414 Claims Management Jobs - Page 5

We are hiring for a Senior Process Associate in Insurance Claims with 37 years of relevant experience. This is an excellent opportunity to join a reputed financial services firm and play a key role in managing claims, ensuring operational accuracy, and supporting risk management initiatives. Your Future Employer - A globally respected organization in the financial services space, known for its strong commitment to process excellence, innovation, and employee growth. Responsibilities - Manage end-to-end claims processes within the insurance domain Demonstrate strong understanding of banking and insurance services Communicate clearly and effectively with internal and external stakeholders Perform risk management activities and support insurance programs Execute reconciliation tasks and ensure accurate documentation Prioritize tasks and meet deadlines in a fast-paced environment Collaborate with product and process experts to stay updated on workflows Requirements - 3-7 years of relevant experience in insurance claims Any graduate (Finance qualification preferred) Excellent written and verbal communication skills Proficiency in Microsoft Excel Comfortable working in a 6 PM - 3 AM shift (Hybrid work model, Pune) What is in it for you - A hybrid work environment providing flexibility and structure Opportunity to be a part of a high-performing, growth-focused team Exposure to end-to-end insurance operations with a global client base Continuous learning and career advancement in a leading firm Reach us: If you think this role aligns with your career aspirations, kindly send your updated CV to vasu.joshi@crescendogroup.in for a confidential discussion on the opportunity. Disclaimer: Crescendo Global specializes in Senior to C-level niche recruitment. We are passionate about empowering job seekers and employers with an engaging, memorable job search and leadership hiring experience. Crescendo Global does not discriminate based on race, religion, color, origin, gender, sexual orientation, age, marital status, veteran status, or disability status. Note: Due to the high volume of applications, if you do not hear back within 1 week, please assume your profile was not shortlisted. Your patience is appreciated. Scam Alert: Crescendo Global never asks for money, purchases, or system upgrades. Verify all opportunities at www.crescendo-global.com and report any fraud immediately. Stay alert! Profile Keywords - Claims Management Jobs, Insurance Jobs, Finance Operations, Reconciliation, Claims Analyst, Risk Management, Hybrid Jobs Pune, Excel Insurance Jobs, SPA Jobs Pune, Insurance Claims Processing, Banking and Insurance Careers.

As the primary point of contact for Group business management with Bank employees, your role involves collaborating with various departments to facilitate the closure of cases. You will champion products and processes to boost top-line sales through the business sales team and maintain penetration levels of group insurance products with channel partners. It is essential to coordinate and provide training to key officials (ASSL, DSA, other bank officials) to enhance their comprehension of the business, thereby increasing seller activation. Your responsibilities also include offering market feedback on competitor activities and other products in the market. Strengthening relationships through engagement with Partners Zonal Leadership team, Ops & Credit Team, DSAs, SMs, Field Sales Staff, and other key stakeholders will be crucial. Your active involvement in key initiatives will contribute to enhancing attachment ratio and business volume through training and service initiatives. You will be accountable for tracking penetration performance, publishing dashboards, and collaborating with Group Operations to ensure smooth operations. Monitoring various metrics such as Files and sum assured Penetration rates, seller activation, Claim denial rates/pending rates, rejection ratios, medical TATs, and more is essential to minimize issues and adhere to TATs while also contributing to product improvements. Furthermore, you will oversee the monitoring and control processes of Post Sales, as well as manage the complete claims operation and end-to-end processes to ensure operational efficiency and customer satisfaction.,

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. You should possess a high level of proficiency in managing insurance claims, particularly PDBI claims, and demonstrate a strong technical knowledge of insurance products, coverage features, and claims processes. Your role will also involve coordinating with cross-functional teams, both internally and externally, including the Company, Subsidiaries, insurers, and surveyors. Implementing best practices in accordance with the company's guidelines will be essential, as well as ensuring compliance with various processes through internal and external audits. Additionally, you will be responsible for obtaining and compiling relevant information from different departments on insurance requirements, understanding various risks, suggesting appropriate clauses or wordings in insurance policies to mitigate risks, and securing the desired insurance coverage. Monitoring and reviewing the performance of insurers and TPAs to ensure prompt settlement of insurance claims within specified time frames will be part of your duties. Promptly addressing queries and concerns related to insurance matters and conducting knowledge-sharing sessions with colleagues from other departments on important insurance policies and the claims process will also be expected from you. To be eligible for this role, you should hold a degree as a Graduate with Associate or Fellow from the Insurance Institute of India, or an MBA/PGDBA with insurance specialization, or a BE with additional qualifications specialized in insurance.,

