710 Claims Processing Jobs - Page 10

Project Role : Business Architect Project Role Description : Define opportunities to create tangible business value for the client by leading current state assessments and identifying high level customer requirements, defining the business solutions and structures needed to realize these opportunities, and developing business case to achieve the vision. Must have skills : GuideWire ClaimCenter Good to have skills : NA Minimum 7.5 year(s) of experience is required Educational Qualification : Any Degree Minimum 15 years full time Summary: As a Business Architect, you will be responsible for leading current state assessments, identifying high-level customer requirements, and developing business solutions and structures to create tangible business value for the client. Your typical day will involve defining opportunities, developing business cases, and achieving the vision using your expertise in GuideWire ClaimCenter. Roles & Responsibilities: - Lead current state assessments and identify high-level customer requirements. - Define opportunities to create tangible business value for the client. - Develop business solutions and structures needed to realize these opportunities. - Develop business cases to achieve the vision. - Utilize expertise in GuideWire ClaimCenter to deliver impactful solutions. - Work directly with the client gathering requirements to align technology with business strategy and goals - GuideWire ClaimCenter ie FNOL, claim closure, exposures, reserves - Good experience in Property and Casualty - Working knowledge of SOAP / REST web service - Should be able to create/ consume the web services in Java - Understanding of XML, XSD - Knowledge of messaging, plugins Professional & Technical Skills: - Must To Have Skills: Expertise in GuideWire ClaimCenter. - Good To Have Skills: Knowledge of other insurance platforms. - Strong understanding of business architecture principles and practices. - Experience in leading current state assessments and identifying high-level customer requirements. - Experience in developing business solutions and structures to create tangible business value for the client. - Experience in developing business cases to achieve the vision. - Good to have Guidewire Developer in Integration/ Configuration, GOSU scripting and Java Enterprise Edition - Good to have Experts internally and externally for their deep functional or industry expertise, domain knowledge, or offering expertise - Basic SQL and Database knowledge Additional Information: - The candidate should have a minimum of 7.5 years of experience in Business Architecture. - The ideal candidate will possess a strong educational background in business administration, computer science, or a related field, along with a proven track record of delivering impactful business-driven solutions. - This position is based at our Bengaluru office. Any Degree Minimum 15 years full time

Project Role : Business Architect Project Role Description : Define opportunities to create tangible business value for the client by leading current state assessments and identifying high level customer requirements, defining the business solutions and structures needed to realize these opportunities, and developing business case to achieve the vision. Must have skills : GuideWire BillingCenter / GuideWire ClaimCenter /Guidewire Integration Good to have skills : NA Minimum 7.5 year(s) of experience is required Educational Qualification : Any Degree Minimum 15 years full time Summary: As a Business Architect, you will be responsible for leading current state assessments and identifying high-level customer requirements, defining the business solutions and structures needed to realize these opportunities, and developing a business case to achieve the vision. Your typical day will involve working with GuideWire BillingCenter and collaborating with cross-functional teams to create tangible business value for the client. Roles & Responsibilities: - Lead current state assessments and identify high-level customer requirements. - Define the business solutions and structures needed to realize opportunities. - Develop a business case to achieve the vision. - Collaborate with cross-functional teams to create tangible business value for the client. - Utilize GuideWire BillingCenter to implement business solutions. - Work directly with the client gathering requirements to align technology with business strategy and goals - Well versed with OOTB BC functionalities - Should be able to explain OOTB features and capture user requirements - Perform gap analysis to identify configuration and customization scope - Suggest solutions for business based on their requirements while aligning to the OOTB configuration as much as possible Professional & Technical Skills: - Must To Have Skills: Expertise in GuideWire BillingCenter. - Good To Have Skills: Knowledge of other GuideWire products. - Strong understanding of business architecture principles and practices. - Experience in leading current state assessments and identifying high-level customer requirements. - Experience in developing business cases to achieve the vision. - Good to have OOTB understanding of Invoicing Delinquency, Payments, Commission, General Ledger etc, OOTB Data Model - Experience in Property and Casualty - Basic SQL and Database knowledge Additional Information: - The candidate should have a minimum of 7.5 years of experience in GuideWire BillingCenter. - The ideal candidate will possess a strong educational background in business architecture, computer science, or a related field, along with a proven track record of delivering impactful business-driven solutions. - This position is based at our Bengaluru office.

