1074 Claims Management Jobs - Page 39

Venue Walk-In Interview on 30-May-2025, Registration will End by 11:00AM Responsibilities: Applying medical knowledge in evaluating the medical claim files to ascertain the medical admissibility. Must understand the policy wordings including Terms & conditions to adjudicate the Admissibility/Rejection. Processing of claims as per regulatory guidelines. Adhering to the TATs in processing. Quality review of processed files. Grievance redressal, handling escalations and Identifying the fraudulent claims. Required understanding and evaluation criteria: Qualified MBBS, BAMS, BHMS having all certificates in hand Preferably from Insurance and TPA experience Clinical Acumen/knowledge in terms of hos...

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 Hindi & Malayalam. CTC – Upto 3.5 LPA.

Role: Senior Executive/Team Lead CRM Job Responsibilities Client Servicing Resolving customer queries within TAT and ensuring smooth claim process Providing information to the customers and to respond to their claim related queries Coordinating with the customers/agents for cashless claim settlement Coordinating with internal stakeholders like enrolment, Account management, claims, investigation, support team to settle claims Transactional Activities To coordinate with inward team for claim receiving and claim registration Allocating new generated claims to processing team for action Liasoning with enrolment team to register the policy for cashless and reimbursement Coordination with regiona...

Job Title : Marine | End-to-end Claims Insurance Qualification : Any Graduate and Above Relevant Experience : 3 7 years Must Have Skills : 1.Insurance regulations and laws 2.Claims handling procedures 3.Risk management principles 4.Industry standards 5.Maritime law and regulations 6.Investigate and analyze claims documentation 7.Determine coverage and liability 8.Negotiate settlements and resolve disputes 9.Communicate effectively with insureds, claimants, suppliers and brokers 10.Apply industry-standard claims handling procedures. 11.Collaboration and teamwork Good Have Skills : Experience in Marine Adjuster Roles and Responsibilities : 1.Investigate the circumstances surrounding marine inc...

Role: Knowledge Lead Claims Location: Pune Shift : 6PM to 3AM *************************************************** IMMEDIATE JOINERS REQUIRED Send your updated CV directly to: 9152808909 **************************************************** Note: It is an Individual Contributor Role Job Description: 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 Man...

Position: Claims Executive Experience: Only Fresher Qualification: Any Graduate Job Location: Mysore Note: Apply only if fine to work at hospital and location Job Description: * Good communication skill. * Updating records and files in portal * Knowledge in computers like MS office. * Usage of company platform for patients data updation. * Database management. * Good interpersonal skill. * Coordination with other team members and internal department of the hospital * Share daily activity report to the reporting manager

Tendering 1. Tender identification: Identify and track relevant tender opportunities. 2. Tender preparation: Shall be able to thoroughly understand tender clauses. Check the pre-qualification criteria and tender requirements. Prepare and submit tenders, ensuring compliance with client requirements. Pre-bid meeting points. 3. Bid management: Coordinate with internal stakeholders i.e. government officers & consultants to gather necessary information and documentation. Shall be able to form good relations with these stakeholders. 4. Claim management & Arbitration handling skills will be preferred. 5. Experience of correspondence with client, sub-contractor and supplier 6. Knowledge of Escalatio...

25+ years in healthcare payer leadership. Expertise in claims, value-based models, risk adjustment, and member engagement. Deep knowledge of CMS, HIPAA, ACA regulations. Experience with payer tech systems (claims, analytics, CRM).

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...

Job Summary The Contracts Manager is responsible for overseeing contract management, ensuring compliance with contractual terms, mitigating risks, and optimizing contractual outcomes for infrastructure projects This role requires strong expertise in contract negotiation, legal compliance, claims management, and stakeholder coordination, Key Responsibilities Contract Management & Administration Draft, review, negotiate, and finalize contracts, subcontracts, and agreements with clients, vendors, and subcontractors, Ensure compliance with contractual obligations, company policies, and legal requirements, Monitor contract performance, identifying and mitigating risks, Maintain proper documentati...

Back to Careers Page Senior Manager Insurance Full Time Gurugram Overview Key Terms & Benefits: The Senior Manager Insurance will oversee the management and placement of comprehensive insurance policies, ensuring coverage for the companys operations, assets, and projects, specifically within the renewable energy sector (solar, wind, and energy storage) The role requires expertise in multiple insurance lines, working with brokers and underwriters, managing claims, and optimizing risk coverage while ensuring compliance with industry standards and regulatory requirements, Insurance Program Management Develop and manage the companys insurance portfolio, including but not limited to General Liabi...

Long Term Disability Claim Manager Role Overview: The LTD Claim Manager will manage an assigned caseload of Long-Term Disability cases. This includes management of claims with longer duration and evolving medical conditions. LTD Claim Managers will have meaningful and transparent conversations with their customers and clinical partners in order to gather the information that is most relevant to each claim. It also requires potentially complex benefit calculations on a monthly basis. The candidate will also evaluate customer eligibility and interact with internal and external customers including, but not limited to, customers, employers, physicians, internal business matrix partners and attor...