Ready to shape the future of work At Genpact, we don&rsquot just adapt to change&mdashwe drive it. AI and digital innovation are redefining industries, and we&rsquore leading the charge. Genpact&rsquos , our industry-first accelerator, is an example of how we&rsquore scaling advanced technology solutions to help global enterprises work smarter, grow faster, and transform at scale. From large-scale models to , our breakthrough solutions tackle companies most complex challenges. If you thrive in a fast-moving, tech-driven environment, love solving real-world problems, and want to be part of a team that&rsquos shaping the future, this is your moment. Genpact (NYSE: G) is an advanced technology services and solutions company that delivers lasting value for leading enterprises globally. Through our deep business knowledge, operational excellence, and cutting-edge solutions - we help companies across industries get ahead and stay ahead. Powered by curiosity, courage, and innovation , our teams implement data, technology, and AI to create tomorrow, today. Get to know us at and on , , , and . Inviting applications for the role of V ice President - Salesforce Insurance Consultant We are seeking a highly skilled Salesforce Insurance Consultant to lead and support digital transformation initiatives for financial institutions and insurance providers. The ideal candidate will possess deep expertise in Salesforce Financial Services Cloud , Salesforce Data Cloud , and other Salesforce tools, with a strong understanding of Property & Casualty (P&C) insurance and/or Life & Annuity processes . This role will help clients streamline workflows, improve customer experience, and enhance operational efficiency across their organizations using the Salesforce technology stack . Responsibilities Implementation Leadership : Lead and support the implementation of Salesforce solutions for financial institutions and insurance providers, ensuring seamless execution and integration with existing business processes. Workflow Optimization : Analyze, design, and configure Salesforce workflows to optimize claims processing , underwriting , policy management , and regulatory compliance in P&C insurance. Stakeholder Engagement : Collaborate closely with business stakeholders to identify pain points in existing processes and propose tailored solutions using Salesforce Financial Services Cloud and other Salesforce tools. System Integration : Drive the integration of Salesforce with core insurance platforms such as Guidewire , Duck Creek , or other legacy policy administration systems to ensure end-to-end automation and smooth data flow. Automation and Process Improvement : Enable and drive the seamless automation of policy servicing , claims management , and underwriting processes on the Salesforce platform , enhancing operational efficiency. Strategic Advisory : Provide strategic advisory services to insurance firms on leveraging Salesforce for improving operational excellence, customer satisfaction, and profitability. Client Presentations and Workshops : Lead Salesforce demonstrations and workshops for clients to showcase the platform%27s capabilities, highlighting potential ROI and business benefits. Best Practices and Governance : Develop and deliver best practices, governance models, and continual improvement strategies to ensure Salesforce implementations are efficient, scalable, and sustainable. Cross-Functional Collaboration : Work closely with cross-functional teams, including developers, architects, and business analysts, to implement solutions effectively, ensuring alignment with client objectives Qualifications we seek in you! Minimum Q ualifications / Skills Extensive experience in Salesforce implementation with a focus on Financial Services Cloud and/or Insurance industry solutions . Deep understanding of P&C insurance processes , including claims management , underwriting , and policy administration . Hands-on experience in Salesforce Financial Services Cloud and other relevant Salesforce products, including Salesforce Service Cloud , Salesforce Sales Cloud , and Salesforce Data Cloud . Knowledge of Salesforce integration with core insurance platforms like Guidewire , Duck Creek , or other policy administration systems is a plus. Strong analytical and problem-solving skills , with the ability to translate business needs into technical requirements . Salesforce certifications (Financial Services Cloud, Sales Cloud, Service Cloud, or other relevant certifications) preferred. Excellent communication skills , with the ability to engage with stakeholders at all levels and present complex solutions clearly Preferred Q ualifications / Skills Experience working with mid -to-large insurance companies in a consulting or technical advisory role. Familiarity with AI-powered automation and digital transformation trends in financial services and insurance . Exposure to Salesforce AppExchange solutions and custom app development using Salesforce Lightning . Ability to lead Salesforce training sessions and change management initiatives to empower clients to adopt and effectively utilize Salesforce solutions. Salesforce Certified Administrator (ADM 201) Salesforce Certified Financial Services Cloud Consultant Salesforce Certified Service Cloud Consultant Salesforce Certified Sales Cloud Consultant Salesforce Platform App Builder Why join Genpact Be a transformation leader - Work at the cutting edge of AI, automation, and digital innovation Make an impact - Drive change for global enterprises and solve business challenges that matter Accelerate your career - Get hands-on experience, mentorship, and continuous learning opportunities Work with the best - Join 140,000+ bold thinkers and problem-solvers who push boundaries every day Thrive in a values-driven culture - Our courage, curiosity, and incisiveness - built on a foundation of integrity and inclusion - allow your ideas to fuel progress Come join the tech shapers and growth makers at Genpact and take your career in the only direction that matters: Up. Let&rsquos build tomorrow together. Genpact is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, religion or belief, sex, age, national origin, citizenship status, marital status, military/veteran status, genetic information, sexual orientation, gender identity, physical or mental disability or any other characteristic protected by applicable laws. Genpact is committed to creating a dynamic work environment that values respect and integrity, customer focus, and innovation. Furthermore, please do note that Genpact does not charge fees to process job applications and applicants are not required to pay to participate in our hiring process in any other way. Examples of such scams include purchasing a %27starter kit,%27 paying to apply, or purchasing equipment or training.

