1040 Claims Management Jobs - Page 11

Role & responsibilities Short Paid Claim Contesting Executive-Drive timely and accurate contesting of short-paid claims across hospital-insurer interfaces, ensuring recovery yield and SOP compliance. Analyze short-paid claims and categorize by deduction type, insurer, and RCA triggers. Draft and submit contest letters with supporting documentation via IHX and insurer portals. Track contesting outcomes and escalate unresolved cases per SLA timelines. Collaborate with unit credit cells and central recovery team for RCA discipline and documentation hygiene. Maintain dashboards for contesting status, win-loss ratios, and financial impact. Ensure adherence to SOPs and flag deviation trends for go...

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 admissibil...

This Position reports to: Business Manager - Operations Your role and responsibilities In this role, you will have the opportunity to lead the local management of all project execution activities in the area of responsibility. Each day, you will ensure operations are executed in accordance with procedures, regulations, standards, specifications and targets. You will also showcase your expertise by coordinating and overseeing team development and standardized process development to continually improve the effectiveness of Project Execution teams. In this role, youll help run what runs the world, by taking on meaningful work that drives real impact. This role is contributing to the Electrifica...

Analyst Claims- Review and process property insurance claims, including analyzing policies, assessing damage, and determining coverage and settlements. Work with insurance adjusters, clients, and third-Frty vendors to gather necessary information and documentation for claims processing. Collation of data and information of claims for reporting purposes Investigate and evaluate claims to ensure accuracy and completeness. Prepare and present reports and recommendations to management regarding claims status, trends, and outcomes. Involvement in subrogation requests and required follow-ups. Communicate with clients and stakeholders regarding claims status and resolution. Provide support to other...

Mercer is seeking candidates to join our Claims Service team based in the Pune/Mumbai office. This is a hybrid role that requires working in the office at least three days a week. Specialist Claims Service (Grade C1) What can you expect: Excellent exposure to complex & diverse claims handling. Opportunity to enhance Claims knowledge and understanding & build on client management skills. As a new colleague, you will be provided with Business Overview/Insights, in-depth process training, roles & responsibilities overview, expectations of various stakeholders to make you successful in this role. Within the first 30 days, we expect you to gain good understanding of the role and requirement that ...

About The Role Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years What would you do? We help insurers redefine their customer experience while accelerating their innovation agenda to drive sustainable growth by transforming to an intelligent operating model. Intelligent Insurance Operations combines our advisory, technology, and operations expertise, global scale, and robust ecosystem with our insurance transformation capabilities. It is structured to address the scope and complexity of the ever-changing insurance environment and offers a flexible operating mod...

Skill required Fulfill - Order Management Designation Supply Chain Operations Assoc Manager Qualifications Any Graduation Years of Experience 10 to 14 years What would you do? The Sales Trader Manager is responsible for leading and driving the strategic direction and execution of orders. This role oversees the performance and development of the Sales Trader team, ensuring alignment with organizational goals and financial health. The manager collaborates with senior leadership to define key initiatives, set goals, and implement long-term strategies to optimize the efficiency of the write down process. This position is key to driving continuous improvement and innovation within the team. The m...

Position: Senior Analyst/Process Lead- Oil & Gas Claims & Contract Management Location: Bangalore Shift: UK Shift Exp: 4 to 8 Years Salary: Upto 10 LPA Role: Experience of working on Oil and Gas Marine logistics *Experience of Marine claims management and processing Research, review and analyze contract terms, documents and events to prepare critical claim calculations Negotiation of claims with 3rd Party (regular phone calls and emails) and issue invoices for Receivable claims Timely escalation of relevant issues to supervisor and business line as appropriate Develop and review control reports to ensure receivable claims are submitted to 3rd party/Affiliate within contract limits; monitor a...

Position: Senior Analyst/Process Lead- Marine Claims (Oil & Gas) Location: Bangalore Shift: UK Shift Exp: 4 to 8 Years Salary: Upto 10 LPA Role: Experience of working on Oil and Gas Marine logistics *Experience of Marine claims management and processing Research, review and analyze contract terms, documents and events to prepare critical claim calculations Negotiation of claims with 3rd Party (regular phone calls and emails) and issue invoices for Receivable claims Timely escalation of relevant issues to supervisor and business line as appropriate Develop and review control reports to ensure receivable claims are submitted to 3rd party/Affiliate within contract limits; monitor additional con...

Role & responsibilities : Manage the performance of the key accounts in the branches. Set goals and targets for the teams. Monitor and review the performance of the team periodically. Preparation of reports which will be shared with other teams. Understand the training needs of team members, develop them through training, coaching and mentoring sessions. Handle escalations and associated documentation if any. Preferred candidate profile : Education: Min Graduation completion. Experience: 7+ years of experience with broker or hospital or insurance background preferred. Managed large accounts in a TPA/insurance/hospital background with ability to handle 10-20 team members. Location: Bangalore-...

Role Overview: As an Insurance Portfolio Manager, your primary responsibility will be to oversee all types of insurance policies within the company. Your key tasks will involve ensuring adequate risk coverage at optimal costs, efficient claims management, and timely renewal of insurance policies. It will be crucial for you to procure various insurance policies with sufficient coverage at the best possible cost, meeting internal customer expectations for deliverables in terms of time, cost, and service quality aligned with business objectives. Key Responsibilities: - Manage insurance claims, particularly PDBI claims, with a high level of proficiency. - Demonstrate a strong technical knowledge...

RINA is currently recruiting for a Construction Supervision Principal Engineer to join its office in Mumbai within the Civil Engineering Division. Mission The role is focuses on overseeing and managing construction activities to ensure they adhere to project specifications, quality standards, safety regulations, envirnomental issues and are completed on time and within budget by coordinating and supervising the work of construction teams and subcontractors. Key Accountabilities Project Supervision: Supervise construction projects, ensuring that work aligns with approved designs, specifications, and relevant regulations. Document Approval: Approve and sign accountable documents vs Contractor ...