Claims Analyst The job profile for this position is Claims Analyst, which is a Band 2 Senior Contributor Career Track Role. Excited to grow your career? We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply! Our people make all the difference in our success. YOUR JOB As an SME you will support the supervisor and team manager in your relevant process. Key to the role will be building/maintaining an in-depth knowledge of (part of) the process to continuously improve the processes and share that knowledge to deliver a high quality customer centric service offering. Your role includes: - Being responsible for managing a portfolio of key clients: you engage with clients to build relationships and you educate, i.e. communicating directly via email and telephone, or processing claims within the agreed service levels (based on the process you belong to) - Building and maintaining a solid in depth knowledge in (part of) your process - Being an expert user of any of the used tools within the team and/or any of the partner set-ups in place - Being the organizational ambassador for your knowledge area within your own team and across the wider organization. You are the go to person in case of questions on your area of expertise. - In that role, being able to represent the Process / Organisation in (enterprise wide) projects, stakeholder meetings, or act as a relationship manager towards some of our (internal/external) strategic partners or act as a trainer. - Option to take over SPOC role for particular clients/accounts if required - Being proactive in identifying improvement/enhancement opportunities and be active in seeking and sharing ideas for innovation in business processes. - Striving to provide excellent service to our members and clients - Playing an active role in a culture of continuous improvement - Taking ownership of any escalated cases and providing updates to the Supervisor on any issues - Taking ownership of solving any issues (if applicable) in your area of expertise - Proactively addressing and/or escalating any risks - Developing/maintaining proactive/effective business relationships, both internally and externally to ensure a seamless delivery of service. Specific for Claims SME s: - Support the financial verification of the team, including approval of manual payments - Support of quality audits (financial verification + extra verification) with a clear focus on the financial and procedural accuracy company KPI s. You document your findings, share them with the supervisor and you discuss corrective actions on individual and team level with the Supervisor. - Responsible to provide training on specific topics where you act as a subject matter expert, be it a process or a client, including the lead of the training organisation and coordination. - Support the on boarding and training phase of newbies, or colleagues taking up new accounts, including their performance reporting. YOUR PROFILE/SKILLS Strong performance track record International mind-set, with holistic and able to work remotely with peers across locations 2 years of Cigna experience Good communication skills, and knowledge of Window tools, e.g. Excel, PowerPoint, Windows A growth mind set with a positive attitude towards change and the ability to play an active role in implementing change initiatives within your own process Action-orientated problem-solving attitude Able to seek out best practice in order to effectively deal with diverse, complex and highly sensitive issues Accountability - assume ownership for achieving personal results and collective team goals

Job Description: A talented application Guidewire Claims Center Technical Lead with deep knowledge of Guidewire Claim Centre & Guidewire Products. Must be skilled in all aspects of Guidewire implementation, from design and configuration to customization and support after the solution goes live. Well versed with Latest Guidewire offering, products, innovation, and best practices. Work with Customer Architects, Lead Engineers, Solution architects to identify the solutions that are relevant to business problems and targeted architecture. Identify, create, extend, and maintain reusable architectural patterns & solutions and to facilitate development of future solutions Prepare detailed designs for complex features and assist developers with implementation. Guide the Tech leads and Teams on ground on implementation and execution challenges. Create Guidewire SAAS best practices, product standards, quality assurance norms and guidelines. and track until implement into the projects. Review code and ensure developers are adhering to standards, Guidewire best practices and properly addressing. Create detailed design document/technical specifications, for select Guidewire Claimcenter, Digital and Edge services-based projects. Track the teams on efficient and quality code based on given specifications. Create Guidewire Accelerators and white papers. Required Skills: Strong Guidewire Product knowledge and Insurance domain knowledge. Guidewire Ace certified in configuration and Integration. Minimum of 4+ years experience in a Guidewire Technical Lead role. Must have Guidewire cloud experience. Minimum of 4 to 7 years of hands-on experience in Guidewire Claims centre Configuration, Integration and Testing Frameworks. Proven development experience in Object Oriented Programming (such as Java) and SQL. Experience supporting Property & Casualty Insurance to understand and analyse the business needs of the customer. Should have Guidewire SAAS implementation experience. Prior experience with Apache and JBOSS Application servers. Experience with either XML, GUnit, Jenkins, GIT/Subversion/TFS, Code Coverage and Code Scan Plugin/Tools. Prior experience with Application Servers like WebSphere, WebLogic, JBoss and/or Tomcat. Good To have Expertise in designing the overall solutions on Guidewire Products like Jutro, cloud API’s, Integration framework. Expertise in writing G Unit test cases and integrate them to build/pipeline. Background in consulting or equivalent in a customer-facing role in professional services. Ability to handle technical leadership tasks (Solution Design, estimating, delivery of technical training/education). Ability to become certified in multiple Guidewire Insurance Suite products and develop a thorough understanding of product platform, including all integration technologies. Demonstrable proficiency in designing, implementing and supporting packaged vendor products. Prior experience with Database Servers like SQL Server, Oracle, and/or DB2. Ability to engage different stakeholders (Configuration, Integration, Middleware and Legacy teams) to resolve issues.