A TPA (Third Party Administrator) Manager is responsible for overseeing and managing the relationship between the insurance company, healthcare providers, and policyholders. You will ensure the smooth processing of health insurance claims, handle grievances, and maintain compliance with regulatory requirements. Your key responsibilities will include overseeing the entire health insurance claim process from initiation to settlement. You will coordinate with insurance companies, hospitals, and policyholders for timely processing while ensuring accuracy in documentation and compliance with regulations. Reviewing high-value or complicated claims and approving based on policy guidelines will also be part of your role. As the TPA Manager, you will serve as the primary point of contact between healthcare providers and the insurance company. Monitoring the performance of the TPA team and ensuring efficient claim handling will be essential. Managing relationships with multiple hospitals and negotiating terms when necessary are also key aspects of the role. Ensuring compliance with all insurance regulations, industry standards, and internal policies will be crucial. Staying up-to-date with changes in insurance policies and healthcare regulations will be necessary to handle escalated cases and resolve disputes related to claims or policyholder grievances. In terms of team leadership, you will lead, mentor, and manage a team of claim processors and support staff. Conducting regular training sessions on claim processes, industry trends, and regulatory updates will be part of your responsibilities. Monitoring team performance, setting KPIs, and ensuring objectives are met will also fall under your purview. This is a full-time position requiring a total work experience of 10 years. The work location is in person, and the application deadline is 15/10/2024.,

Job Title: Employee Benefits & Insurance Manager Department: Client Success / Insurance Operations Location: Gurgaon Company: Pazcare Type: Full-time About Pazcare Pazcare is on a mission to transform the way modern Indian companies manage employee health & wellness. Trusted by 2000+ brands like Mamaearth, Chaayos, Mindtickle, and more we offer a digital-first platform for managing employee benefits, insurance, and wellness programs with clarity, transparency, and speed. Role Overview As an Employee Benefits & Insurance Practice Manager, you will lead client relationships for key mid-market and enterprise accounts. You will act as a strategic advisor to HR teams, ensuring smooth execution of employee insurance programs, wellness rollouts, and claims experience. You will also collaborate with insurers, TPAs, and brokers to solve high-impact client issues and drive continuous improvement in benefits delivery. Key Responsibilities Client Partnership & Success Be the single point of contact for key clients on all employee benefits matters. Build deep partnerships with HR teams, understanding their unique org needs. Own end-to-end delivery of group health, term life, and wellness programs. Insurance Practice Leadership Work closely with insurers and TPAs to manage policy issuance, endorsements, and claims. Track service-level adherence (claims TATs, resolution rates) and drive escalations where needed. Reopen and resolve wrongly repudiated claims with insurer/TPA coordination. Strategic Benefits Consulting Guide clients on plan design, utilization analytics, and cost control strategies. Translate data insights into actionable benefit improvements. Lead benefits renewal conversations in collaboration with internal teams. Internal Collaboration Work with tech, insurance ops, and sales to ensure client needs are delivered consistently. Mentor junior team members in the client success and insurance operations teams. Ideal Profile 5-10 years of experience in group health insurance / employee benefits / corporate wellness. Experience working with insurance brokers, TPAs, or insurers Strong client-facing skills with the ability to communicate at CXO/HR Head level. Deep understanding of group policy structures, endorsements, claims, and wellness delivery. Hands-on, empathetic, and accountable with a bias for action. Why Join Pazcare? Shape the future of health benefits in India. Work at the intersection of tech, insurance, and employee wellness. Lead high-impact initiatives with ownership and visibility. Be part of a growing team that values empathy, trust, and relentless execution.

