414 Claims Management Jobs - Page 2

You would be responsible for managing the end-to-end claims process for clients, ensuring seamless handling from claim intimation to settlement follow-ups. You will be the key point of contact for clients and AMCs regarding claim processes. You should be strategic and detail-oriented, ensuring timely documentation, filing, and resolution of claims while also contributing to business growth through lead generation and upselling. Requirements You have a bachelors degree in administration, commerce, or a related field. 2-3 years of hands-on experience in insurance claims processing. Ability to communicate correctly and clearly with all customers. Maintain a positive attitude with a focus on customer satisfaction. Documentation and organizational skills.

An excellent opportunity for a seasoned operation professional to lead and manage high-performing teams in motor insurance claims. This role offers exposure to end-to-end claims operations, client interactions, and team leadership in a process excellence-driven environment. Your Future Employer - A leading global business process management company serving clients across industries like Insurance, Banking, Travel, Healthcare, and more. With a strong focus on innovation, analytics, and digital transformation, the organization enables businesses to achieve superior operational outcomes and efficiency. Responsibilities - Managing day-to-day operations and driving performance improvements across functions. Overseeing the motor bodily injury claims process with a focus on compliance and timely resolution. Leading and mentoring a team to foster engagement and accountability. Collaborating with legal and external stakeholders on complex claims. Monitoring KPIs, identifying process gaps, and driving continuous improvement initiatives. Ensuring compliance with industry regulations and internal controls. Driving automation initiatives and contributing to digital transformation efforts. Requirements - Graduate degree in Business Administration, Insurance, or a related field. Strong experience in operations management, especially in the insurance sector. Proven track record in managing motor insurance claims and leading large teams. Excellent communication, analytical, and stakeholder management skills. Familiarity with claims systems, risk assessment methodologies, and process optimization tools. What is in it for you - Opportunity to drive operational excellence and team performance. Exposure to global best practices in insurance operations. Be a key contributor to digital transformation and strategic projects. Reach us: If you think this role aligns with your career goals, please email your updated resume to vasu.joshi@crescendogroup.in for a confidential discussion. Disclaimer: Crescendo Global specializes in Senior to C-level niche recruitment. We are committed to enabling job seekers and employers with an engaging and professional recruitment experience. Crescendo Global does not discriminate on the basis of race, religion, gender, sexual orientation, age, disability, or any other protected status. Note: Due to the volume of applications we receive, we may only respond to shortlisted candidates. Thank you for your understanding. Scam Alert: Beware of fraudulent job offers in the name of Crescendo Global. We do not charge fees or request purchases. All valid opportunities are listed at www.crescendo-global.com. Profile Keywords - Deputy Manager Jobs, Operations Jobs, Insurance Claims Jobs, Motor Insurance, Claims Management, SLA Management, Team Leadership, Client Management, Operations Excellence, BPM Jobs, Insurance Operations, Claims Processing.

Role & responsibilities Strong understanding of Banking and services. Incorporates product knowledge into internal and external customer communications Demonstrates knowledge of insurance and claims industry Understands who to go to for additional information Communicates in a timely and effective manner (verbally and written) Understands priorities and objectives to ensure all deadlines are met Claims Management Risk Management Insurance Programs Reconciliation Preferred candidate profile Graduated from finance background

Greetings from NTT DATA, Roles and Responsibilities: Process Adjudication claims and resolve for payment and Denials Knowledge in handling authorization, COB, duplicate, pricing and corrected claims 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 Ensuring accurate and timely completion of transactions to meet or exceed client SLAs Organizing and completing tasks according to 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: 1-3 years of experience in processing claims adjudication and adjustment process Experience of Facets is an added advantage. 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 **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.