Job Tile Assistant Manager List of Responsibilities Team Handling: FLP, Billing, Combined, FA, DMS Specific Geography Responsibility for Coordination and Claims Processing/ Marketing Escalations/ Claims Escalations from All Verticals / IT Co ordination DAC/Audit: Response /Rectification /Counselling along with OH Payment query Pending TAT Monitoring Reimbursement Claims Processing Tabulation / Arithmetic Calculations checks as per the agreed Terms/Policy Terms of Reimbursement File Coordination with Medical Processors Referring back for insufficient documents /Rejection Cashless Claim Processing Tabulation / Arithmetic Calculations checks as per the agreed Terms/Policy Terms Coordination with Medical Processors Job Description: Communicating with insurance agents and beneficiaries. Preparing claim forms and related documentation. Reviewing claim submissions and verifying the information. Recording and maintaining insurance policy and claims information in a database system. Determining policy coverage and calculating claim amounts. Processing claim payments. Performing other clerical tasks, as required. Job Qualifications and Requirements Any Degree At least 4 years of experience as a claims processor or in a related role. Working knowledge of the insurance industry and relevant federal and state regulations. Computer literate and proficient in MS Office. Excellent critical thinking and decision-making skills. Good administrative and organizational skills. Strong customer service skills. Ability to work under pressure. High attention to detail.

Hiring For OPTUM With the Payroll of J2W Experience: 6months to 3Year Location Hyderabad Work module Work from office Cab facility - Both way cab provided CTC :2.4 LPA Notice period Immediate Nature of work: Non-Voice Role: Billing & Enrollment Associate (Contractual/Temp Would be converted purely based on performance) Skills Required Good verbal and written communication skills, Ability to multi-task, Critical thinking abilities, open and ready to work on feedback Quality focused, Good Analytical skills. Proficiency with Windows, MS Office and basis computer skills Demonstrate skills necessary to interpret regulations and guidelines Ability to interact positively with internal and external customers Selection process: Candidates need to be available in Optum premises during the Interview process, no scope of virtual interview. 1st round Typing Assessment (30 WPM, 95% accuracy) 2nd round Written assessment (Analytical, Reasoning, US Healthcare) 3rd round Line Manager Round 4th round Final Round Need to carry pens along Need to be in formal attire Shift timings: 5:45 PM to 3:15 AM (Night shift Salaries + Incentives: Package 2.4 LPA + Additional Incentives Incentives Rs.400 for 100% attendance (monthly) Rs.200 is allocated towards team outings and team refreshment activities (monthly) Top 10% of the performers would receive a GV worth Rs.1000 (monthly) Rs.400 per month towards Project retention bonus which would be accumulated and released along with FnF. Candidates serving the entire tenure of the program are eligible for it. INTERESTED CONTACT HR : 9606973198 PRIYA NOTE : NO BE/BTECH,MCA, & NO EX Employee of Optum

Role :Relationship Manager Skill-Good Communication skill with Healthtech&healthcare domain Location:Chennai Company:ViFin Industry: Fintech -Hospital Claim Settlement Process&Insurance Affordability Experince 1+years Contact 9962442924/7825845773

Hiring Alert Medical Officer (Claims) | Contract Role Location: IBC KNOWLEDGE PARK, Bhavani Nagar, S.G. Palya, Bengaluru, Karnataka 560029 Company: Medi Assist Insurance TPA Private Limited CTC: 3.4 LPA Timing: 9:30 AM 6:00 PM | MonFri (Rotational Saturdays working) Duration: 12-month contract (with chance of contract extension/on-roll conversion) Eligibility: BAMS or BHMS graduates only 0–3 years experience (freshers welcome!) Role Overview: You will scrutinize and process insurance claims based on policy terms, verify treatment/diagnosis, raise queries for incomplete documents, and ensure accurate and timely closure of claims. Key Skills: Strong medical understanding Basic computer & typing skills Good communication Send your resume to: pavana.praveen@mediassist.in prathiba.b@mediassist.in

Job Summary We are seeking a skilled professional with 1 to 6 years of experience in Claim Management to join our team in Insurance Claims. The ideal candidate will have strong expertise in MS Excel and excellent English language skills. This role requires working from the office during night shifts. Responsibilities Analyze and process annuity claims efficiently to ensure timely settlements. Utilize MS Excel to manage and organize claim data effectively. Collaborate with team members to resolve complex claim issues. Communicate clearly with stakeholders to provide updates on claim status. Ensure compliance with company policies and industry regulations. Identify opportunities for process improvements in claim management. Maintain accurate records of all claim transactions and communications. Provide exceptional customer service to claimants and beneficiaries. Conduct thorough investigations to validate claim authenticity. Prepare detailed reports on claim activities and outcomes. Support the team in achieving departmental goals and objectives. Stay updated with industry trends and best practices in claim management. Contribute to the companys mission by ensuring fair and accurate claim processing.

