploy (HTD), Build-Operate-Transfer (BOT) and Offshore staffing. Job Title : Veeva Vault Developer Required Experience : 5+ Years Location : PAN India Job Summary:- Proven experience in implementing and configuring Veeva Vault applications Design and develop workflows and lifecycles for objects and documents within the Veeva Vault platform Customize object structures, fields, and relationships within the Vault data model Configure Claims Management settings including claim tiers, statement uniqueness, and local adaptations Integrate Veeva Vault with other enterprise systems ensuring data security and compliance Configure Claims Management settings including claim tiers, statement uniqueness, and local adaptations Life Sciences / Healthcare / FMCG / Regulatory Compliance