Job Responsibilities: ***ONLY BHMS GRADUATES CAN APPLY.*** Having experience (at least 5 yrs) in TPA claim processing. Having a Good relationship with Hospitals under the East Zone. Financial Contribute to renewal portfolio expansion through relationship building with the insurance companies and surveyors to ensure optimum claim settlement in minimum time During processing of claim analyse the following and communicate to underwriters: adequacy of sum insured anomalies in the policy scope of additional policies other related information Control expenses Business Process Facilitate proper settlement of the claim in the shortest possible time to the satisfaction of the client by ensuring the following: Obtain complete information on the loss from the client after initial intimation Submit intimation to the insurance company for Registration of claim Allocation of a surveyor Obtain LOR (List of Requirements) from the Surveyor Match LOR with the Salasar requirement already taken from the client and take rest of the documents Once documents are received, check exclusions in fine print and prepare the draft reply from client submitted to insurance company Follow up with client for repair and reinstatement for early completion and help in documentation of estimate, contractor details, expenses etc. so that surveyor gets structured inputs for preparation of the survey report Follow up with surveyor for completion of assessment Communicate surveyors comments to client in terms of estimate and exclusion and arrange meeting between surveyor and client to resolve differences to obtain client assessment Ensure surveyors report is submitted at the earliest Follow up with insurance company for early settlement of claim Obtain settlement voucher from insurance company and forward to client Get discharge of client (signoff) and submit to insurance company for disbursement Update each step in SAIBA on real time basis and ensure due IRDA compliance Ensure resolution of all complex technical issues in claims and timely escalation of the same for quick disposal of the claim Customer Support the marketing department in obtaining new business and ensuring best possible coverage for client, talk to technical dept of client to understand which risks need to be covered, type of production (continuous/ batch) Reopen claims in case of new businesses and follow up to obtain claims after reopening of file by insurance company if repudiation is not time-barred Participate in fortnightly meetings to give updates to the business development and client servicing teams on the status of claims in order that they are updated about the same before meeting client for renewals Interface with clients to reinforce relationship with existing clients Prepare and submit daily / monthly reports on status of claims People Growth Acquire product knowledge and always keep self updated with latest variations in product offerings Attend training sessions (external/ internal) and working on on-job assignments to implement new learning Conduct training sessions for marketing team as well underwriting and claims teams to build product knowledge across functions Set objectives, review and evaluate performance periodically and give feedback Review pending work and initiate action Perform all such duties which are required to be performed by this position in an insurance broking house in general course and to perform all such duties and carry out all such responsibilities so delegated or asked to be performed by the Designated Authority from time to time External Interface: Internal interface: Existing clients Prospective clients Insurance companies Employees Preferred Competencies of Incumbent a) Functional Competencies Demonstrates domain knowledge in own area of operation Understands product offerings Understands service standards as per the Organization's ethos Learns continuously and keeps self-updated b ) Leadership Competencies : Relationship Building Networks effectively with both external and internal customers Focuses on building long-term, sustainable relationships Delivers on commitment every time Creative & Analytical Problem Solving Understands the strategic objectives of the Organization, unit, and function Collates data and analyses them objectively Takes objective decisions based on data to achieve the strategic objective of the Organization Goes the extra mile to achieve creative solutions Customer Focus Designs solutions that meet the requirements of the customer (external/ internal) Demonstrates a sense of urgency to resolve all external and internal customer concerns and responds to queries and requests within defined timelines and processes Educates customers (external/ internal) about changes in processes, policies and offerings Creates long term relationships with customers (external/ internal) through continuous interface Obtains customer (external/ internal) feedback to improve processes Promotes loyalty and converts customers to brand ambassadors Achieves customer delight concerning both internal and external customers Is sensitive to the code of conduct in the office and customer establishments Perseverance Makes every possible effort to understand the viewpoints of external and internal customers Takes all possible steps to resolve issues Understands the importance of deadlines, proactively removes roadblocks, and delivers as per requirement Tries alternatives to achieve the target Does not give up in the face of adversity Explains own point of view assertively to get necessary support and approval Is patient and persistent towards follow-up on all leads and prospects generated during the past, towards new client acquisition Achievement Orientation Understands the strategic objectives of the Organisation, unit, and function Aligns individual and team targets with strategic goals Plan and deploy appropriate resources to meet targets in the short and long term Goes the extra mile to achieve targets as per committed timelines and enables the team to do so Achieves and motivates excellence irrespective of circumstances Shares best practices across businesses Benchmarks with the best and continuously raise the bar Upgrades competencies of self and team to achieve excellence Interested candidate can share their CVs at susweta@salasarserviecs.com