Job Description: Senior Software Engineer Guidewire-ClaimCenter Job Title: Senior Software Engineer Primary Skill: #Guidewire,#ClaimCenter Location: Hyderabad/Pune/Coimbatore Experience: 5-8 years About the job Are you a programmer who loves to design solutions to solve customers business problems? Do you enjoy guiding and mentoring a team of software developers? If yes, then this job is the perfect fit for you. We are looking for a Senior Software Engineer who has good experience in the configuration and integration of Guidewire ClaimCenter to join our team. In this role, you will work with Guidewire developers in all stages of the software development lifecycle. Responsibilities: Following are the day-to-day work activities: • Prepare and enhance design documents that would be needed to support product configuration Field mapping, Data definition, rules definition and so on • Understand product vision and expectation on technical solution architecture. • Demonstrate a strong understanding of application development projects involving the implementation of complex business rules. • Have proven technical experience in requirement analysis, detailed designs and implementation activities required to ensure the development, integration, and long-term maintenance of applications. • Expertise in configuration and development of various areas of Guidewire Integration Transactions, Job/batch configuration, Messaging, Webservices, Experience in implementing multiple LOBs, Forms Management, Administration, Account Management, Contacts and so on. • Configure, build & develop Guidewire Claim Center components using GOSU, Wizards, PCF, Data Model, GX Model definition, Workflow, Activities, etc., • Work on third party integrations for ClaimCenter. • Have previous experience with using XML, JSON, GUnit, Jenkins / GIT /TFS etc, any code coverage or code scanning tools like SonarQube. • Identify value additions that can be built as configuration components and reused on multiple projects, in order to gain efficiency / productivity. • WBS creation from User stories • Work as an individual contributor on ClaimCenter configuration and integration area. • Ensure application code is developed as per the defined architecture standards. • Sprint acceptance tracking and management. • Responsible for Sprint and Release deployments • Do thorough impact analysis and identify risks in advance. Requirements: Candidates are required to have these mandatory skills to get the eligibility of their profile assessed. The must have requirements are: • Strong technical expertise and work experience in GW ClaimCenter Integration. • Experience in GOSU scripting is a must. • Strong database skills preferably in SQL Server 2012 or ORACLE 11g. • Conversant with expansion, new development, and maintenance projects • Experience in code merging. • Experience in release deployment plan and activities. • Excellent verbal and written communication skills. • Strong analytical and problem-solving skills. • Must demonstrate clear abilities to independently work on complex technical defects/ tasks. • To be an excellent team player. • Having hands on experience on CC Configuration areas is a plus.

* Review AR claims, understand the denial reason, call the payers if required resolve the issue. *Research and interpret from the available data in billing software, EOB, MR, authorization & understand the reasons for denial/underpayment/no response. Required Candidate profile * All kinds of Denials * Strong Technical Knowledge * RCM * Authorization * Timely Filed Limit * Phyician Billing/Hospital billing * Commercial/Federal Payers * AR CALLER Contact Info - 9384813917

Mandate Skill- Duckreek Claims, Dot Net & Dot net Framework. Candidate should have strong experience in Duck Creek Claims. Candidate should have strong experience in .NET and .Net Frame work. Candidate should have knowledge Address binding Contract in services. Candidate should have knowledge of pages in FNOL process. Hands-on experience in Claims Configuration and Console modules, Configuring & Customizing Party. Hands on Exp in Module, Task Creation, Configuring/Customizing, Extension and Advanced Extension points etc. Candidate should have knowledge on customizing Automated Reserves, Process automation and Auto assignments. Good understanding of underwriting, rating, insurance rules, forms. Experience in Insurance / P&C insurance domain. Good knowledge rest and soap services. Must have excellent Communication Skills.

We will count on you for : Daily Work Management and delivery of schemes Written and Verbal communication with onshore business partners Process reporting and training Ensuring compliance of all internal and client policies Providing timely updates to AM and Onshore counterparts Driving Process improvements Assist in analyzing and evaluating Benefits data files. Review data to identify issues and discrepancies and provides resolution of errors. Maintains operation systems and tools and provides system support. Performs daily operational assignments and activities, including data analysis, system support and reporting. What you need to have? Graduate with minimum 1 year experience overall Strong health knowledge and experience in global and regional benefits Proficient with MS Word, PowerPoint, and Excel Experience in process building, best practices and/or efficiency projects Strong oral and written communication & presentation skills Good analytical skills Ability to work within a team environment Strong self-starter, fast learner, quality conscious, committed to deadlines Strong attention to detail Strong teamwork skills combined with the ability to work independently with minimal supervision. Language skills are a plus and highly desired, but not required. knowledge of H&B domain What is in it for you? Medical insurance, personal accident insurance, group term life insurance from the day you join us Holidays (As Per the location) Shared Transport (Provided the address falls in service zone) What makes you stand out? Adaptable communicator, facilitator, influencer and problem solver High attention to detail Good relationship skills, Proven ability to work on own initiative as well as in a team Adaptable communicator, facilitator and problem solver High attention to detail Ability to multi-task and prioritize time effectively

