1040 Claims Management Jobs - Page 12

Roles and Responsibilities Manage claim settlement process from intimation to finality, ensuring timely and accurate resolution. Ensure compliance with regulatory requirements and internal processes for claims processing and management. Coordinate with various stakeholders such as customers, agents, and third-party administrators to resolve complex claims issues. Analyze data to identify trends and areas for improvement in the claims department.

As a Manager - Insurance Training in Noida, you will play a crucial role in supporting a leading player in the UK Insurance domain. With 8-10 years of experience, you will utilize your expertise in General Insurance, Health, and Property & Casualty (P&C) to deliver comprehensive training programs. Your responsibilities will include designing, developing, and executing end-to-end training initiatives for operational teams across Insurers, Brokers, and MGA environments. - Create training materials - Conduct new hire onboarding sessions - Deliver specialized training on Underwriting, Claims Management, Finance Operations, and Customer Service - Evaluate learner performance - Monitor training ef...

Role & responsibilities: The role holder is accountable for managing all contractual, commercial, and claims-related aspects of highway/road projects. The role involves contract administration, risk analysis, vendor/contractor management, claims/dispute resolution, and ensuring compliance with legal and contractual obligations throughout the project lifecycle. Preferred candidate profile Contract Administration: Review, interpret, and administer contract terms and conditions for highway projects (EPC/PPP/HAM/Item-rate). Support in drafting, reviewing, and finalizing subcontracts, work orders, and vendor agreements. Ensure compliance with FIDIC/MoRTH/IRC conditions of contract and applicable ...

About this role: Wells Fargo is seeking a Fraud & Claims Operations Associate Manager In this role, you will: Supervise a team of specialists within a fraud and claims program for proactive fraud identification, prevention, and detection, as well as ensuring the recovery, execution, and handling of claims Identify opportunities for process improvement and risk control development in fraud and claims management to maximize efficiency and enhance customer service Make supervisory decisions and resolve issues related to work distribution under direction of fraud and claims management Leverage interpretation of internal processes and procedures to establish performance standards, evaluate perfor...

About this role: Wells Fargo is seeking a Fraud & Claims Operations Associate Manager. In this role, you will: Supervise a team of specialists within a fraud and claims program for proactive fraud identification, prevention, and detection, as well as ensuring the recovery, execution, and handling of claims Identify opportunities for process improvement and risk control development in fraud and claims management to maximize efficiency and enhance customer service Make supervisory decisions and resolve issues related to work distribution under direction of fraud and claims management Leverage interpretation of internal processes and procedures to establish performance standards, evaluate perfo...

Vacancy Announcement GK Superspeciality Hospital is a 100-bedded multispeciality healthcare facility located in Narnaul, Haryana. We are dedicated to providing top-tier medical care, offering a wide range of specialized services to cater to the diverse needs of our community. Our hospital is equipped with state-of-the-art medical technology and is supported by a team of highly experienced doctors, specialists, and paramedics who work together to ensure the best possible care for our patients. Currently, we are expanding our team and are looking for dynamic and dedicated candidates for the position of Front Desk and TPA Executives to strengthen our administrative and patient service team. Pos...

To contact the insured for Underwriting referred proposals to procure the complete medical history using Audio and/or Video tools. To Follow up with customer for past medical records and/or relevant health documents Maintain end to end TAT / SLAs. Required Candidate profile Location – Bangalore Candidate must know to speak excellent English and Hindi CTC – Upto 3.5 LPA

Your role involves managing the Group business with the Bank employees and liaising with different departments for closure of cases. You will champion product and process to drive top-line sales through the business sales team and maintain penetration levels of group insurance products with channel partners. - Coordinating and training key officials such as ASSL, DSA, and other bank officials to enhance their understanding of the business for increased seller activation is a key responsibility. - Providing market feedback on competition and other products in the market is essential for staying competitive. - Managing and strengthening relationships through engagement with Partners Zonal Lead...

About the Role: Contact hospitals, claims, and police departments to collect essential records and TCRs. Prepare and send request letters for medical records, claims, and TCRs. Follow-up on pending records and ensure timely updates in CRM tools. Required Candidate profile Fluent in English (oral & written). Experience in customer service or claims is a plus. US Shift: Available to work night shift (8 PM - 5 AM PST). Tech-savvy with basic CRM and MS Office skills.

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 ...

11) ____________________________________________________________________________ Position Title: DAMAGE SPECIALIST Tier: As a Damage Specialist, you will be responsible for reviewing images of the vehicle and comparing the vehicle's condition upon return to its original state to ensure accurate and efficient damage assessment and claim processing in the event of an accident. Key Responsibilities: Review images captured from vehicle inspections to verify and document damages. Document and photograph damages using company systems and ensure accurate record-keeping. Classify damages as wear & tear or chargeable based on company policies. Review and verify images and damage reports to ensure con...

