1337 Claims Management Jobs - Page 7

As a Billing and Invoicing Specialist, your role will involve generating accurate and timely bills for all inpatient services. You will be responsible for verifying that all services rendered are correctly billed and ensuring that all patient records and insurance details are complete and accurate. Key Responsibilities: - Process and submit insurance claims to various Third-Party Administrators (TPAs) - Follow up on claims, including resolving denials and rejections - Reconcile billing records to identify and resolve discrepancies - Generate reports on billing activities, revenue, and financial status - Ensure all billing practices comply with healthcare regulations, policies, and standards ...

Role Overview: As a Buyer in the Contracts Engineer variant, your main responsibility is to support the end-to-end contract lifecycle execution by understanding requirements, identifying pre-qualified vendors, tender preparation, inviting bids, and conducting technical & commercial negotiations in line with company standards. Key Responsibilities: - Assist Category / Contract Manager in sourcing critical contracts by selecting and evaluating vendors based on package briefs and planning timelines - Support pre-qualification of vendors by specifying sourcing events and conducting technical validation - Develop Internal Cost Estimates and float RFQ via digital RFX systems - Study offers from ve...

How will you CONTRIBUTE and GROW Under the guidance of the Manager, accountable for the on time delivery of equipment, material and documentation within the OM/E budget and in conformity to the purchase order specifications.Main Accountabilities Expedite and manage suppliers of static, fired, rotating, E&I equipment, and bulk materials to ensure on-time delivery within the OM/E budget. 2, Monitor, track, and manage the receipt of critical documents and information from suppliers, including organization charts, progress reports, fabrication schedules, and critical material overviews for prefabrication. Conduct shop visits to supplier facilities to audit manufacturing status, compile and issue...

Role & responsibilities 1. Claim File Review Conduct end-to-end review of closed claim files (cashless & reimbursement). Verify correctness of claim adjudication, coding, documentation, and decision rationale. Ensure all required documents (policy, KYC, bills, prescriptions, investigations) are present and valid. Check medical necessity, line of treatment, and adherence to standard treatment guidelines. 2. Compliance & Quality Checks Ensure claim decisions comply with IRDAI regulations and company SOPs. Identify any potential non-compliance, financial leakage, or process discrepancy. Validate adherence to TAT norms and communication standards. 3. Fraud, Waste & Abuse (FWA) Indicators Identif...

Role: Process Specialist Exp: 2+ yrs Budget: Max up to 5.5 LPA Must Have: Contracts, Quoting, Pricing, Invoice Billing, Claims Management. Immediate to 15 Days Available Walk-in Location: Chennai & Bangalore Work Location: Bangalore

US Healthcare – Claims Adjudication Process Voice Process Team Leader – Operations Quality Specialist Subject Matter Expert (SME) Process Trainer Location : Bangalore Mode of Interview : Fact to Face US Shift / 5 Days Working HR Hari : 7618776218

As a Process Analyst– Insurance (Claims), you will be involved in the Processing of Life and Annuity Insurance, Claims processing. You should be flexible to work in shifts. Your primary responsibilities include: Handling claims investigation, processing, and payments Claims document validation, calculating benefit amount, and releasing same to the beneficiary Meet productivity and quality targets on a daily, weekly, and monthly basis Required education Bachelor's Degree Preferred education Master's Degree Required technical and professional expertise Graduate (except B.Tech/Technical Graduation/Law) with a minimum of 1.5 years of experience in Life/Annuities products in Claims Good Communica...

Processing life and annuity insurance claims involves investigating, processing, and disbursing payments, including validating documents, determining claim actions, and calculating benefit amounts for beneficiaries. Work well with Onshore /Offshore customers encouragingly and professionally via email and on calls. Meet productivity and quality targets on a daily, weekly, and monthly basis. Render overtime whenever requested by the Supervisor including rest day. Use expertise to evaluate the work of others and assist in process calibration. Facilitate team huddles and teach-back sessions as scheduled. Complete certification on the identified process and developmental training. Participate in ...