Claim registration - On Daily Basis need to register the claims which has been assigned for processing , Scrutiny of the documents Reserve Setting :- Need to do the proper reserve setting on system based on the claim documents Technical processing claims which has been assigned for processing for health/ personal accident etc claims and deductions of Non-Medical charges, Standard deductions of co-payment as per the policy terms and conditions - On Daily basis need to do technical Assessment of the claims post registration of the claim which include billing of the claim as per the respective heads, Data Entry as per the standard fields in system, Deductions of non-Medical Charges as per the standard IRDAI list, Co-Payment deductions as per the policy terms and condition/ Benefit charts etc Co-ordination with Branch Offices/Clients/Hospitals for requirements - Need to have follow up with branches office/clients/hospitals for additional documents whenever require NEFT Updation - Updation of customer/insured NEFT details on system while processing the claims Travelling/Relocation - Candidate should be open for travelling whenever require for official work and also ready to relocate based on the organization or business requirement.

Job Summary Join our dynamic team as a PE-Ins Claims specialist where youll leverage your customer service skills and domain knowledge to enhance our claims processing efficiency. This hybrid role offers a unique opportunity to work in a rotational shift environment providing comprehensive support in the Property & Casualty Insurance sector. Your contributions will directly impact our service quality and customer satisfaction. Responsibilities Assist in processing insurance claims efficiently to ensure timely resolution and customer satisfaction. Collaborate with team members to analyze and verify claim information for accuracy and completeness. Utilize customer service skills to address inquiries and provide clear information to clients regarding their claims. Support the team in maintaining accurate records of claims and related documentation. Contribute to the development of process improvements to enhance claims processing efficiency. Participate in training sessions to stay updated on industry trends and company policies. Work closely with the Property & Casualty Insurance domain to understand specific claim requirements. Engage in rotational shifts to provide consistent support and coverage for claim processing. Communicate effectively with clients and stakeholders to ensure a smooth claims experience. Apply domain knowledge to identify potential issues and escalate them appropriately. Provide feedback to management on customer service improvements and claim processing enhancements. Ensure compliance with company policies and industry regulations in all claim handling activities. Foster a collaborative work environment to achieve team goals and improve service delivery. Qualifications Demonstrate strong customer service skills with a focus on client satisfaction. Possess basic understanding of the Property & Casualty Insurance domain. Exhibit excellent communication and interpersonal skills. Show ability to work effectively in a hybrid work model and rotational shifts. Display attention to detail and accuracy in claim processing. Have a proactive approach to problem-solving and process improvement. Certifications Required Customer Service Certification Property & Casualty Insurance Certification

Experience 3 to 15 years Skills Guidewire Developer experience with any of the detailed skill like (Policy / Billing / Claims / Integration / Configuration / Insurance Now / Portal / Rating) Insurance domain knowledge with Property & Casualty background Hands on experience in at least one of the Guidewire products (Claim/Policy/Billing) Should have knowledge on Admin data loading. Good knowledge in Web services, XML, GxModel, Messaging, Batch implementation, Integrating with 3rd Party Systems and Document composition tools like Xpressions, Thunderhead Experience on any database Oracle / SQL Server and well versed in SQL Designed & modified existing workflows (required for Billing Integration) Experience in SCRUM Agile, prefer Certified Scrum Master (CSM) Good written and oral communication Excellent analytical skills. Works in the area of Software Engineering, which encompasses the development, maintenance and optimization of software solutions/applications.1. Applies scientific methods to analyse and solve software engineering problems.2. He/she is responsible for the development and application of software engineering practice and knowledge, in research, design, development and maintenance.3. His/her work requires the exercise of original thought and judgement and the ability to supervise the technical and administrative work of other software engineers.4. The software engineer builds skills and expertise of his/her software engineering discipline to reach standard software engineer skills expectations for the applicable role, as defined in Professional Communities.5. The software engineer collaborates and acts as team player with other software engineers and stakeholders. - Grade Specific Experience 3 to 15 years Skills Guidewire Developer experience with any of the detailed skill like (Policy / Billing / Claims / Integration / Configuration / Insurance Now / Portal / Rating) Insurance domain knowledge with Property & Casualty background Hands on experience in at least one of the Guidewire products (Claim/Policy/Billing) Should have knowledge on Admin data loading. Good knowledge in Web services, XML, GxModel, Messaging, Batch implementation, Integrating with 3rd Party Systems and Document composition tools like Xpressions, Thunderhead Experience on any database Oracle / SQL Server and well versed in SQL Designed & modified existing workflows (required for Billing Integration) Experience in SCRUM Agile, prefer Certified Scrum Master (CSM) Good written and oral communication Excellent analytical skills.