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 d...

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 d...

Calling Insurance companies (in US) and follow up on outstanding Accounts Receivable. Calls to insurances for claim status and eligibility verification Denial documentation and taking further action Required Candidate profile Get the status of the unpaid claims 1+ year experience in USA AR calling experience /US healthcare Ready to work in night shift Completes targets with speed and accuracy as per client SLAs

Communicate with customers for their insurance claims and explain the process Follow up for and verify insurance claim documents Assist customers with claim filing process and keep the claim status updated Follow up with TPA / insurers for smooth and timely claim settlement Track claims on the insurers portal Claims end to end settlement/relationship with insurers/ good communication/ good knowledge of claims in Health insurance

Role Overview: As a Buyer - Contracts Engineer, you will be responsible for supporting the end-to-end contract lifecycle execution by understanding requirements, identifying pre-qualified vendors, tender preparation, inviting bids, and conducting technical & commercial negotiation in line with company standards aligned to Procurement & Contracting (P&C) objectives and guidelines. Key Responsibilities: - Assist Category / Contract Manager in sourcing critical contracts by selecting and evaluating vendors, planning for assigned items, and preparing contracting plans in compliance with terms and conditions. - Support pre-qualification of vendors by specifying sourcing events and conducting tech...

Key Responsibilities: Communicate with clients to address day-to-day information requests and resolve lower-level billing-related issues promptly. Handle escalated billing responsibilities, including co-insurance, Medicare Part B, therapy filings, and claims for multiple facilities. Ensure claims compliance with Medicare, Medicaid, and private insurance guidelines while maintaining high accuracy in coding and submissions. Provide detailed and reliable reports on billing activity. Act as a Team lead for certain operational tasks, such as monitoring billing performance metrics and assisting with budget management for assigned facilities. Mentor and support less experienced team members, provid...

As a Guidewire developer at PwC, your focus will be on developing and customizing applications using the Guidewire platform, which is a software suite that offers tools for policy administration, claims management, and billing. Your responsibilities will include: - Designing, coding, and testing software solutions tailored to meet the specific needs of insurance organizations. In this role, you will be expected to: - Build meaningful client connections - Manage and inspire others - Navigate complex situations - Deepen your technical expertise - Enhance your personal brand - Anticipate the needs of your teams and clients to deliver high-quality work To succeed in this position, you will need ...

As an AR Caller at M&D Capital, a premier billing company based in New York, you will be responsible for managing accounts receivable, contacting insurance companies for claim updates, addressing claim denials, and pursuing outstanding claims. This full-time hybrid role offers work-from-home options, allowing for flexibility in your work schedule. - Maintain accurate records of accounts receivable - Contact insurance companies for claim updates - Address claim denials - Pursue outstanding claims - Collaborate with various departments - Ensure prompt reimbursements The ideal candidate should have: - Prior experience in Accounts Receivable, Claims Management, and Medical Billing - Strong commu...

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 d...

Key Responsibilities 1. Claims Management Oversee end-to-end claims handling for Health (cashless and reimbursement) and Life Insurance. Ensure timely submission and processing of claim documentation. Liaise with insurers to expedite claims approvals and settlements. 2. Coordination & Communication Serve as the single point of contact for all internal and external stakeholders regarding claims. Coordinate with RMs, Partners, and clients to gather necessary claim documents and information. Work closely with the Product and Insurance Operations teams to resolve claim queries. 3. Process Excellence Monitor claim progress and proactively follow up with insurers to avoid delays. Maintain and upda...

The candidate must have experience in Infra Projects Should have good understanding in FIDIC/CPWD/PPP Contract Models Must have knowledge and experience in Claims Management, Change orders , Risk Allocation Good experience in Client / Subcontractor negotiation The candidate with Post Graduation NICMAR would be added advantage

Role Overview As a Senior Quantity Surveyor at our company, you will play a crucial role in managing project costs, contract administration, and financial reporting for civil engineering and infrastructure projects. Your expertise in civil works such as roads, bridges, utilities, drainage systems, and earthworks will contribute to the successful and timely delivery of projects within budget. Key Responsibilities - Prepare detailed cost estimates and bills of quantities (BOQ) for civil engineering works. - Analyze project drawings and specifications to ensure accurate costings. - Manage project budgets, valuations, and cash flow forecasting effectively. - Evaluate and negotiate subcontractor ...

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...

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...