2028 Claims Processing Jobs - Page 14

Max Life Insurance Company Limited is looking for Relationship Associate - Bancassurance to join our dynamic team and embark on a rewarding career journey A Relationship Associate in Bancassurance is a role within the banking sector that focuses on building and maintaining relationships with customers in relation to insurance products and services offered by the bank Bancassurance refers to the distribution of insurance products through banks, leveraging their existing customer base and distribution channels Here are the key responsibilities of a Relationship Associate in BancassuranceCustomer Relationship Management Relationship Associates in Bancassurance establish and maintain strong relationships with bank customers They engage with customers to understand their insurance needs, provide information about available insurance products, and offer personalized solutions based on individual requirements Insurance Product Knowledge They develop a comprehensive understanding of the insurance products offered by the bank This includes life insurance, health insurance, general insurance, and other relevant insurance solutions They stay updated on product features, benefits, terms, and conditions to effectively communicate the offerings to customers Sales and Cross-Selling Relationship Associates actively promote and sell insurance products to bank customers They identify cross-selling opportunities by analyzing customer profiles and financial needs They explain the features and benefits of insurance products, address customer queries, and guide customers through the insurance purchasing process Needs Analysis and Solution Design They conduct needs analysis for customers to determine their insurance requirements They assess the customer's risk profile, financial goals, and coverage needs Based on the analysis, they design suitable insurance solutions that align with the customer's preferences and financial capabilities Documentation and Application Processing Relationship Associates assist customers with the completion of insurance application forms and related documentation They ensure accuracy and completeness of information provided by customers and facilitate the smooth processing of insurance applications Customer Service and Support They provide ongoing customer service and support to address inquiries, claims processing, and policy servicing requirements They act as a point of contact for customers throughout the insurance policy lifecycle, resolving any issues or concerns that may arise

Max Life Insurance Company Limited is looking for Relationship Associate - Bancassurance to join our dynamic team and embark on a rewarding career journey A Relationship Associate in Bancassurance is a role within the banking sector that focuses on building and maintaining relationships with customers in relation to insurance products and services offered by the bank Bancassurance refers to the distribution of insurance products through banks, leveraging their existing customer base and distribution channels Here are the key responsibilities of a Relationship Associate in BancassuranceCustomer Relationship Management Relationship Associates in Bancassurance establish and maintain strong relationships with bank customers They engage with customers to understand their insurance needs, provide information about available insurance products, and offer personalized solutions based on individual requirements Insurance Product Knowledge They develop a comprehensive understanding of the insurance products offered by the bank This includes life insurance, health insurance, general insurance, and other relevant insurance solutions They stay updated on product features, benefits, terms, and conditions to effectively communicate the offerings to customers Sales and Cross-Selling Relationship Associates actively promote and sell insurance products to bank customers They identify cross-selling opportunities by analyzing customer profiles and financial needs They explain the features and benefits of insurance products, address customer queries, and guide customers through the insurance purchasing process Needs Analysis and Solution Design They conduct needs analysis for customers to determine their insurance requirements They assess the customer's risk profile, financial goals, and coverage needs Based on the analysis, they design suitable insurance solutions that align with the customer's preferences and financial capabilities Documentation and Application Processing Relationship Associates assist customers with the completion of insurance application forms and related documentation They ensure accuracy and completeness of information provided by customers and facilitate the smooth processing of insurance applications Customer Service and Support They provide ongoing customer service and support to address inquiries, claims processing, and policy servicing requirements They act as a point of contact for customers throughout the insurance policy lifecycle, resolving any issues or concerns that may arise

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)