Job description We Are Hiring for International Semi voice Process Profile -: Claim Processing associate ( Semi voice) Languages req: Excellent English communication Requirement -: Good Communication Skills Exp-: 6m- 5 yrs in claims Shifts:Rotational Location : Bangalore Immediate joiners only *** Only 2 rounds of interview Job description Document claim file by accurately capturing and updating claims data/information in compliance with best practices for low to moderate. exposure and complexity for Property and Content damage and Liability/Injury claims. Exercise judgement to determine policy verification and coverage determination by analysing applicable coverage for claims and determining whether the loss falls within the coverage. Exercise judgement to determine liability by gathering and analysing relevant facts, images; utilizing applicable coverages. Identify anomalies and patterns to identify fraudulent claims and refer to SIU team based on SOPs Work to have a timely resolution to claims with complete ownership from initiation/intake to settlement. Assess damages by calculating applicable damage or range of damages. Negotiate settlement of a claim by establishing the appropriate negotiation strategy and utilizing available resources within authority limits. Meet quality standards by following best practices Responsible for data integrity and the appropriate documentation of the claim file as well as for compliance with regulatory requirements. Accountability in customer satisfaction and execute on the strategy to provide the best claims service for host damage protection. Ensure customer service by proactively communicating information, responding to inquiries, following customer protocols and special handling instructions. Ensure legal compliance by following federal laws and regulations, and internal control requirements. Key skills required: Bachelor's degree or college Diploma. • Experience in P&C, Healthcare Claims dealing with damage, liability or injury claims. • Good knowledge of Insurance claims end-to-end value chain activities, challenges and best practices. • Good knowledge of how to evaluate injuries and damage using market tools and technology. •General knowledge of the coverages available under the damage protection, liability policy and some common exclusions. • Results driven, ability to multi-task, pay attention to detail and follow procedures. Proven leadership and time management skills in a team environment. Job Type: Full-time Qualification :Any graduates (Note: All the rounds are Held through telephonic) Email : careers@glympsehr.com NOTE: - Please call or whatsapp Manya @ 9606553811 / 9606557106 !!!Thanks & Regards HR TEAM!!!

Company: Sutherland Global Services Job Title: Senior Claims/Insurance Executive Position Level: L2 Employment Type: Full-Time Work Model: Brick & Mortar (On-site) Process Type: Blended Process Package: 4.0 4.5 LPA (Based on Experience & Skills) Experience Required: Minimum 2 years of relevant experience in Insurance or Claims Processing Preference will be given to candidates with Motor Claims experience Key Responsibilities: Handle end-to-end claims processing and insurance operations within a blended process model Ensure accurate and timely resolution of insurance claims in line with company policies and procedures Liaise with internal teams, clients, and insurers to gather and verify required documentation Maintain a high level of accuracy and attention to detail in claim evaluation and documentation Provide prompt responses and resolutions to queries and escalations Ensure strict compliance with industry regulations and internal standards Mandatory Requirements: Excellent communication skills in English – both written and verbal Strong understanding of insurance terms, processes, and documentation Ability to work independently and collaboratively in a fast-paced environment Proficiency in MS Office tools and digital claim processing systems Interview Process: HR Round Assessment Managerial Round Preferred Candidate Profile: Detail-oriented and organized Strong analytical and problem-solving skills Customer-focused with a professional approach Prior experience in a corporate insurance/claims environment Job Location: Unit No. 202, 2nd Floor, Campus D, Centennial Business Park, Kundalahalli Main Road, EPIP Area, Bangalore, Karnataka, India – 560066 Walkin now to be a part of a dynamic and growing team!

Skill required: Claims Services - Payer Claims Processing Designation: Health Admin Services 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 Embedding digital transformation in healthcare operations end-to-end, driving superior outcomes and value realization today, and enabling streamlined operations to serve the emerging health care market of tomorrowYou will be a part of the Healthcare Claims team which is responsible for the administration of health claims. This team is involved in core claim processing such as registering claims, editing & verification, claims evaluation, and examination & litigation.Business solutions that support the healthcare claim function, leveraging a knowledge of the processes and systems to receive, edit, price, adjudicate, and process payments for claims. What are we looking for contract conversion 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