Job Title: Sr Manager Health Insurance Claims Location: Bangalore (Hybrid) Company: Pazcare Type: Full-time About Pazcare Pazcare is transforming employee healthcare and wellness for 2000+ companies including Mamaearth, Chaayos, Mindtickle, and more. We simplify health insurance and wellness benefits, giving HR teams superpowers through real-time claim tracking, analytics, and stellar employee experiences. Role Overview As a Claims Manager, you will be the frontline owner of ensuring claims are settled within the agreed turnaround time (TAT) across TPAs. You will play a critical role in driving TPA performance, resolving escalations, and advocating on behalf of our clients to ensure no valid claim is wrongly repudiated. Key Responsibilities Ensure all reimbursement and cashless claims are processed within the committed TAT across clients. Track, analyze, and manage TAT performance of multiple TPAs; escalate and hold them accountable for delays or service gaps. Reopen wrongly repudiated claims with TPAs/insurers and fight for fair resolution on behalf of clients. Collaborate closely with the customer success and insurance teams to address claim escalations proactively. Drive continuous process improvement in claims handling and communication workflows. Maintain internal dashboards and reports to track SLAs and spot trends. Requirements 3+ years of experience in health insurance claims (TPA/insurance broker/insurer preferred). Strong understanding of reimbursement, cashless claim processes, and IRDAI guidelines. Assertive communicator with negotiation skills to handle TPAs and insurers. Analytical mindset with ability to identify patterns in delays or rejections. Empathy for the end user the employee or HR dealing with a health issue. Why Join Pazcare? Work with a mission-driven, fast-growing team redefining how India experiences employee health benefits. Ownership of high-impact outcomes and the opportunity to shape the future of claims at scale. Be part of a culture that values transparency, speed, and customer-first thinking.

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.

Responsibilities: Ensure timely claim settlements within policy limits. Manage health claims from intake to payment. Process mediclaim & TPA claims with accuracy. Collaborate with insurers on claim resolution. Health insurance Annual bonus

The Contract Administration Manager is responsible for overseeing and managing all contract related activities throughout the life cycle of construction projects. This role ensures that contractual obligations are fulfilled, risks are mitigated, and all contract documentation aligns with project goals, budgets, and legal requirements. Key Responsibilities: Contract Management: • Review and manage pre-award and post-award contracts for subcontractors, suppliers, and consultants. • Ensure compliance with the main contract terms and conditions. • Evaluate and review contract amendments, claims and variations. • Maintain and update contract records and logs. Procurement Support: • Coordinate with the Contracts & Budgeting and Procurement team to ensure timely and compliant subcontract awards. • Draft scopes of work, tender documents, and support bid evaluations. • Assist in subcontractor negotiations to optimize cost and schedule outcomes. Risk and Claims Management: • Identify and assess contractual and commercial risks. • Prepare and manage claims for extensions of time, loss and expense, or variations. • Defend against unjustified claims from subcontractors. Reporting and Documentation: • Maintain contract administration logs (variations, claims, correspondence). • Prepare regular reports on contract status, cost impacts, and risk exposure. • Ensure that all contractual correspondence is logged and addressed in a timely manner.

POSITION: MEDICAL OFFICER/CONSULTANT PA/RI APPROVER PURPOSE OF ROLE: To scrutinize and process the claims within the agreed TAT by having an understanding of the policy terms & conditions while applying their domain medical knowledge. Designation Function Medical Officer/Consultant Claims PA/RI Approver Reporting to Location Assistant Manager Claims Mumbai Educational Qualification Shift BHMS, , BAMS, MBBS(Indian registration Required) Rotational Shift (for female employee shift ends at 8:30 PM) 6 rotational week offs Provided per month Week offs Related courses attended None Management Level Junior Management Level Industry Type Hospital/TPA/Healthcare/Insurance Roles and 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. • • • Responsibilities 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. • • • • Error-free processing (100% Accuracy) Maintaining TAT Productivity (Achieve the daily targets) Key Results and Outcomes driven by this role: 0- 5 years Relevant Experience No of years of experience 0-5 years None Demonstrated abilities if any Technical Competencies • Analytical Skills • • Basic Computer knowledge Type writing skills • • Communication skills Decision Making Behavioral competencies