Role Overview: As a Claims Specialist, your primary responsibility will be to effectively manage the claims process for clients, ensuring a smooth and fair settlement of claims. You will accurately review and process claims, collect and maintain all necessary documentation, and act as the main point of contact for clients. Additionally, you will advocate for clients" interests, engage in negotiations with insurers for optimal settlements, address client concerns and inquiries, and facilitate conflict resolution to maintain positive client relationships. Key Responsibilities: - Review and process claims accurately - Collect and maintain all necessary documentation - Act as the main point of c...

In this role at PwC, you will be specializing in providing consulting services for various business applications to help clients enhance operational efficiency. Your responsibilities will include analyzing client requirements, implementing software solutions, and offering training and support for the seamless integration and utilization of business applications. By assisting clients in achieving their strategic objectives, you will play a crucial role in their success. As a Guidewire developer, your primary focus will be on developing and customizing applications using the Guidewire platform. This software suite equips insurance companies with tools for policy administration, claims manageme...

Global Insurance Risk Manager HCL (Job Profile) At least 15 years of stable Insurance experience with a professional insurance education background. Global insurer or broker (Aon, Marsh, Willis, Howden) or Large I.T. Company /Service company which has global presence at least USD 2 Bio. Customer base of this companies should be outside India. In depth understanding Global Liability Insurance market, deep connects with insurers and reinsurers in London , U.S. Minimum Aggregate program size of USD 200 Mio + Deep understanding of IT Customer Contracting practice including in depth experience of vetting customer contract, interacting with business teams to guide on insurance related contracts. E...

About The Role Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Analyst Qualifications: Any Graduation Years of Experience: 3 to 5 years What would you do? We are seeking a dedicated and detail-oriented Workmen Compensation Claims Adjuster to manage and resolve Workmen Compensation (WC) claims end-to-end. The ideal candidate should have in-depth knowledge of applicable labor laws, a strong grasp of claim computation methodologies, and experience handling claims related to permanent disability, temporary disability, medical reimbursement, and death benefits. This role requires excellent analytical skills and the ability to interpret medi...

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Senior Analyst Qualifications: Any Graduation Years of Experience: 5 to 8 years Language - Ability: English(Domestic) - Advanced About Accenture Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. Visit us at www.accenture.com What would yo...

Role: Claims Executive Industry Type: Insurance Department: BFSI, Investments & Trading Employment Type: Full Time, Permanent Role Category: General Insurance Education: B. Tech/B.E. in Mechanical Key Skills: Insurance claims Job Responsibilities: Financial Contribute to renewal portfolio expansion through relationship building with the insurance companies and surveyors to ensure optimum claim settlement in the minimum time. During the processing of the claim analyze the following and communicate to underwriters: adequacy of coverage wrt. location specifications e.g.. Earthquake /flood etc. adequacy of the sum insured anomalies in the policy scope of additional policies other related informa...

About The Role Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Analyst Qualifications: Any Graduation Years of Experience: 3 to 5 years Language - Ability: English(Domestic) - Intermediate What would you do? We help insurers redefine their customer experience while accelerating their innovation agenda to drive sustainable growth by transforming to an intelligent operating model. Intelligent Insurance Operations combines our advisory, technology, and operations expertise, global scale, and robust ecosystem with our insurance transformation capabilities. It is structured to address the scope and complexity of the ever-changing insurance ...

Retail Claims - Automation & ProjectsKey Responsibilities1 Automate Claims Processes- Design anddevelop automated workflows and business rules to streamline claims processing Integrate with Existing Systems- Integrateautomated claims processing solutions with existing systems and technologies Testing and UAT - Test and validateautomated claims processing solutions to ensure accuracy and efficiency Daily production issue - Troubleshootissues and resolve problems related any day-to-day production issues across allclaim systems for death and health claims5 Collaborate with IT stakeholders, claim team and other requiredstakeholders to understand requirements and implement solutions6 Strong techn...

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 admissibil...

MVR Cancer Center is looking for Manager - Insurance to join our dynamic team and embark on a rewarding career journey Develop and implement insurance policies and programs. Manage insurance claims and processes. Monitor and report on insurance performance. Collaborate with insurance providers and stakeholders. Ensure compliance with insurance regulations and standards. Provide support and guidance on insurance matters. 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. More than 1...

Listening and Typing Data Entry Work Accounts Management and Claims Management Voice Preferred candidate profile Freshers with UG Perks and benefits Food provided Health insurance Provident Fund Weekend off Incentives Provided Shift allowance.

Role Overview: As a qualified candidate for the position, you will have a minimum of 12 years of experience specializing in Property & Casualty (P&C) Insurance. Your background should showcase a successful track record in overseeing complex service delivery and managing diverse projects, particularly within the Insurance industry. You will be expected to lead teams consisting of 100 or more Full-Time Equivalents (FTEs). Key Responsibilities: - Define, implement, and successfully complete projects within specified timelines and budget constraints. - Manage various stakeholders effectively while adapting to a fast-paced and ever-changing environment. - Devise contingency plans for staffing flu...

Role Overview: As a Consultant at QualityKiosk Technologies Private Limited, your primary responsibility is to manage and oversee the delivery of testing services for insurance clients globally. You will ensure that testing services meet both global and regional client objectives while upholding high-quality standards. Your deep expertise in the insurance domain is crucial as you provide insights and leadership within the sector, focusing on core workflows such as policy administration, underwriting, claims management, and day-end processing to align testing efforts with client business needs. Key Responsibilities: - Act as the primary contact for key insurance clients, ensuring customer sat...