Skill required: Talent Development - Learning Operations Designation: Learning Operations Senior Analyst Qualifications: Any Graduation Years of Experience: 5 to 8 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 Improve workforce performance and productivity, boosts business agility, increases revenue and reduces costsTalent Development processManage learning solutions, including activities such as registration, vendor management, product support, learning management system. What are we looking for Work with BI/ BP to prepare demand plan by collating training requests and working with country stakeholders, BPs.Work with BI to understand training needs and collect demand from the stakeholders and build out quarterly detailed demand plan.Conduct interviews with facilitators to assess their qualifications and expertise, and subsequently assign them to appropriate workshops based on their skillsets and experience.Conduct Train-the-Trainer (TTT) and Train-the-Backbone (TB) sessions to upskill facilitators, equipping them with the necessary knowledge and tools to effectively deliver workshops.Collaborate with the scheduling team to ensure that all session details, including session loading, enrollment, and attendance marking, were accurately updated in the Learning Management System (LMS).Collaborate with Business Partner and Stakeholders to retrieve session nominations.Manage session fill rate and handle ad hoc requests, collaborate with regional business partner, and take appropriate actions within cancellation window.Coordinate communication between facilitators and session requestors as necessary to ensure clear expectations are established regarding training delivery.Project management skills (Planning & Organizing)Working independently, accountable for deadlines, able to escalate if necessaryComfortable with ambiguity, able to provide advice and guidance when direction is not well definedConfidence/assured working with client leadership and delivering difficult messagesAbility to prioritize conflicting requirementsAbility to gather, analyze and formulate conclusions on dataPeople management skills (Coaching, listening, giving direction)Cost estimating and financial analysisStrong written and verbal communication skillsEnglish language proficiency requiredEvent planning experienceInitiative and bias for actionCritical thinking / problem solving skills Roles and Responsibilities: In this role you are required to do analysis and solving of increasingly complex problems Your day to day interactions are with peers within Accenture You are likely to have some interaction with clients and/or Accenture management You will be given minimal instruction on daily work/tasks and a moderate level of instruction on new assignments Decisions that are made by you impact your own work and may impact the work of others In this role you would be an individual contributor and/or oversee a small work effort and/or team Please note that this role may require you to work in rotational shifts Qualification Any Graduation

Skill required: Delivery - Actuarial Analysis Designation: I&F Decision Sci Practitioner Sr Analyst Qualifications: Bachelors in actuarial science Years of Experience: 5 to 8 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 "Data & AIActuarial analysis uses statistical models to manage financial uncertainty by making educated predictions about future events. Insurance companies, banks, government agencies, and corporations use actuarial analysis to design optimal insurance policies, retirement plans, and pension plans." What are we looking for " Actuarial Modeling Actuarial Science Insurance Claims Adaptable and flexible Commitment to quality Ability to work well in a team Agility for quick learning Written and verbal communication" Roles and Responsibilities: " In this role you are required to do analysis and solving of increasingly complex problems Your day-to-day interactions are with peers within Accenture You are likely to have some interaction with clients and/or Accenture management You will be given minimal instruction on daily work/tasks and a moderate level of instruction on new assignments Decisions that are made by you impact your own work and may impact the work of others In this role you would be an individual contributor and/or oversee a small work effort and/or team" Qualification Bachelors in actuarial science

Company: Marsh Description: Ensures timely and accurate production/processing of complex documents/information (includes report preparation) Maintains a basic understanding of the core aspects of relevant Insurance and related legislation (customer awareness) and strengthen established relationships Adheres to Company policies and performance standards Contributes to the achievement of Operations team Service Level Agreements (SLA) , Key Performance Indicators (KPI) and business objectives Marsh, a business of Marsh McLennan (NYSE: MMC), is the world s top insurance broker and risk advisor. Marsh McLennan is a global leader in risk, strategy and people, advising clients in 130 countries across four businesses: Marsh, Guy Carpenter, Mercer and Oliver Wyman. With annual revenue of $24 billion and more than 90,000 colleagues, Marsh McLennan helps build the confidence to thrive through the power of perspective. For more information, visit marsh.com, or follow on LinkedIn and X.

Skill required: Operations Support - Pharmacy Benefits Management (PBM) Designation: Health Operations New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years Language - Ability: English(International) - Intermediate 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 Embedding digital transformation in healthcare operations end-to-end, driving superior outcomes and value realization today, and enabling streamlined operations to serve the emerging health care market of tomorrowYou will be a part of the Healthcare Claims team which is responsible for the administration of health claims. This team is involved in core claim processing such as registering claims, editing & verification, claims evaluation, and examination & litigation.The business processes, operations and interactions of third party administrators of prescription drug programs, understanding of the processes used to manage programs for payers, process and pay prescription drug claims, develop and maintain the formulary, contract with pharmacies and negotiate discounts and rebates with drug manufacturers. What are we looking for Ability to perform under pressureAdaptable and flexibleAbility to establish strong client relationshipWritten and verbal communicationPrioritization of workload 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