About The Role Skill required: Supply Chain - Automotive Supply Chain Designation: Business Advisory Associate Qualifications: BE/Diploma in Automobile Years of Experience: 1 to 3 years What would you do? To maintain quality and service standards of the Warranty Claims processing team in support of the contracted Service Level AgreementInvestigate and Verify warranty claims based on available external support resources (Parts catalog, Dealer Assist & Standard labor time) & take appropriate decisionImplement practices to improve operational efficiencies What are we looking for? Mechanical knowledge of machinery/auto-componentInvestigate and Verify warranty claims based on available external support resources (Parts catalog, Dealer Assist & Standard labor time) & take appropriate decision Roles and Responsibilities: BE Automobile Graduate/Diploma with or without Automotive experienceBE Mechanical Graduate/Diploma with Automotive experienceExperience in WarrantyExperience with Auto componentsInterpersonal skills to deal with dealers, warranty engineers, etcData processing accuracy, detail oriented, and ability to evaluate/research a warranty claimExpert level capability in use of desktop software (MS Office Suite, with focus on Excel)Organized, timely, pro-active and highly productiveStrong written communication in EnglishAttention to detail and ability to multi-taskExperience in Warranty /Auto Dealership Qualification BE,Diploma in Automobile

About The Role Skill required: Supply Chain - Automotive Supply Chain Designation: Business Advisory Associate Qualifications: BE/Diploma in Automobile Years of Experience: 1 to 3 years What would you do? To maintain quality and service standards of the Warranty Claims processing team in support of the contracted Service Level AgreementInvestigate and Verify warranty claims based on available external support resources (Parts catalog, Dealer Assist & Standard labor time) & take appropriate decisionImplement practices to improve operational efficienciesAnalyze, improve and optimize automotive supply chains to make them more effective, efficient and resilient through digitization. What are we looking for? Mechanical knowledge of machinery/auto-componentInvestigate and Verify warranty claims based on available external support resources (Parts catalog, Dealer Assist & Standard labor time) & take appropriate decision Roles and Responsibilities: BE Automobile Graduate/Diploma with or without Automotive experienceBE Mechanical Graduate/Diploma with Automotive experienceExperience in WarrantyExperience with Auto componentsInterpersonal skills to deal with dealers, warranty engineers, etcData processing accuracy, detail oriented, and ability to evaluate/research a warranty claimExpert level capability in use of desktop software (MS Office Suite, with focus on Excel)Organized, timely, pro-active and highly productiveStrong written communication in EnglishAttention to detail and ability to multi-taskExperience in Warranty /Auto Dealership Qualification BE,Diploma in Automobile

About The Role Skill required: Claims Services - Payer Claims Processing Designation: Health Admin Services New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years 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? Flexible to US shifts and RTOAbility to learn quickly and understand the work. Emphasize on quality work 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

About The Role Skill required: Claims Services - Payer Claims Processing Designation: Health Admin Services New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years 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? Flexible to US shifts and RTOAbility to learn quickly and understand the work. Emphasize on quality work 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

You will be responsible for managing a portfolio of clients, analyzing their insurance needs, and recommending appropriate coverage options. You will also be responsible for developing new business opportunities, building relationships with potential clients, and negotiating terms to secure new accounts. Key Responsibilities: Client Management: Build and maintain strong relationships with existing clients, serving as their primary point of contact for all insurance-related matters. Conduct regular reviews to assess their evolving needs and recommend adjustments to their coverage as necessary. New Business Development: Identify and pursue opportunities to expand our client base, targeting key industries and market segments. Develop strategies to attract new clients, including cold calling, networking, and attending industry events. Risk Assessment: Conduct thorough risk assessments for clients to understand their unique exposures and insurance requirements. Analyze data and industry trends to anticipate potential risks and recommend proactive risk management solutions. Policy Analysis: Evaluate insurance policies to ensure they provide adequate coverage for clients' needs. Review policy terms and conditions, exclusions, and endorsements to identify any gaps or deficiencies in coverage. Negotiation: Negotiate terms and conditions with insurance carriers to obtain the most favorable terms for clients. Advocate on behalf of clients to secure competitive premiums, favorable policy terms, and optimal coverage limits. Compliance: Stay abreast of regulatory changes and industry developments affecting the insurance landscape. Ensure compliance with all relevant laws, regulations, and industry standards in the placement and servicing of insurance policies. Team Collaboration: Collaborate with internal teams, including underwriting, claims, and risk management, to deliver comprehensive solutions to clients. Coordinate with colleagues to address client inquiries, resolve issues, and streamline the insurance process.