Role & responsibilities Good understanding of Contract. Ensuring efficient contract compliance and efficient contract management. Claims Management including identification of potential claim events, preparing grounds, timely notices / Contemporary submissions, strategic development of case and submission of claims includes Extension of time & Change of Scope and follow up till realization. Preparation of delay analysis and impacted schedule. Preparation and maintenance of various EOT and Cost Claim management information formats. Reviewing and analyzing various risk factors and mitigation action. Coordinating & guiding Site team for adherence to contractual obligations, identification of ne...

Team Management Participate in recruitment process to identify the right talent within the function. Guide and direct the team in efficiently achieving their targets. Establish individual performance expectations and regularly review individual performance of the team. Identify and create development opportunities for team members to enhance functional knowledge. 2. Non Motor Claims and Network Management Implement Claims SOP within the team and service network and ensure adherence of the same. Claims forecasting and workload distribution within the team and service providers based on claims volume, seasonality and ASP skill sets Claim processing an monitoring day to day claims activities an...

job highlights Freshers & Experienced with any qualification and proficiency in English Solve customer queries inbound/outbound call centers Salary range of 13,000 to 28,000 CTC Multiple opportunities Good perks and other facilities kindly apply here, we will call once your profile is shortlisted.

Job Profile Summary To provide administrative and operational support to the claims team and carry out other assigned office tasks in alignment with the requirements of the client program. Primary Purpose: To assist in the creation and maintenance of Auto Liability (AL), General Liability (GL), and Property loss claims in the client system. Essential Functions and Responsibilities Must be available to work in a 24/7 rotational shift schedule, including nights, weekends, and public holidays, as per business needs. Willingness to work from the office in either a hybrid or fully on-site setup based on client or organizational requirements. Accurately sets up and enters new claims into the claim...

Job Description: Health Admin Services Representative The Claims Processor will play a key role in supporting the healthcare claims function by ensuring accurate and efficient processing of claims from start to finish. The position requires strong knowledge of claims operations, including receiving, reviewing, editing, pricing, adjudicating, and processing payments. The ideal candidate must be detail-oriented, analytical, and capable of working with established processes, guidelines, and systems to ensure timely and accurate claim outcomes. Key Responsibilities: Receive incoming healthcare claims and verify completeness of required information. Review and edit claim details to ensure accurac...

Department: Claims Management Location: Pune Description Davies is seeking a highly organised and self-motivated professional to our Life & Health team. In this role you will be responsible for document indexing, imaging, quality audits, data entry and processing. Key Responsibilities We will start to build your skill set with the vision that you increase in competence across all activities in your role day to day but also broaden capacity across all administration areas. Inbound Document Indexing & Verification Accurately and efficiently index inbound documents into document retention system Use data entry to process information from documents to ensure accuracy Classify, and index document...

About The Role Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Associate Manager Qualifications: Any Graduation Years of Experience: 14 Years to 16 Years What would you do? We are seeking a highly experienced and results-driven Claims Associate Manager with a strong background in Property & Casualty (P&C) insurance claims operations. The ideal candidate will have a minimum of 14 years of experience, including proven leadership in managing large teams (~40 FTEs) across First Notice of Loss (FNOL), claims adjudication, and payment processing functions.This role demands strong capabilities in people leadership, client relationship managem...

About The Role Skill required: Reinsurance - Collections Processing Designation: Claims Management Manager Qualifications: Any Graduation Years of Experience: 13 to 18 years What would you do? We help insurers redefine their customer experience while accelerating their innovation agenda to drive sustainable growth by transforming to an intelligent operating model. Intelligent Insurance Operations combines our advisory, technology, and operations expertise, global scale, and robust ecosystem with our insurance transformation capabilities. It is structured to address the scope and complexity of the ever-changing insurance environment and offers a flexible operating model that can meet the uniq...

About The Role Skill required: Group Core Benefits- Claims Case Mgmt. Group Disability Insurance Designation: Claims Management Senior Analyst Qualifications: Any Graduation Years of Experience: 5 to 8 years What would you do? We help insurers redefine their customer experience while accelerating their innovation agenda to drive sustainable growth by transforming to an intelligent operating model. Intelligent Insurance Operations combines our advisory, technology, and operations expertise, global scale, and robust ecosystem with our insurance transformation capabilities. It is structured to address the scope and complexity of the ever-changing insurance environment and offers a flexible oper...