Davies is seeking a highly organised and self-motivated professional to join our Life & Health team as an Administrator Team Leader. In this role, you will provide leadership, guidance, and direction to a dedicated team, ensuring the achievement of key results and operational excellence. Your responsibilities will include overseeing document indexing, imaging, quality audits, data entry and the review of Proof of Loss (POL), as well as processing policy documents and claims. You will play a critical role in handling sensitive files and processing essential documents to support our US operations. This is an excellent opportunity for a proactive and detail-oriented individual looking to make an impact within a dynamic and collaborative environment.

Job Summary: The Contract Administrator is responsible for overseeing and managing all contract related activities throughout the lifecycle of construction projects. This role ensures that contractual obligations are fulfilled, risks are mitigated, and all contract documentation aligns with project goals, budgets, and legal requirements. Key Responsibilities: Contract Management: 1) Review and manage pre-award and post-award contracts for subcontractors, suppliers, and consultants. 2) Ensure compliance with the main contract terms and conditions. 3) Evaluate and review contract amendments, claims and variations. 4) Maintain and update contract records and logs. Procurement Support: 1) Coordinate with the Contracts & Budgeting and Procurement team to ensure timely and compliant subcontract awards. 2) Draft scopes of work, tender documents, and support bid evaluations. 3) Assist in subcontractor negotiations to optimize cost and schedule outcomes. Risk and Claims Management: 1) Identify and assess contractual and commercial risks. 2) Prepare and manage claims for extensions of time, loss and expense, or variations. 3) Defend against unjustified claims from subcontractors. Reporting and Documentation: 1) Maintain contract administration logs (variations, claims, correspondence). 2) Prepare regular reports on contract status, cost impacts, and risk exposure. 3) Ensure that all contractual correspondence is logged and addressed in a timely manner.

Join our dynamic international business team across Bangalore and Hyderabad Job Description Claims Service Support (CSS) - AM/Manager Summary: We at Prudent Insurance Brokers, are seeking an experienced Employee Benefit-Claims Service Support professional for our International Business (IB) vertical. Employee Benefits Practice at Prudent is a strategic business unit dedicated to strengthening Prudent’s global brand in the international market. The individual will be responsible to Serve as primary point of contact for all employee claim queries etc. We are committed to delivering bespoke Benefit & Total Reward Solutions with high standards of service excellence, world-class advisory and consultancy support for MNC clients who have their operations in India. Our team forms a bridge of trust between the expectations of senior stakeholders globally and the seamless delivery of these best practices in India. Roles & Responsibilities: • 1) Exceptional Employee Experience Support system by Prudent Serve as primary point of contact for all employee claim queries and own the process of developing strong employee relationships & engagement 2) Facilitating the cashless and reimbursement process: Ensuring employees understand the steps involved in both cashless and reimbursement claims. Offering exceptional support and guidance to employees/HR throughout the entire process to ensure a smooth experience. 3) E-cards/network hospitals: To provide employees e-cards and information about network hospitals. 4) Providing claim-related queries: Addressing questions about claim status, claim deductions, and explanations of queries. 5) TPA Co-ordination: Co-ordinating with TPA daily to ensure the smooth functioning of employee-related queries 6) Employee Engagement & Support SPOC: Daily tracking of claims on status/rejections/deductions and providing the report to MCS Desired profile/who should join: Good listening & communication skills Should have good technical knowledge about Employee health Insurance/ General Insurance products. (Cashless/Reimbursements) Experience in General Insurance/ Insurance Brokers Years of experience: 2 to 5 years Education qualification: Bachelor's Degree, Master's Degree Good knowledge of the TPA/Insurance processes Well-versed in health insurance policy conditions Well-versed with current medical practices & advancements Should know about IRDAI health regulation If the opportunity interests you, kindly share your updated CV with Tanay Srivastava (tanay.srivastava@prudentbrokers.com) or Yogesh Nagar (Yogesh.nagar@prudentbrokers.com) with the subject ‘’Claims role_*Location*’’ Role & responsibilities