Job Title: Assistant General Manager Role Purpose The Incumbent is a technical expert and is responsible of scrutinising the correspondence for contractual replies and technical issues and drafting the accurate responses for client replies and the documents required for ADR/legal matters. They handle coordination with external consultants for the preparation of correct documents. They vet the CoS, prior to submission. Key Responsibilities Contract Administration & Monitoring Preparation of CAD (Contract Appreciation Document), formats for CIS (Contract information system), risk register and monthly reports that can be used as reference by the Head - Contracts and the management team and foll...

Adhere billing process guidelines Review claims, Verify coverage Assist with inquiries Prepare claim forms & documents & timely claim processing Record Keeping & upload files on the portal Assist pre-authorizations Resolve billing issues/escalation Required Candidate profile Any graduation or BBA/BHA min. 1 year Billing Experience is preferred Please Email your resume at hr@jimsh.org

Check the medical admissibility of claim by confirming diagnosis and treatment details Verify the required documents for processing claims and raise an information request in case of an insufficiency Approve or deny claims as per T&C within TAT If candidates are interested please drop your update resume/CV on my WhatsApp no - 8951865563 Thanks & Regards Sarika Email - sarika.pallap@mediassist.in

About this role: Wells Fargo is seeking an Audit Manager - Executive Director (SSO). The Audit Manager Executive Director is individual contributor role that supervises, executes and oversees multiple concurrent projects or audit engagements as directed by senior management and also participates in audits generally as subject matter expert in a consulting capacity. Audit Managers demonstrate depth and breadth of knowledge that includes technology, operational, financial, and regulatory understanding across multiple businesses and may develop knowledge in a critical subject matter area. About Chief Operating Office (COO) Audit: The Chief Operating Office (COO) Audit team is responsible for de...

Job Descriptions: Check the medical admissibility of claims by confirming the diagnosis and treatment details. Verify the required documents for processing claims and raise an information. Request a case of an insufficiency. Approve or Deny claims as per T&C witihin TAT. Required Qualification : B.Sc. Nursing, Msc Nursing, Interested candidates can share there profiles to sarika.pallap@mediassist.in or WhatsApp to 8951865563.

Exclusive Walk in Drive - US Healthcare RCM Trainer - 24 May 2025 Date : 24th May 2025 Venue : HCL Tech , 138, 602/3, Medavakkam High Road, Elcot Sez, Sholinganallur, Chennai, Tamil Nadu 600119 POC : Shinaz JOB SUMMARY We are seeking a knowledgeable and experienced US Healthcare RCM Trainer to join our team. The ideal candidate will be responsible for training employees on various aspects of revenue cycle management, including insurance processing, registration, eligibility, claims management, billing, collections, and denials. The trainer will develop and deliver training programs to ensure that employees are well-versed in RCM processes and best practices. Role & responsibilities Train new...

Managing CGHS, ECHS, CAPF and ESIC and All Government Portals: Medical file Audit Claim Processing Uploading Query Management Required Candidate profile Mandatory practical experience of government empanelment such as CGHS ECHS ESIC CAPF etc. and medical file audit and processing for Railways, CGHS, ECHS and other govt empanelment's.

Responsible for P&L of the branch Achievement of Branch targets for retention, cross selling and new business Retention of the Companys clients in assigned region Leveraging on the existing clients of the Company for cross selling Identification and conversion of leads for new business generation (corporate business) in assigned region Handling day-to day underwriting and servicing requirements of clients on a timely basis to ensure complete customer satisfaction Effectively managing the team that reports to him Ensuring that all underwriting requirements of clients are met as per Company defined TATs Effectively coordinating between client / centralised claims team to ensure timely resoluti...

Preferred candidate profile Candidate should be from Property and Casualty Claims Process Immediate Joiners Only Good English Communications

We Have Urgent Requirement of TPA Manager

In this role, you will: Support and capture all pertinent information from customers about their claims Conduct research and provide updates on status of new and existing claims Identify opportunities to improve customer experience after thorough research of complex account activity, and take appropriate actions to handle the claim Perform routine customer support tasks by maintaining balance between exceptional customer service and solid investigative research while answering incoming calls in a call center environment Receive direction from team lead and escalate questions and issues to more experienced roles Interact with colleagues on basic day-to-day issues, and network with supporting ...

Job Summary The Insurance Verification Manager will be responsible for overseeing the insurance verification process, ensuring timely and accurate verification of patient insurance eligibility and benefits. This role involves managing a team, optimizing workflows, and leveraging advanced features to enhance operational efficiency and patient experience. Key Responsibilities: Supervise and mentor the insurance verification team, setting performance goals and conducting regular evaluations. Provide training and support to team members on insurance verification tools and best practices. Ensure timely verification of patient insurance eligibility, benefits, coverage levels, exclusions, and limit...

Job Title: MBBS Medical expert- Claim & Insurance (Claim Adjudication & Medical Auditor) Location: Delhi/NCR Key Responsibilities Review and adjudicate medical claims for accuracy, completeness, and compliance with established guidelines and protocols. Evaluate clinical documentation and medical necessity to ensure appropriate utilization and minimize fraudulent claims. Support the development and implementation of medical audit frameworks and tools. Collaborate with internal teams, insurers, and government stakeholders for scheme design and policy formulation. Analyze claim trends, identify irregularities, and propose corrective and preventive actions. Provide expert insights and recommenda...