Educational Requirements: Medical Degree or Related Field: BAMS/BHMS only Understanding of Medical Terminology: Proficiency in medical terminology, procedures, and diagnoses. Certification: Certification in medical coding (such as CPC, CCS, or equivalent) can be advantageous. Experience: Healthcare Experience: Experience working in a non- clinical setting can be beneficial, providing a solid understanding of medical procedures and billing practices. Claims Processing Experience: Prior experience in medical billing, coding, or claims processing is required. Familiarity with Insurance Policies: Understanding of various health insurance policies and coverage criteria. Skills: Analytical Skills:...

TATA AIG General Insurance Company Limited is looking for Deputy Manager - Health Claims to join our dynamic team and embark on a rewarding career journey Assist the Manager in the day-to-day operations of the business, including setting goals, developing strategies, and overseeing the work of team members Take on leadership responsibilities as needed, including managing team members and making decisions in the absence of the Manager Identify and address problems or challenges within the business, and develop and implement solutions Collaborate with other departments and teams to ensure smooth and efficient operations Maintain accurate records and documentation Contribute to the development ...

Access risk factor to determine coverage, eligibility, premium pricing & Policy terms Suggesting the client policies proper covers the Risk Gaps, preparation of Quote/Broking slip Use underwriting guideline, rating manuals & industry standard Required Candidate profile Graduate 3 +years of work exp with insurance underwriting Knowledge of insurance principles, underwriting guidelines & risk assessment Strong analytical & critical thinking skill What's UP 9318431991

Role: AVP/ Chief Manager/Senior Manager/Manager - Accident & Travel Claims Job location: Goregaon East Position Overview: A Claims Manager in the Accident & Travel department oversees the processing and settlement of claims related to travel accidents and incidents. They ensure timely, accurate claims assessment, manage a team of adjusters, and maintain compliance with legal and policy guidelines while delivering excellent customer service. Additionally, they are responsible for mitigating risk and resolving complex claims efficiently. Role & responsibilities: Involvement in daily claim processing Regular Updating of Claims System data Calling customers for intimation details & reminders E-m...

About the Role: We are looking for an experienced Motor Insurance professional to head our Motor Insurance vertical. The role involves overseeing policy procurement, renewals, claims management, IRDAI compliance, and coordination with internal teams to ensure cost-efficient and seamless insurance operations. Key Responsibilities: Lead end-to-end procurement and renewal of motor insurance policies for commercial and private vehicles. Maintain complete and accurate documentation of insurance coverages, endorsements, and premium payments. Handle complete claims management including documentation, claim intimation, and coordination with surveyors, garages, and insurance companies. Monitor claim ...

Key Responsibilities Manage and support insurance policies and claims, including processing claims and handling policy renewals. Maintain and update policyholder data accurately. Develop and implement insurance policies and procedures in line with regulatory requirements. Ensure compliance with industry best practices. Manage and support insurance software and claims processing tools. Communicate effectively with clients and internal stakeholders.

Key Responsibilities Manage and support insurance policies and claims, including processing claims and handling policy renewals. Maintain and update policyholder data accurately. Develop and implement insurance policies and procedures in line with regulatory requirements. Ensure compliance with industry best practices. Manage and support insurance software and claims processing tools. Communicate effectively with clients and internal stakeholders.

Job Summary The Process Executive-Ops will play a crucial role in supporting our operations by providing exceptional customer service and managing workers compensation processes. With a hybrid work model and rotational shifts the candidate will ensure efficient policy administration new business processing and claims management. This role requires a keen understanding of workers compensation and a commitment to enhancing customer satisfaction. Responsibilities Manage customer inquiries and provide timely resolutions to ensure high levels of customer satisfaction. Oversee the administration of workers compensation policies ensuring accuracy and compliance with regulations. Process new busines...