I am hiring for this position for one of our Life Insurance clients. Role & responsibilities Prudent claim Assessment and management of end-to-end claim settlement /repudiations, including Life, Group claims Coordinate with Reinsurers /sales/customers for closure of claims within the regulatory framework and timelines Direct and oversee the maintenance of complete and accurate claim management records. Managing the claim teams on day-to-day claims transactions, guidance on claims philosophy, regulatory, and audit procedures Ensuring daily claim deliverables are met and claims decisions within prescribed SLA with quality Ensure customer centric approach while delivering sensitive area of death claims. Accuracy and Speed in delivery Customer satisfaction Quality in claims assessment/approvals Preferred candidate profile Graduate with required communication skills, A minimum of five to seven years progressively responsible previous insurance industry experience. Life Insurance domain knowledge Decision-making skills. MIS, MS Excel, Workflows , Group Asia and Life Asia system knowledge

Hiring: Revenue Cycle Management (XiFin) Executive US Healthcare Location: Pune CTC: Up to 5.5 LPA Shift: US Shift (Night) Work Days: 5 Days Working | 2 Days Rotational Off Notice Period: Immediate to 30 Days About the Role: We are looking for experienced professionals to join our US Healthcare RCM team. The ideal candidate must have hands-on experience with XiFin software (Provider Side) and a solid understanding of end-to-end RCM processes. Eligibility Criteria: Experience: Minimum 1 year in RCM with XiFin expertise Qualification: Any graduate or equivalent Key Responsibilities: Revenue Cycle Management (RCM) Payment Posting Denial Management and Resolution AR Follow-up / Collections Physician / Provider Billing Prior Authorization HIPAA Compliance How to Apply: Contact: Chanchal 9251688424

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 performance, develop training materials, and ensure compliance with internal policies, risk controls, and government regulations Interact directly with fraud and claims management to develop and implement functional area policies or procedures, and to provide exceptional customer experience Manage allocation of people and financial resources for Fraud and Claims Operations Mentor and guide talent development of direct reports and assist in hiring talent Required Qualifications: 2+ years of Financial Services, Fraud, or Investigation experience, or equivalent demonstrated through one or a combination of the following: work experience, training, military experience, education 1+ years Leadership experience Desired Qualifications: Ability to manage a team of 15 and above Excellent verbal, written, and interpersonal communication skills Ability to facilitate new learning to staff as information, systems, and processes change Ability to assess issues, make quick decisions, implement solutions, and influence change Ability to work effectively in a team environment and across all organizational levels, where flexibility, collaboration, and adaptability are important Excellent knowledge on MS Office (Power point, Excel) Job Expectations: Shift : 6:30 PM to 3:30 AM IST

Key Roles & Responsibility : Planning and supervising changes and managing the daily operations of customer service. Setting up and meeting performance goals and targets. Maintaining current knowledge of industry new developments, productions, and involvement in network. Recording statistics, performance levels and feedback of clients and preparing the reports. Motivating, coaching, and retaining staff as well as coordinating reward, bonus, and incentive scheme. Reviewing the staffs performance, determining training needs and scheduling training sessions. Responsible for the efficient functioning of CRM by ensuring that the Team attends to customer calls & Networking with the concerned departments to settle the query. Resolving escalations from other departments Responsible to monitor Key performance Indicators, Responsible for corrective and Preventive action Responsible to ensure Inspection and Correct response to the customer calls To liaison with major Corporates / Insurer for ID card issues, Claim related issues, Cashless authorizations, Endorsements and Renewal of policies. Retention of clients, Meeting key stakeholders for weekly/monthly/quarterly portfolio review Managerial & Behavioral Punctual, Drive for results, Decision Making skills, Excellent communication, customer service and interpersonal skills. Exceptional analytical and listening skills, Team Management, Functional, Excellent problem-solving and communication skills. Solid customer focus and should be able to operate well in teams. Good telephone manner, Ability to develop and motivate staff, Great confidence and an excellent business sense. Should be able to set, satisfy, and exceed targets. Interested candidate can send their resume on roopa.kulkarni@mediassist.in Or simply on Naukri. Location: Begumpet, Hyderabad Company Name : Medi Assist TPA Pvt. LTD