Role & responsibilities 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 information Control expenses Business Process Facilitate proper settlement of the claim in the shortest possible time to the satisfaction of the client by ensuring the following: Obtain complete information of loss from the client after initial intimation Submit intimation to the insurance company for Registration of claim, Allocation of surveyor. Follow up for deputation of surveyor In case of big losses, ensure Salasar representative accompanies the surveyor to understand the nature and extent of loss and give the client an indication of documents required. Intimate documents requirement for the client. Obtain LOR (List of requirements) from Surveyor Match LOR with Salasar's requirement already taken from the client and take the rest of the documents. Once documents are received, check exclusions in fine print and prepare the draft reply from the client submitted to the insurance company Follow up with a client for repair and reinstatement for early completion and help in documentation of estimate, contractor details, expenses, etc. so that the surveyor gets structured inputs for preparation of the survey report Follow up with surveyor for completion of assessment Communicate surveyor comments to the client in terms of estimate and exclusion and arrange a meeting between the surveyor and client to resolve differences to obtain client assessment Ensure surveyors report is submitted at the earliest Follow up with insurance company for early settlement of claim Obtain settlement voucher from insurance company and forward to client Get discharge of client (signoff) and submit to the insurance company for disbursement Update each step in SAIBA on real time basis and ensure due IRDA compliance Ensure resolution of all complex technical issues in claims and timely escalation of the same for quick disposal of the claim Customer Support the marketing department in obtaining new business and ensuring the best possible coverage for clients, talk to the technical dept of the client to understand which risks need to be covered, type of production (continuous/ batch) Reopen claims in case of new businesses and follow up to obtain claims after reopening of the file by the insurance company if the repudiation is not time-barred. Participate in fortnightly meetings to give updates to the business development and client servicing teams on the status of claims in order that they are updated about the same before meeting clients for renewals Interface with clients to reinforce relationships with existing clients Prepare and submit daily/monthly reports on the status of claims. People Growth Acquire product knowledge and always keep yourself updated with the latest variations in product offerings Attend training sessions (external/ internal) and work on on-job assignments to implement new learning Conduct training sessions for the marketing team as well as underwriting and claims teams to build product knowledge across functions Set objectives, review and evaluate performance periodically, and give feedback Review pending work and initiate action Perform all such duties which are required to be performed by this position in an insurance broking house in general course and to perform all such duties and carry out all such responsibilities so delegated or asked to be performed by the Designated Authority from time to time External Interface: Internal interface: Existing clients Prospective clients Insurance companies Surveyors Employees Preferred candidate profile a) Functional Competencies Demonstrates domain knowledge in own area of operation Understands product offerings Understands service standards as per Organisation ethos Learns continuously and keeps self-updated b ) Leadership Competencies: Relationship Building Networks effectively with both external and internal customers Focuses on building long-term sustainable relationships Delivers on commitment every time Creative & Analytical Problem Solving Understands the strategic objectives of the Organisation, unit, function Collates data and analyses them objectively Takes objective decisions based on data to achieve the strategic objective of the Organisation Goes the extra mile to achieve creative solutions Customer Focus Designs solutions that meet the requirements of the customer (external/ internal) Demonstrates a sense of urgency to resolve all external and internal customer concerns and responds to queries and requests within defined timelines and processes Educates customers (external/ internal) about changes in processes, policies, and offerings Creates long-term relationships with customers (external/ internal) through continuous interface Obtains customer (external/ internal) feedback to improve processes Promotes loyalty and converts customers to brand ambassadors Achieves customer delight with respect to both internal and external customers Is sensitive to code of conduct in office and customer establishments Perseverance Makes all possible efforts to understand the viewpoints of external and internal customers Takes all possible steps to resolve issues Understands the importance of deadlines, proactively removes roadblocks, and delivers as per requirement Tries alternatives to achieve the target Does not give up in the face of adversity Explains own point of view assertively to get necessary support and approval Is patient and persistent towards following up on all leads and prospects generated during the past towards new client acquisition Achievement Orientation Understands the strategic objectives of the Organisation, unit, function Aligns individual and team targets with strategic goals Plans and deploy appropriate resources to meet targets in the short and long term Goes the extra mile to achieve targets as per committed timelines and enable the team to do so Achieves and motivates excellence irrespective of circumstances Shares best practices across businesses Benchmarks with the best and continuously raises the bar Upgrades competencies of self and team to achieve excellence. Share your resume at susweta@salasarservices.com

As the Group Business Manager with the Bank, you will be responsible for managing the Group business operations in collaboration with the Bank employees. Your role will involve liaising with different departments to ensure the timely closure of cases and maintain a smooth workflow. A key aspect of your responsibilities will be to champion the group insurance products and processes to drive top-line sales through the business sales team. You will also be tasked with maintaining penetration levels of group insurance products with channel partners by coordinating and providing training to key officials such as ASSL, DSA, and other bank officials. In addition to driving sales, you will be required to provide valuable market feedback on competition and other products in the market. Building and strengthening relationships through engagement with various stakeholders including Partners Zonal Leadership team, Ops & Credit Team, DSAs, SMs, and Field Sales Staff will be crucial in enhancing attachment ratio and business volume. Your performance will be evaluated based on tracking penetration performance and publishing dashboards in alignment with Group Operations. Monitoring and controlling various metrics such as Files and sum assured Penetration rates, seller activation, Claim denial rates/ pending rates, rejection ratios, and medical TATs will be essential to minimize discrepancies and contribute to product improvement. Furthermore, you will oversee the post-sales process and manage the complete claims operation from end to end. Your proactive approach in managing the Group business and collaborating with internal and external stakeholders will play a key role in achieving business objectives and ensuring operational efficiency.,