Prescribing medication Physically administering treatments Interpreting laboratory results Assessing symptoms Diagnosing Providing follow-up care Staying up to date on medical research Problem Solving and Critical Thinking The primary role of an Medical Officer involves problem-solving and critical thinking to find solutions for patients. Doctors mainly use these skills to assess symptoms, diagnose conditions and develop a treatment plan for their patients. These skills help doctors to evaluate information and make decisions according to their observations. Some of the problem-solving and critical thinking skills are: Analytical thinking Creative thinking Solution-oriented thinking Ability to raise questions Open-minded Communication Skills Medical Officers spend every day interacting with patients, they need better communication skills to master their roles. Having strong communication skills helps doctors understand their patients' mental health, making it easier to diagnose patients effectively and recommend the best treatment. Doctors must also possess the communication skills to explain charts and reports to nurses to ensure proper care of the patients. Some of the communication skills for Medical Officers are : Verbal communication Written communication Body language Clarity in language To be able to give feedbacks Listening skills Interpersonal Skills Just like communication skills, interpersonal skills help Medical Officers build a bond between their patients and colleagues. These interpersonal skills refer to abilities like interacting personally in a mature and empathetic way with the patients. It is essential for the Medical Officers to use this emotional intelligence so that their patients feel positive and relaxed, which may help in fast healing. Doctors should focus on developing interpersonal skills like: Empathy Dependability Patience Compassion Sensitivity Flexibility Conflict resolution Professionalism Medical Officers work and operate under specific SOPs of professionalism to ensure fast recovery of their patients. Patients are always stressed and emotional, so doctors must stay calm and be respectful at all levels throughout the treatment cycle. Here are a few skills that can help doctors remain professional throughout their specialization: Respect Cultural awareness Positive attitude De-escalation Level Headedness Integrity Reassurance Discipline Responsibility

Job Descriptions: Check the medical admissibility of a claim by confirming the diagnosis and treatment details. Scrutinize the claims, as per the terms and conditions of the insurance policy. Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiation of open billing and package etc. Understand the process difference between PA and an RI claim and verify the necessary details accordingly. Verify the required documents for processing claims and raise an IR in case of an insufficiency. Coordinate with the LCM team in case of higher billing and with the provider team in case of nonavailability of tariff. Approve or deny the claims as per the terms and conditions within the TAT. Required Qualification : BAMS, BHMS Work from Office only Interested candidates can share there profiles to livya.jennifer@mediassist.in or WhatsApp to 9008118597.

Job Descriptions: Check the medical admissibility of a claim by confirming the diagnosis and treatment details. Scrutinize the claims, as per the terms and conditions of the insurance policy. Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiation of open billing and package etc. Understand the process difference between PA and an RI claim and verify the necessary details accordingly. Verify the required documents for processing claims and raise an IR in case of an insufficiency. Coordinate with the LCM team in case of higher billing and with the provider team in case of nonavailability of tariff. Approve or deny the claims as per the terms and conditions within the TAT. Required Qualification : BAMS, BHMS Work from Office only Interested candidates can share there profiles to livya.jennifer@mediassist.in or WhatsApp to 9008118597.