As a professional involved in import planning and coordination, your primary responsibilities will include finalizing the import plan based on inventory and sales requirements, as well as arranging vessel nominations for the import of Coal in adherence to the established plan. Reviewing and providing feedback on contracts will be an essential part of your role, along with issuing Documentary/Shipping Instructions to suppliers and managing import documentation meticulously to ensure accuracy and compliance. You will be required to check freight calculations against C/P, obtain freight certificates from suppliers, and oversee the proper execution of LC issuance in alignment with the draft received from the import supplier. Coordinating with the banking team for the issuance of Letter of Credit and L/C retirement will also fall within your scope of duties. Monitoring and communicating all costs associated with each shipment to the finance desk, documenting and presenting claims to third parties accurately, and tracking vessel progress during voyages to keep relevant departments informed will be crucial aspects of your daily tasks. Additionally, ensuring timely vessel berthing without demurrage through effective coordination with CHA/Agent will be a key responsibility. Building and maintaining strong relationships with local and international clients to facilitate smooth shipment activities, coordinating with CHA and Shipping Agents for timely documentation filing, and adhering to customs clearance procedures as prescribed by authorities are integral parts of your role. Preparing various claims such as short claims, Letter of Indemnity (LOI)/Bank Guarantee, interest claims, and trade confirmations will also be part of your routine tasks. Gathering trading opportunities information, maintaining respective MIS records, and supporting the trader will require your attention, in addition to verifying demurrage computations and ensuring timely claim submissions. Taking charge of the brokerage business of the firm and overseeing the seamless completion of shipments will be among your responsibilities as well. This is a full-time position that involves day shifts, and the ability to commute or relocate to Bengaluru, Karnataka 560092, is preferred for this role. The work location will be in person, necessitating your physical presence at the designated workplace.,

Claims processing Doctor Job Description: Medical claims processor will have to look into claims where payment was denied. Commonly due to issues of insurance coverage eligibility, the claims handler may be tasked with reviewing documentation from the patient, their physicians, or the insurance. With the medical expertise ,need to master the various products and to apply the same during claim processing. Claims processors process any claim payments when applicable and must ensure they comply with federal, state, and company regulations and policies. List of Responsibilities: To validate the authenticity and the credibility of the claims. To coordinate with various persons (Claimant, Treating Physician, Hospital insurance desk, Field Visit Drs, Investigation officers)for hassle-free claim processing . To expertise ,the process of negotiation when necessitated. The claim handler owes a duty of care to the patient, ensuring that their needs are being met and that they re receiving the treatment or medicine they need. Job Qualifications and Requirements: Required BDS, BHMS, BAMS, MD, Pharm D Graduates. Adapt and inbuilt the process of communication and coordination across the zones and the supporting verticals accordingly.

Basic Function Handle and administer Family & Medical Leave Act standalone (as well as other leave) claims and adhere to federal and state regulatory and/or company plan requirements and established FMLA workflow procedures Complete eligibility decisions and review for entitlement, gather pertinent data when necessary, from employee, physicians office or employer through outgoing calls, email, fax or other supporting systems. Promptly review new FMLA and other leave claims within regulatory timelines, evaluate against appropriate leave plans and make initial claim decision. Perform leave administration tasks as required, including recertification of health condition, intermittent claim tracking, RTW confirmation, return phone calls, etc. Update systems to accurately reflect leave status and ensure appropriate diary documentation exists Business recommended TAT to complete the activity is up to 5 business days to maintain compliance measures The position is expected to do absence management and adjudication on Federal, State and company leaves. Interact with claim specialist, claim support specialist, QA, Claims Unit Leader (stateside supervisors), employees, employers/customer and physicians office Essential Functions: Analyze, validate and process transactions as per Desktop procedures (L3 & L4) Analyze and research all discrepancies Research & Investigate and resolve outstanding items Determine eligibility, entitlement and applicable plan provisions while meeting timeliness goals Clear and accurate written and verbal communication (Mix of scripted/unscripted) with employee, employer & stateside resources by email and outgoing calls Establish action plans for each file to bring claims to resolution Utilize internal and external specialty resources to maximize impact on each claim file Use PC programs to increase productivity and performance Ensure that the assigned targets are met in accordance with SLA, Performance Guarantee and Internal standards Ensure that the quality of transaction is in compliance with predefined parameters as defined by Process Excellence Work as a team member to meet office goals to obtain disabilitys vision while demonstrating core values and meeting key measures Ensure adherence to established attendance schedules Close visual activity - viewing a computer terminal and extensive reading To apply call Miss Jaspreet Kaur at 9667037957