As a Contract Specialist, you will have the opportunity to gain experience in a wide variety of commercial disciplines. This includes contract reviews, providing contract advice, managing cross border delivery, handling disputes and claims, as well as dealing with tax and insurance matters. A proven track record of advising on contract matters across various jurisdictions, especially civil law jurisdictions in the UK, is considered a distinct advantage. Ideally, you should have demonstrated experience in delivering contract reviews, drafting agreements, and negotiating terms. We are specifically looking for individuals who excel in collaboration, possess excellent teamworking skills, and are open to working with graduates who have the right mindset. Your key responsibilities will include but are not limited to: - Drafting, reviewing, and negotiating a wide range of commercial agreements such as consultancy agreements, framework agreements, memorandums of understanding, and non-disclosure agreements. - Conducting commercial reviews to identify deviations from governance standards and assisting project teams in obtaining internal approvals when necessary. - Developing and updating commercial guidance to enhance awareness of recurring topics and new regulations in key markets and jurisdictions. - Supporting Divisional Commercial Managers and other team members by leading on commercial risk management for projects. - Managing and resolving claims with the support of internal Commercial and Legal functions. - Providing assistance to other departments for governance purposes, including liaising with the Legal Department, Ethics & Compliance, Data Protection, and Insurance teams. Candidate specifications: - Possession of a Law Degree LLB or equivalent. - Preferably, relevant experience in a large engineering or construction company. - Understanding of UK infrastructure contract law and familiarity with standardized contracts like the New Engineering Contract. - Practical experience in applying legal principles and commercial law. - Strong analytical skills and deep legal knowledge. - Ability to multitask, problem solve, and manage competing priorities. - Effective and confident communication with a diverse range of stakeholders. - Capability to work independently as well as part of a larger team. Skills required: infrastructure, drafting, multitasking, knowledge of civil law jurisdictions, commercial governance, contract advice, negotiation, contract reviews, analytical skills, claims management, stakeholder communication, legal compliance, arbitration, contract review, commercial risk management.,

The role of Claims Coordinator at Genins India Insurance TPA Limited, based in New Delhi, is a full-time on-site position that involves managing insurance claims from initiation to completion. As a Claims Coordinator, your primary responsibility will be to ensure the efficient processing and resolution of insurance claims within specified timeframes. This includes tasks such as verifying claim details, coordinating with insurance providers, maintaining accurate documentation, and engaging with clients to provide updates on their claims status. To excel in this role, you must possess strong analytical skills and keen attention to detail. Expertise in insurance and claims management is essential, along with the ability to effectively handle various types of claims. Your role will also require you to have excellent communication skills to interact with insurance providers, clients, and internal stakeholders. Proficiency in relevant software and claims processing tools is necessary to streamline the claims management process effectively. Ideally, you should hold a Bachelor's degree in Insurance, Business Administration, or a related field. Previous experience in a similar role would be advantageous. The ability to work both independently and collaboratively as part of a team is crucial for success in this position. By demonstrating efficient claims management practices and adherence to company policies, you will contribute to ensuring client satisfaction and organizational efficiency.,

You will be responsible for managing the execution of the complete Contracting Process, which includes Contract Strategy, Tactics, Contract Award, and Contract Management activities for the projects execution contracts. Your primary focus will be on PMC contract, installation contracts, construction Contracts, and EPC Contracts. During the post-award phase, you will be tasked with maintaining the commerciality of these contracts, with a specific emphasis on the management and settlement of variations and claims. Your key accountabilities will include managing internal (Nayara) stakeholders in the development and execution of contract strategies and tactics to drive value maximization in awarded contracts and commercial deals during the pre-award phase. Additionally, you will be responsible for managing both internal (Nayara) and external (Suppliers/Contractors) stakeholders to ensure the delivery and protection of value under each contract. This will involve leading negotiations and settling disputes during the post-award phase.,