Bpo Hiring For Health Care Domain Voice Process 6.5 LPA Location Gurugram Only Graduates. No B.E./Btech/UG''s Minimum 1 Year of Voice Experience With International BpO MUST Pls Cal Dipankar @ 9650094552 Email CV @ jobsatsmartsource@gmail.com

Managing office administration assets and upkeep of the same. Agents Contracting New Business Processing Banking of Initial & Renewal Premium Managing Petty cash & vendor payments Retention of Surrender Requests Execution of all Service Requests - Post Policy Issuance Reverting on customer queries and complaints Maintaining high NPS Scores Life Claims processing Handling compliance issues. Audit Rating Measure of Success Service to Delight-NPS-90 & 3 days TAT Customer Engagement - 70% Surrender Retention - 70% NPS-90 100% Banking with 24 hours. Vendor payment TAT should be Surrender Requests 100 % Accuracy of POS requests 100 % Accuracy of Customer service Zero Day upload of POS & Claims Docs in FTP server. Audit rating 2 Service to Recruitment-100% Service to Sales(Agency & Cat)-100% Persistency-90% Freelook to retain-45% Desired qualifications and experience Graduate / Post-Graduate in any discipline. 2-3 years experience handling front end customer services Knowledge of service quality is required Knowledge and skills required Must be highly customer centric Excellent communication skills Good co-ordination skills Data management on Excel should be good

Managing office administration assets and upkeep of the same. Agents Contracting New Business Processing Banking of Initial & Renewal Premium Managing Petty cash & vendor payments Retention of Surrender Requests Execution of all Service Requests - Post Policy Issuance Reverting on customer queries and complaints Maintaining high NPS Scores Life Claims processing Handling compliance issues. Audit Rating Measure of Success Service to Delight-NPS-90 & 3 days TAT Customer Engagement - 70% Surrender Retention - 70% NPS-90 100% Banking with 24 hours. Vendor payment TAT should be Surrender Requests 100 % Accuracy of POS requests 100 % Accuracy of Customer service Zero Day upload of POS & Claims Docs in FTP server. Audit rating 2 Service to Recruitment-100% Service to Sales(Agency & Cat)-100% Persistency-90% Freelook to retain-45% Desired qualifications and experience Graduate / Post-Graduate in any discipline. 2-3 years experience handling front end customer services Knowledge of service quality is required Knowledge and skills required Must be highly customer centric Excellent communication skills Good co-ordination skills Data management on Excel should be good

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

Experienced Trainer with a strong background in the life insurance sector, specializing in developing and delivering impactful training programs for employees and agents. Skilled in product knowledge, sales training, and compliance, with a focus on improving performance and achieving organizational goals. Adept at identifying training needs, creating engaging learning content, and measuring the effectiveness of training initiatives. Passionate about fostering continuous learning and development to drive success within the team and enhance customer service and sales outcomes. Key Responsibilities Conduct training modules for Agent Advisors and ADMs Conducting induction and on-boarding training programs Training on selling skills Training on all MLI Insurance products and processes Training on all MLI Digital tools and Assets All other training programs as outlined in the Agent and ADM learning journey Conducting GID s and IID s Conducting PRP and FOD as and when required Conducting training in blended delivery format Delivering training in accordance with the learning journey design and blended delivery format - classroom training and/or virtual trainings Developing facilitation skills and virtual delivery skills to ensure seamless training delivery across all sessions Administrative Manager-trainer to drive adoption of the digital learning platform across all roles Responsible for driving digital assessments amongst Agents and ADMs Responsible for driving self-learning among Agents and ADMs Responsible for calendaring and effectively planning all training sessions with the OH / OHs Responsible for delivering all training adhering to the training calendar designed Responsible for driving business performance of all learners Responsible to drive attendance to all training sessions Responsible to capture attendance in TMS/ELM within the stipulated time defined Responsible to coordinate with the OH / OHs in calendaring all training sessions for an office Responsible to plan travel for training sessions in various locations as required Look after training logistics Schedule training sessions Ensure wider participation of agents in programs Ensure set-up of SMART Classroom is in place before commencing a session Monitor progress of agents on a continuous basis Seek regular feedback from agents, Sales Managers, Partner and Managing Partner Ensure that agents follow moral and ethical standards when dealing with clients Monitor Agent development Update training material Review present training material Scan environment Incorporate feedback from Agents, Customers, SMs, Ps, MPs Ensure that the agents get updated and continuous information on MLI products Facilitate self- development of agents Key skills required Industry Knowledge Strong understanding of life insurance products, regulations, and market trends. Communication Skills Ability to explain complex concepts clearly and engage with a diverse audience. Presentation Skills Skilled in creating and delivering effective training sessions and workshops. Coaching and Mentoring Ability to guide and motivate employees, helping them improve their skills and performance. Product Knowledge Deep knowledge of life insurance policies, claims processes, underwriting, and sales techniques. Training Development Experience in designing training materials, modules, and assessments tailored to the audiences needs. Adaptability Ability to adjust training methods and content to fit different learning styles and levels. Sales Skills Familiarity with sales techniques, as training often focuses on improving sales performance within the life insurance space. Problem-Solving Skills Ability to address any performance issues or knowledge gaps in trainees effectively. Technology Proficiency Familiarity with e-learning platforms, learning management systems (LMS), and other training tools. Interpersonal Skills Strong relationship-building skills to connect with trainees and collaborate with other departments. Assessment and Feedback Ability to assess trainee progress and provide constructive feedback for improvement. Desired qualification and experience Graduate in any discipline At least 2-3 years in sales and 3-4 years in conducting sales training, life insurance domain would be a plus Role: Leadership Trainer Industry Type: Insurance Department: Teaching & Training Employment Type: Full Time, Permanent Role Category: Corporate Training Education UG: Any Graduate PG: Any Postgraduate