Manage and lead a team of claims specialists, providing guidance, mentorship, and support to ensure exceptional customer service and efficient claims processing. Oversee the end-to-end claims process, from initial claim submission to resolution, ensuring accuracy, compliance, and timely processing. Implement and maintain quality control measures to uphold the highest standards of claims handling Interact with policyholders, agents and other stakeholders to address claim related inquiries and concerns. Utilize claims data and analytics to identify trends, patterns and opportunities for process improvement. Ensure compliance with insurance regulations and company policies in all claims processing activities. Monitor and report on departmental performance metrics, including claims processing times, customer satisfaction and efficiency. Identify and implement process enhancements to streamline claims operations and enhance the customer experience. Provide training and development opportunities for team members to enhance their skills and knowledge.

Dear Candidate, We are seeking a highly skilled Contract Manager with a strong legal background in business law to oversee contract lifecycle management and ensure legal compliance across all business agreements. The ideal candidate will have expertise in contract drafting, negotiation, risk assessment, and regulatory compliance, supporting the companys commercial and legal interests. Company Website: www.mukandsumi.com Job Location: Hospete, Karnataka. Key Responsibilities: Contract Drafting & Negotiation: Draft, review, and negotiate various commercial contracts, including vendor agreements, service contracts, NDAs, SLAs, MoUs, and joint venture agreements. Legal Risk Management: Identify potential legal risks, provide mitigation strategies, and ensure contract terms align with business objectives and regulatory requirements. Regulatory Compliance: Ensure all contracts comply with applicable laws, including contract law, corporate law, and industry-specific regulations. Dispute Resolution & Claims Management: Handle contract disputes, liaise with legal teams for litigation matters, and ensure timely resolution of contractual issues. Stakeholder Collaboration: Work closely with internal teams (legal, finance, procurement, and operations) to streamline contract execution and ensure smooth business transactions. Contract Lifecycle Management: Maintain a structured system for contract storage, renewal tracking, amendments, and compliance audits. Policy & Process Development: Establish and enhance contract management policies, standard templates, and best practices to improve efficiency. Regulatory Updates & Training: Stay updated on legal developments in business law and provide training to internal stakeholders on contract compliance and risk mitigation. Required Qualifications & Experience: Education: Bachelors or masters degree in law (LLB / LLM) with a specialization in Business Law, Corporate Law, or Commercial Law. Experience: 8+ years. Legal Expertise: Strong knowledge of contract law, corporate governance, commercial transactions, and regulatory compliance. Technical Skills: Proficiency in contract management software and legal research tools. Strong analytical and negotiation skills. Excellent legal drafting and interpretation capabilities. Key Competencies & Personal Attributes: Attention to Detail: Strong ability to identify legal risks and loopholes. Problem-Solving: Ability to handle contract disputes and mitigate risks proactively. Interpersonal Skills: Strong communication and collaboration with internal and external stakeholders. If interested then, please share your cv at heena@mukandsumi.com Regards Heena Shaikh

Hiring: Revenue Cycle Management (XiFin) Executive US Healthcare Location: Pune CTC: Up to 5.5 LPA Shift: US Shift (Night) Work Days: 5 Days Working | 2 Days Rotational Off Notice Period: Immediate to 30 Days About the Role: We are looking for experienced professionals to join our US Healthcare RCM team. The ideal candidate must have hands-on experience with XiFin software (Provider Side) and a solid understanding of end-to-end RCM processes. Eligibility Criteria: Experience: Minimum 1 year in RCM with XiFin expertise Qualification: Any graduate or equivalent Key Responsibilities: Revenue Cycle Management (RCM) Payment Posting Denial Management and Resolution AR Follow-up / Collections Physician / Provider Billing Prior Authorization HIPAA Compliance How to Apply: Contact: Sanjana 9251688426

International KYC disputes/claims process Gurgaon location Any graduate with 1 year Kyc dispute/claims/onboarding exp. can apply Only 5 days working 2 roster off Night shifts Both side cabs Salary - upto 6.5 lpa Gautam- 9319001798 Kashish-99107 38003 Required Candidate profile Candidate must be an immediate joiner. Candidate must be comfortable working in night shifts. Candidate must have hands on experience about KYC dispute/claims/onboarding. Perks and benefits Both side cabs MIV INCENTIVES