Vidal is hiring for claim Processor Designation: Executive-Claims Location: Gurgaon, Key Responsibilities: Review and validate claim documents submitted by hospitals or insured members Scrutinize medical records and bills for completeness and accuracy Apply policy terms, conditions, and exclusions to adjudicate claims Perform ICD and procedure coding as per ailment and treatment Coordinate with medical officers for clinical opinion when required Maintain claim logs and update CRM systems with claim status Ensure adherence to defined SLAs and minimize processing errors Flag suspicious or potentially fraudulent claims for investigation Communicate with stakeholders for clarifications or missing documents Support audit and compliance teams with documentation and reports Shortfalls & Queries Required Skills & Competencies: Strong understanding of health insurance policies and TPA workflows Familiarity with medical terminology and coding (ICD, CPT) Attention to detail and analytical thinking Proficiency in claims processing software and MS Office tools Good written and verbal communication skills Ability to manage high volumes under pressure Commitment to confidentiality and data protection norms Qualifications & Experience: Graduate in any discipline (preferably life sciences or healthcare) 1-3 years of experience in claims processing within a TPA or insurer

Job Summary As a member of the NA Client Service Teams this role supports the processing of pre renewal, broking, binding and post binding activities required for placement and service of our NA CRB clients and prospects. The work closely with Client Advocacy, Client Service and Broking on a daily basis to delivery White Glove Service to our clients and prospects Principal Duties/Responsibilities . Participate in the draft proposal creation process alongside the Client Team Collaborate with the Client Team to support the activities required to file taxes in a timely manner to avoid fines and penalties due to late fees Support the Client team in process of binding coverage with carriers by drafting of binding confirmation documents and following up with carriers for receipt of binders Support in preparation of the Summary of Insurance to facilitate Clients understanding of their coverage Arrange and facilitate internal strategy meetings to discuss insurance upcoming renewals for a specific period. Support Client Managers and Account Executives in the coordination process Monitor renewal activities and assist in the preparation, review and update of documents and data required for the renewal process Support the Client Service and Advocacy teams with reporting needs Support the Client Service and Advocacy teams in the skillful management of ad hoc and mid term requests to support such activities and endorsements, certificates, loss runs, etc Support Client Management and Client Advocacy colleagues with the preparation and management of tasks and deliverables required as part of the renewal process. Collaborate with functional teams to initiate and finalize client deliverables. Follow up and handle questions and requests for information from functional teams. E.g., Loss Runs, Policy Checking, Certificates, Accounting and Settlement. Support the billing and invoicing process by ensuring that all necessary documents and key data elements are included and accurate Support onboarding of new clients Create and manage Client Exposure details Support the renewal process with document preparation/management, data analysis/management and delivery as part of a packet to Advocacy/Service team in preparation for client renewals Schedule, attend and take minutes of Internal Strategy meetings Data entry required to load and update client details for submission, proposal, binding and billing Knowledge and Experience: 2 to 5 years for experience in the Insurance renewal cycle business US insurance experience (Must) Understanding of the end-to-end insurance renewal cycle and its stages Thorough knowledge and understanding of various insurance documents An understanding of catastrophe modelling will be useful

Responsibilities: Drive sales growth through channel management Manage profit & loss statements Lead team performance Ensure claims resolution excellence Oversee retention strategies

Responsibilities: Prepare ILAs, Final Survey Reports, and requirement letters Maintain records of claim intimation, surveyor visits, documents, and reports Follow up with insured/internal teams to reduce TAT Enter claims data into CMS software Provident fund Health insurance

Job Summary We are seeking a skilled professional with 3 to 5 years of experience in the Life and Annuity domain for the role of SPE-Ins Claims. The candidate will work from our office during night shifts focusing on claims processing and analysis. This role requires a strong understanding of Life and Annuities Insurance to ensure accurate and efficient claims management contributing to the companys success and customer satisfaction. Responsibilities Analyze and process insurance claims in the Life and Annuity domain to ensure timely and accurate resolution. Collaborate with team members to identify and resolve discrepancies in claims documentation. Utilize domain knowledge to enhance the efficiency of claims processing and improve customer satisfaction. Maintain up-to-date records of claims and ensure compliance with company policies and industry regulations. Provide insights and recommendations to improve claims processing workflows and reduce processing times. Communicate effectively with internal and external stakeholders to facilitate smooth claims handling. Monitor claims trends and provide reports to management for strategic decision-making. Ensure adherence to quality standards and regulatory requirements in all claims processing activities. Support the development and implementation of new claims processing tools and technologies. Participate in training sessions to stay updated with industry trends and best practices. Assist in the preparation of claims-related documentation and reports for audits and reviews. Contribute to team meetings and discussions to share knowledge and improve processes. Engage in continuous learning to enhance domain expertise and professional growth. Qualifications Possess strong analytical skills and attention to detail for accurate claims processing. Demonstrate excellent communication skills for effective stakeholder interactions. Have a solid understanding of Life and Annuities Insurance to apply domain knowledge effectively. Show proficiency in using claims processing software and tools. Exhibit problem-solving abilities to address and resolve claims issues efficiently. Display a commitment to maintaining high-quality standards and compliance with regulations. Be open to working night shifts and adapting to a dynamic work environment. Certifications Required Certified Life and Health Insurance Specialist (CLHIS) or equivalent certification in Life and Annuities.