Key Responsibilities Managing office administration assets and upkeep of the same. Agents Contracting New Business Processing Banking of Initial & Renewal Premium Managing Petty cash & vendor payments Retention of Surrender Requests Execution of all Service Requests - Post Policy Issuance Reverting on customer queries and complaints Maintaining high NPS Scores Life and Health Claims processing Handling compliance issues. Audit Rating Measure of Success Service to Delight- 3Days Customer Engagement - 70% Surrender Retention - 68% NPS-85 100% Banking with 24 hours. Vendor payment TAT should be Surrender Requests 100 % Accuracy of POS requests 100 % Accuracy of Customer service Zero Day upload of POS & Claims Docs in FTP server. Audit rating 2 Desired qualifications and experience Graduate / Post-Graduate in any discipline. 2-3 years experience handling front end customer services Knowledge of service quality is required Knowledge and skills required Must be highly customer centric Excellent communication skills Good co-ordination skills Data management on Excel should be good Role: Operations - Other Industry Type: Insurance Department: Customer Success , Service & Operations Employment Type: Full Time, Permanent Role Category: Operations Education UG: Any Graduate PG: Any Postgraduate

Sr. Team Member - Compliance: Responsibilities Closely monitoring, analysis and reporting of Operational risks KRIs of the company which may include Operations, Claims, Grievance etc. Assist in identification of key risks and conduct risk assessment for such identified areas Review and carry out the impact assessment for various key risks parameters and determine the inherent and residual risks Participate in cross functional discussion, assist in required processes change for mitigating the risks, and provide necessary training and assistance. Prepare & publish Global compliance risk assessment report, discuss with departments and provide inputs for improvements, analyse trends and identify focus areas Conduct Risk Control Self-Assessment (RCSA) of functions, prepare overall summary and conduct control testing of risk controls Support the reporting manager in enhancing the quality of discussions risk-based decision for key committees like Risk Management Committee, etc. Sharing experience and providing necessary assistance to team members on operational process managed Qualification Graduation in any discipline General knowledge on life insurance and pension Should possess excellent communication, collaboration skills with ability to work in a matrix Experience 4 - 8 years of overall experience