Description At Gigamon, our purpose is to protect the hybrid networks and data of the largest, most complex organizations on the planet. Certified as a Great Place to Work, we offer a deep observability pipeline that efficiently delivers network-derived intelligence to cloud, security, and observability tools. This helps our customers to eliminate security blind spots, optimize network traffic, and dramatically reduce tool cost and complexity, enabling them to better secure and manage their hybrid cloud infrastructure. Gigamon has served more than 4,000 customers worldwide, including over 80 percent of Fortune 100 enterprises, 9 of the 10 largest mobile network providers, and hundreds of governments and educational organizations. We are seeking a highly skilled Accountant with 5 years of experience to handle review of expenses reimbursement claims primarily focusing on USA and international entities with knowledge of international travel policy practices. This role requires proficiency in SAP Concur tool or any other tools. The ideal candidate will be proficient in managing expenses claim as per travel policy, interaction with employee for query handling, accounting and payment of claims, This role will ensure accurate processing of expense reimbursements claimed by employees, assist in month-end accounting activities and support audit processes. What you ll do: Expenses reimbursement claims processing: Accurately and timely audit the claims from employees. Ensuring compliance with company travel and other policies along with federal, state, and local tax regulations. International claims Support: Assist in processing expenses claims for international regions, ensuring all payments are processed in accordance with local laws. Employees support: Raise and respond to resolve claims related questions and discrepancies from employees of all regions, ensuring timely clarification. Expenses Accounting: Assist in recording expense claims transactions in the general ledger and the same is reconciled. Remittances: Ensure claims are timely paid to employees and accounted in accounting software. Audit Support: Help to prepare documentation and reports for internal and external audits, ensuring data integrity and compliance. Other Interaction: Work closely with third-party payroll vendors, providing data, ensuring service accuracy, and addressing any issues that arise. Also creation of vendor master in claims tool is necessary. Data Analysis: Analyze claims data for accuracy, troubleshoot issues, and support reporting efforts. What you ve done: Bachelor s or Master s degree in Accounting, Finance, Business, or a related field. Minimum 5 years of experience in expenses claims processing, with strong focus on USA and international entities. Knowledge of domestic and international travel practices and company reimbursements polices. Proficiency in tool like SAP Concur systems, accounting software and Excel. Who you are: Excellent problem-solving and analytical skills. Strong attention to detail, ensuring accuracy in data. Effective communication skills for handling employee inquiries and collaborating with teams. Experience working with multinational operations. Willingness and ability to pick up new stuff with good attitude

About Us At CIGNA Healthcare we are guided by a common purpose to help make financial lives better through the power of every connection. Responsible Growth is how we run our company and how we deliver for our clients, teammates, communities, and shareholders every day. One of the keys to driving Responsible Growth is being a great place to work for our teammates around the world. We are devoted to being a diverse and inclusive workplace for everyone. We hire individuals with a broad range of backgrounds and experiences and invest heavily in our teammates and their families by offering competitive benefits to support their physical, emotional, and financial well-being. CIGNA Healthcare believes both in the importance of working together and offering flexibility to our employees. We use a multi-faceted approach for flexibility, depending on the various roles in our organization. Working at CIGNA Healthcare will give you a great career with opportunities to learn, grow and make an impact, along with the power to make a difference. Join us! Process Overview International insurance claims processing for Member claims. Job Description* Delivers basic technical, administrative, or operative Claims tasks. Examines and processes paper claims and/or electronic claims. Completes data entry, maintains files, and provides support. Understands simple instructions and procedures. Performs Claims duties under direct instruction and close supervision. Work is allocated on a day-to-day or task-by-task basis with clear instructions. Entry point into professional roles. Responsibilities: - Adjudicate international pharmacy claims in accordance with policy terms and conditions to meet personal and team productivity and quality goals. Monitor and highlight high-cost claims and ensure relevant parties are aware. Monitor turnaround times to ensure your claims are settled within required time scales, highlighting to your Supervisor when this is not achievable. Respond within the time commitment given to enquiries regarding plan design, eligibility, claims status and perform necessary action as required, with first issue/call resolution where possible. Interface effectively with internal and external customers to resolve customer issues. Identify potential process improvements and make recommendations to team senior. Actively support other team members and provide resource to enable all team goals to be achieved. Work across International business in line with service needs. Carry out other ad hoc tasks as required in meeting business needs. Work cohesively in a team environment. Adhere to policies and practices, training, and certification requirements. Requirements*: Working knowledge of the insurance industry and relevant federal and state regulations. Good English language communication skills, both verbal and written. Computer literate and proficient in MS Office. Excellent critical thinking and decision-making skills. Ability to meet/exceed targets and manage multiple priorities. Must possess excellent attention to detail, with a high level of accuracy. Strong interpersonal skills. Strong customer focus with ability to identify and solve problems. Ability to work under own initiative and proactive in recommending and implementing process improvements. Ability to organise, prioritise and manage workflow to meet individual and team requirements. Experience in medical administration, claims environment or Contact Centre environment is advantageous but not essential. Education*: Graduate (Any) - medical, Paramedical, Pharmacy or Nursing. Experience Range* : Minimum 1 year of experience in healthcare services or processing of healthcare insurance claims. Foundational Skills- Expertise in international insurance claims processing Work Timings*: 7:30 am- 16:30 pm IST Job Location*: Bengaluru (Bangalore)