About you Minimum of 5+ years of experience in risk management, claims management, insurance industry Strong technical aptitude with project management skills, capable of learning emerging products and creating plans to support the business Comfortable working in a fast-paced environment while still meeting deliverables Candidate should be flexible and willing to work during US time zones Meticulous attention to detail and effective communication to align data needs with organizational goals. What Youll Be Doing Facilitating seamless communication between the broker and the insured party to ensure comprehensive risk management and the integrity of insurance policies Collect and prepare Insurance submissions for Clarivates lines of coverage, maintain project plan, ensure that deadlines are clear and adhered to, follow up with key stakeholders, ensuring responses timely and escalate, as appropriate Review Insurance contract language & provide responses for RFPS, DDQs etc with direct guidance from Sr. Manager, Risk Management Respond to requests of Certificates of Insurance, including requirements intake from business owners, submit information to the insurance broker and review of the CIO for accuracy prior to sending back to the business owner. Upon renewal, ensure prompt issuance of COIs to business stakeholders (e.g. Real Estate teams, contract management, etc) Address US workers compensation program inquiries, including coordinating with insurance broker for evidence of coverage is specific states ( e.g. respond to CRITS, NCCI, in coordination with broker) Facilitate the review and reporting of incidents and claims to the insurance carriers, as appropriate. Ensure that all insurance related payments are made accurately and timely. This includes vendor master file set up, follow up with AP for prompt payment and ensure adherence to business insurance budget For international policies, work with international broker to ensure local requirements are met Evaluate existing business insurance practices, make recommendations on potential process improvements to the Sr. Manager, Risk Management. Responsible for identifying and gathering data requirements across various domains, including Insurance, Enterprise Risk Management (ERM), and Sustainability. This involves ensuring comprehensive data collection to support informed decision-making, risk mitigation, and the development of sustainable practices. Work Mode: Monday to Friday (Hybrid)

Principal AccountabilitiesHow they are achieved/measured Manage the Group business with the Bank employees Liaison with different departments for closure of the cases Champion product and process to drive top line sales through business sales team and maintaining penetration levels of group insurance products with channel partner. Coordinate and train key officials (ASSL, DSA, other bank officials) to enhance their understanding of the business to increase seller activisation Provide market feedback on competition and other products in the market. Manage and strengthen relationship through engagement with Partner s Zonal Leadership team, Ops & Credit Team, DSAs, SMs, Field Sales Staff at all levels and across functions. Values add in key initiatives to enhance attachment ration & business volume through training and service. Tracking penetration performance and publishing dashboards, along with Group Operations. To measure & monitor the various metrics (Files and sum assured Penetration rates, seller activation, Claim denial rates/ pending rates, rejection ratios , medical TATs etc) , to minimize the same and adhere to TATs and contribute to product improvement. Monitoring and control process of Post Sales. Managing complete claims operation & end to end process. Principal AccountabilitiesHow they are achieved/measured Manage the Group business with the Bank employees Liaison with different departments for closure of the cases Champion product and process to drive top line sales through business sales team and maintaining penetration levels of group insurance products with channel partner. Coordinate and train key officials (ASSL, DSA, other bank officials) to enhance their understanding of the business to increase seller activisation Provide market feedback on competition and other products in the market. Manage and strengthen relationship through engagement with Partner s Zonal Leadership team, Ops & Credit Team, DSAs, SMs, Field Sales Staff at all levels and across functions. Values add in key initiatives to enhance attachment ration & business volume through training and service. Tracking penetration performance and publishing dashboards, along with Group Operations. To measure & monitor the various metrics (Files and sum assured Penetration rates, seller activation, Claim denial rates/ pending rates, rejection ratios , medical TATs etc) , to minimize the same and adhere to TATs and contribute to product improvement. Monitoring and control process of Post Sales. Managing complete claims operation & end to end process.