Job description INTERNAL Warranty implementation operator Quality Operation Supply chain EXTERNAL Indian Railways (Customer) OVERALL PURPOSE OF THE ROLE: Troubleshoot the Locomotive technical Issues Ensure the Locomotive Availability Ensure the Locomotive Relaibility RESPONSIBILITIES: Ensure troubleshooting on locomotive during Validation and Certification runs and Warranty according to state of art and best practice. Ensure validity and certification of relevant tools. Populate relevant failure data base (FRACAS, Railsys Light ,) Guarantee information flow within the troubleshooting team. Contribute to reliability growth and return of experience. Provide support in special cases (FMI ..) Respect EHS rules and any work related processes Qualifications & Skills:EDUCATION Minimum of engineering degree/diploma (Electrical) from a recognised University. IT literate ( Word, Excel, PowerPoint, Software uploading/Downloading) English Fluency BEHAVIORAL COMPETENCIES: Flexible and Adaptable. Can adapt to new ideas, new issues Conscientious. Meets proposed deadlines with ability to work under pressure Team Player. Supports team members, Spirit of Team Trust Action Desire to learn and develop Decisive. Obtains and uses necessary information to make decisions. Refers decision to others when appropriate Ability to Coach Others. Occasionally has to share skills/information to others Self-Motivation. Is inspired by the job in hand and inspires others to achieve agreed goals Logical and organized TECHNICAL COMPETENCIES & EXPERIENCE Under standing of Electrical schematic Troubleshooting the Traction, TCMS, Brakes, Blowers ,Lighting, Bogies systems. Software uploading and downloading Data analyses EXPERIENCE / SKILL SET 3-4 years experience as Trouble-shooter/Maintainer in Electric Loco Shed having base of more than 100 Locomotives Proven experience of troubleshooting various defects in WAG5; WAG7, WAG9 and WAP series of locomotives. Thorough knowledge of - Locomotive Power Circuit; DJ Control Circuit; Auxiliary Power Circuit; Traction Power Circuit; Pneumatic Circuit; SMGR Circuit etc. Ability to read and understand schematics drawings and software specifications Language Skills: Proficient in English language, Hindi Language IT Skills: Expertise in MS office tools (Word, Excel, PowerPoint), LEADERSHIP SKILL AGILE Dealing with uncertainty Business Acumen Innovative Learning on the fly INCLUSIVE Building effective (virtual) teams Listening and informing Managing diversity Understanding others with empathy RESPONSIBLE Customer focus (internal and external) Integrity and ethics Managerial courage Managing with vision and purpose.

The Claims Business Analyst for Guidewire ClaimCenter is responsible for developing detailed business and functional requirements for claims processing and administration systems, as well as ensuring proper integration with downstream systems for reporting purposes. Your role also includes planning and conducting User Acceptance Testing to guarantee that the systems meet the necessary specifications. Additionally, you provide analytical support for various projects and initiatives aimed at enhancing the claims management processes within the organization. Lead requirements" definitions for complex projects and multi-year strategic initiatives. Identify & translate business needs into clearly defined requirements. Create Documentation inclusive of business use cases, process / data flows, traceability matrices, and report mock-ups. Plan, facilitate, and conduct requirements" gathering sessions, meetings, and presentations. Lead review sessions for completed business / functional requirements, with key business users focused on gaining consensus and final business approval. Cultivate strong professional relations within business units to thoroughly understand business needs. Collaborate with the development and testing teams to provide subject-matter expertise. Assist in troubleshooting and resolving issues when out-of-the-box functionality is leveraged. Ensure future solutions are efficient and effective across all business processes, while being consistent across products. Participate in the development and planning of the User Acceptance Testing activities, including test plans and scripts, based on requirements. After the planning phase, facilitate the UAT execution phase. Work with the business lead and project manager to obtain UAT signoff. Technical Qualifications: - 3+ years of business analysis experience, including defining functional and reporting requirements and conducting user acceptance testing for business-critical solutions in complex environments. - Experience with Guidewire ClaimCenter systems is required. - Must have detailed claims processing knowledge and experience. - Experience with iterative and agile methodologies, with working knowledge of both SDLC & PMLC processes. - Proven hands-on experience with creation of business process diagrams, data rules, business requirements, and functional requirements / user stories. - Possess knowledge and experience when reviewing, re-engineering, or developing IT solutions for business process / improvements automation. - Candidate has experience operating and interfacing with business management during walkthrough, interview, presentation, and negotiation processes. - Proven track record for creating clear, concise deliverables which reflect a deep understanding of business needs and software functionality. General Qualifications: - Clear verbal and written skills. - Able to understand communication channels and can escalate appropriately. - Experience using standard project and business tools including, Microsoft Project, Excel, PowerPoint, Project, SharePoint, UI mock-up tools, etc. - Must be proficient with process modeling tools (e.g., Visio.) - Experience with visualization tools is beneficial. - Possess excellent problem-solving and analytical skills. - Candidate has experience supervising small teams. - Possess a strong initiative with the ability to self-manage. - Comfortable with ambiguity and able to work through challenges to complete the objectives correctly. - A team player who works well with technical and business resources. - Able to see tasks through to completion without significant guidance. - Has personal time-management skills and an ability to meet individual / team deadlines. Education Requirements: - B.A. / B.S. Degree. - Certified Business Analyst Professional (CBAP) is a plus but not required.,

Urgent Hiring Subject Matter Expert (SME) Operations Claims Adjudication (US Healthcare) Location: Indore, Coimbatore, Bangalore Notice Period: Immediate joiners or candidates with less than 30 days notice preferred Department: Claims Operations Experience: Minimum 3.6 years in US healthcare claims adjudication Role Summary: We are seeking a Subject Matter Expert (SME) Operations for US healthcare claims adjudication . The SME will act as the process authority , supporting operations teams in handling complex claim scenarios, resolving escalations, and ensuring process adherence. This role involves mentoring team members, driving operational excellence, and partnering with stakeholders to deliver high-quality results in compliance with client and regulatory requirements. Key Responsibilities: Serve as the go-to expert for operations in claims adjudication processes, policies, and client requirements. Provide on-floor support to resolve complex claim adjudication cases and escalations. Conduct knowledge-sharing sessions, refreshers, and process updates for the operations team. Collaborate with training teams to build effective learning modules for new hires and existing staff. Support operations leaders in meeting SLAs, accuracy, and productivity targets . Partner with quality teams to ensure error-free processing and compliance adherence . Assist in client calls, process transitions, and audits by offering subject matter expertise. Create, update, and maintain SOPs, job aids, and process documentation . Identify opportunities for process improvement and efficiency enhancement within operations. Core Skills & Competencies: Minimum 3.6 years of experience in US healthcare claims adjudication operations . Strong expertise in claims processing (Medical, Dental, Hospital & Pharmacy claims). Proven ability to resolve complex claims and escalations in operations. Strong analytical, problem-solving, and decision-making skills. Effective communication, mentoring, and stakeholder management . Contact Persons: Coimbatore: Anitha WhatsApp your resume to 9597910418 Bangalore: Preetham – Please share your updated resume on – preetham.hr@sagility.com Indore: Srikanth – WhatsApp your resume to 8309217838

Urgent hiring for Specialist quality for claims adjudication from US Healthcare. Looking for immediate joiners or less than 30 days' notice period. Interested folks can reach out to below mentions contact persons. Quality Analyst Claims Adjudication (US Healthcare) Experience: 4 years Location: Indore, Coimbatore, Bangalore Department: Claims Operations Role Summary: A results-driven Quality Analyst with 4 years of experience in US healthcare claims adjudication. Proficient in conducting audits, ensuring compliance, and improving accuracy in claims processing. Skilled in applying 7 QC tools, Root Cause Analysis (RCA), Corrective & Preventive Actions (CAPA), and Six Sigma methodologies to drive process improvements, error reduction, and compliance adherence. Key Responsibilities: Conduct audits of adjudicated claims to ensure accuracy, compliance with client guidelines, and US healthcare standards. Utilize Six Sigma tools and methodologies for process optimization and efficiency improvement. Apply 7 QC tools to analyze defects, identify trends, and improve quality outcomes. Perform Root Cause Analysis (RCA) on recurring errors and implement CAPA to eliminate reoccurrence. Track and analyze quality performance metrics, prepare audit reports, and share insights with stakeholders. Collaborate with operations and training teams to close feedback loops and implement corrective measures. Ensure compliance with HIPAA and regulatory guidelines while handling sensitive member/provider data. Lead and support continuous process improvement initiatives to enhance accuracy, productivity, and customer satisfaction. Core Skills: Claims adjudication (Medical, Dental, Hospital & Pharmacy claims) Quality audits & compliance review Six Sigma (Green Belt preferred) & process improvements 7 QC tools, RCA & CAPA Error trend analysis and quality reporting Analytical thinking & problem-solving MS Excel, Quality monitoring tools, Workflow management Interested candidates can please reach out as below: For Coimbatore location please reach out to Anitha or whats app your resume on : 9597910418 For Bangalore location please reach out to Preetham - Please share your updated resume on preetham.hr@sagility.com For Indore location please reach out to Srikanth or whats app your resume on : 8309217838