As a Mining Consultant in our team, you will play a crucial role in supporting various consultancy and transaction advisory assignments within the mining industry. Your responsibilities will include assisting the Mining Team in evaluating techno-commercial options, such as mining methodologies, equipment configurations, and estimating CAPEX & OPEX for opencast and underground mining projects. Additionally, you will utilize your expertise in mine planning to prepare Detailed Project Reports (DPR) and secure pre-development clearances. You will be expected to conduct comprehensive research on developments in the mining and natural resources sectors at both national and international levels to identify new opportunities for growth, diversification, and strategic development. Your role will also involve financial analysis, cost modeling, mine costing, budgeting, business proposal drafting, and preparation of detailed project reports (DPR). Furthermore, you will be involved in tender and bidding processes, including asset evaluation and participation in auctions. Your responsibilities will extend to strategy and operations consulting, market assessment, competitive analysis, business development, and client relationship management. You will be instrumental in establishing and managing contract frameworks for mining and equipment/services procurement, drafting RFPs, tenders, and contracts specific to the mining sector. In addition, you will be responsible for drafting reports and correspondence to ensure client-side contract compliance, interpreting and evaluating contractual provisions, identifying risks and implications, monitoring contract implementation, reporting deviations, claims, and other issues. You will also support in claims management, dispute resolution, and revenue optimization strategies. Your role will also involve assisting in scheduling, cost control, and project planning, collaborating with dynamic construction teams under the supervision of a project manager across various mining-related projects, managing contract trade letting, and liaising with subcontractors and suppliers throughout project lifecycles. You will support site-based management tasks alongside the Site Manager to ensure successful project execution. Qualifications: - B.E/ B. Tech in Mining with M. Tech / MBA (finance) will be an added advantage Location: Nagpur Contact: [Please provide the contact details],

As a member of the Strategic Accounts Servicing Team at Plum, your role is crucial in ensuring the smooth processing and servicing of health claims for key strategic accounts. Your primary responsibility is to manage end-to-end cashless/reimbursement claims of employees, providing exceptional service tailored to each client's unique needs. You will act as a Claims buddy, verifying policy coverage, reviewing medical records, coordinating with insurers, and communicating with end customers to ensure accurate and efficient claims processing. Your attention to detail is essential in reviewing and verifying policy details to confirm claim eligibility based on insurance policy terms and conditions. In your role, you will respond to inquiries from customers and stakeholders regarding claim status, coordinate with healthcare providers and insurance companies to obtain necessary information, and resolve any discrepancies or issues that may arise during the claims processing. Your proactive communication with employees on claim status will contribute to a positive experience for all stakeholders involved. Maintaining detailed and accurate records of all claim-related activities is crucial for documentation and audit purposes. You will be expected to meet or exceed established service level agreements and performance metrics related to claim processing, turnaround time, accuracy, and customer satisfaction. Your goal is to achieve a Net Promoter Score (NPS) of 90+ in the claims you handle. To excel in this role, you should have at least 2-4 years of experience in a Health Insurance claims role. Excellent written and verbal communication skills are essential, as well as a background in customer service with a focus on direct customer management. Your commitment to optimizing claims processing workflows, enhancing client satisfaction, and supporting the organization's strategic goals will be key to your success at Plum.,

The role involves managing and coordinating various aspects of insurance policies for the organization. This includes managing claims, liaising with insurance companies, and ensuring policies are up-to-date. You will be responsible for analyzing insurance policies to understand coverage, inclusions, exclusions, and terms and conditions. Your duties will include handling Employees Insurance, Marine transit & Warehouse Storage Insurance, Vehicle Insurance, Company properties, and Multirisk Insurance policies. You will receive and review insurance claims, ensuring all necessary information is included. It will be your responsibility to verify policy coverage and assess eligibility for claim reimbursement. Additionally, you will investigate and resolve discrepancies or missing information in claims. You will be expected to maintain detailed records of claims, correspondence, and actions taken. Timely reminders, follow-ups for the claims, and maintaining claim follow-up trackers will also be part of your responsibilities. This is a full-time position with benefits such as food provided and leave encashment. The work schedule is during the day shift at the designated work location.,

JOB TITLE Claim Resolution Specialist JOB PURPOSE TSI Healthcare specializes in revenue cycle management, offering tailored solutions for healthcare providers to address third-party insurance claims denials, manage underpayments, and optimize reimbursement processes. The Claim Resolution Specialist plays a versatile role in the claims workflow, tasked with submitting appeals to overturn denials and trigger payments or determining whether further action, such as additional appeals or account closure, is required. Specialists in this role may prioritize tasks based on claim complexity and workload, ensuring optimal productivity while maintaining compliance and accuracy. By efficiently processing high volumes of low-balance claims, the specialist ensures compliance, accuracy, and revenue recovery that supports client success. PRIMARY RESPONSIBILITIES Appeal Submission and Resolution: Prepare and submit well-documented and persuasive appeals for denied claims, leveraging payer guidelines, contracts, fee schedules, and medical records to resolve issues and trigger payments. Escalation Management: Address claims escalated by Claim Status Specialists, resolving complex denial scenarios such as coding disputes, medical necessity issues, or payer policy conflicts. Underpayment Resolution: Investigate and address discrepancies between expected and actual payments, taking corrective action to resolve underpayments. Final Determination: Evaluate claims to determine if they are resolved or require further action, such as additional appeals, escalation, or account closure based on client requirements. Account Closure: Review and close accounts when collection efforts have been exhausted, ensuring proper documentation and compliance with client guidelines. Account Review Feedback: Identify incorrectly resolved claims and return them to the appropriate team for review, correction, or training, contributing to process improvements. Collaboration: Utilize documentation provided by Document Retrieval Specialists and Claim Status Specialists to perform resolution activities efficiently PERSON SPECIFICATION High school diploma or equivalent required. Minimum of three years of experience in healthcare claims management, denial resolution, or appeal writing. • Experience in high-volume, low-balance claims processing preferred. Familiarity with payer-specific policies, reimbursement methodologies, and contract terms. Knowledge of coding principles (e.g., CPT, ICD-10, HCPCS) and medical necessity documentation is a plus. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities and qualifications may be required and/or assigned as necessary. This Job Description has been discussed with me and I understand its contents expected of me as an incumbent of this position. This job description is not an exclusive or exhaustive list of all job functions that a team member in this position may be asked to perform. Duties and responsibilities can be changed, expanded, reduced, or delegated by management to meet the business needs of the company. We provide Equal Employment Opportunity for all individuals regardless of race, color, religion, gender, age, national origin, marital status, sexual orientation, status as a protected veteran, genetic information, status as a qualified individual with a disability and any other basis protected by federal, state or local laws. For Further Quarries / to Schedule Interview Contact HR Akila @9632572812 Email: Akila.Ravi@tsico.com

Role & responsibilities Any disputes with regard to works being executed by the contractors under Authority shall be resolved in the most amicable manner in accordance with the provisions of the contract. The General Consultant shall advise and assist the Authority in arbitration proceedings, the appeal of arbitration or litigation relating to the works, whenever required during or after the Consultancy assignment till the expiry of the Defect Liability Period The GC shall support Authority in land-disputes and also assist in process of land acquisition process for projects as per requirement. The GC shall analyze Arbitral Awards & judgments in key cases and advise on suitable remedial measures on a case-by-case basis. The GC shall highlight all unsettled disputes between contractor & Railways based on data captured in PMS to notice of Authority and expedite resolution The GC shall assist in review of impact of Extension of time (EOT) and change of scope (COS) on project budget. The consultant shall assist in approvals of proposals for variations in the shortest possible time duly coordinated with the Contractors and the Authority Engineer/Engineer-in-charge for the projects Rendering advice to Authority on queries from all stake holders of project technical consultants, EPC contractors, Authority Engineers, Independent Engineer, and facility management service agencies as required by the Authority. Preferred candidate profile Contract Management Professional with experience in contracts in Railways, Metro, Highways, Buildings sector. CME has to provide upholding support Gati sakthi unit of Jodhpur railway division as a General consultant in behalf of the company. Office situated at Jodhpur railway office.

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years 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 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 model that can meet the unique needs of each market segment.Claim processing team collects end-end data dataDevelop and deliver business solutions that support the claims process across its lifecycle, including first notice of loss, claims investigation, payment administration or adjudication, provider reimbursement (health care), subrogation and recovery. What are we looking for Communication SkillsTeamwork & CollaborationProblem-Solving & Critical ThinkingAdaptability & Willingness to LearnTime Management & Organization Roles and Responsibilities: In this role you are required to solve routine problems, largely through precedent and referral to general guidelines Your primary interaction is within your own team and your direct supervisor In this role you will be given detailed instructions on all tasks The decisions that you make impact your own work and are closely supervised You will be an individual contributor as a part of a team with a predetermined, narrow scope of work Please note that this role may require you to work in rotational shifts Qualification Any Graduation

Location : Thane, Kalpataru Shift : General shift Job Description : Candidate should have experience in Consumer Good Insurance and claim settlement process Should be very good at knowledge of Excel and PPT. Candidate should know how to perform Reconciliation Activity Should be Very good at Verbal + Written communication. Immediate joiner share the resume at kavita.kamtekar@digitide.com or WhatsApp (only) 9920115154

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 Pune address: C-Wing, First Floor, Manikchand Icon, Balkrishna Sakharam Dhole Patil Rd, Sangamvadi, Pune, Maharashtra 411001 Mumbai address: 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 WhatsApp to 9632777628