Urgent hiring for Team leader operations for claims adjudication from US Healthcare. Looking for immediate joiners or less than 30 days' notice period. Interested folks can reach out to below mentions contact persons. Job Title: Team Leader Claims Adjudication Location: Indore, Coimbatore, Bangalore Department: Claims Operations Reports To: Manager Claims Adjudication Role Overview: The Team Leader Claims Adjudication is responsible for supervising a team of claims processors/adjudicators to ensure accurate and timely adjudication of healthcare/insurance claims in line with policies, compliance requirements, and service-level agreements (SLAs). The role involves performance management, process oversight, and quality monitoring, and driving continuous improvements within the claims adjudication process. Key Responsibilities: Lead, mentor, and manage a team of claims adjudicators to achieve defined productivity, quality, and SLA targets. Review adjudicated claims for accuracy, compliance, and adherence to standard operating procedures. Provide guidance on complex claims, policy interpretation, and exception handling. Monitor daily workflow, allocate tasks, and ensure timely resolution of pending or escalated claims. Track team performance through dashboards and prepare regular reports for management. Conduct regular audits, identify error trends, and implement corrective action plans. Train and coach team members on new processes, updates, and quality standards. Collaborate with cross-functional teams (quality, training, operations) to resolve process gaps and improve efficiency. Ensure compliance with regulatory requirements, privacy, and data security guidelines. Foster a culture of accountability, teamwork, and continuous improvement. Key Requirements: Graduate in any discipline (Bachelors degree required; healthcare/insurance background preferred). Minimum 4.67 years of experience in claims adjudication, with at least 2 years in a SME on papers Strong knowledge of claims processing, adjudication guidelines, and industry regulations. Excellent analytical and decision-making skills with attention to detail. Ability to manage performance, coach teams, and drive results in a fast-paced environment. Strong communication and stakeholder management skills. Proficiency in MS Office tools and claims adjudication systems. Key Competencies: Leadership & People Management Process & Quality Orientation Problem Solving & Decision Making Strong Customer & Service Focus Adaptability and Continuous Improvement Mindset Interested candidates can please reach out as below: For Coimbatore location please reach out to Anitha or whats app your resume on : 9597910418 For Bangalore location please reach out to Preetham - Please share your updated resume on preetham.hr@sagility.com For Indore location please reach out to Srikanth or whats app your resume on : 8309217838

Job Summary As an AR Analysis Trainee at Maxenra, you will play a crucial role in maximizing client reimbursements by accurately analysing and processing medical claims. This role demands strong analytical skills, attention to detail, and effective communication to ensure timely resolution of outstanding claims and adherence to compliance standards. Job Requirements Education: Undergraduate Degree preferably in Arts or Science Skills: Strong communication skills (verbal and written) Good aptitude and analytical thinking Ability to work in a target-driven and quality-focused environment Roles and Responsibilities Maximize insurance reimbursements for US-based healthcare providers Analyze root causes of claim denials, underpayments, or delays Monitor and reconcile aged accounts receivable Follow up with US-based insurance carriers regarding unpaid or delayed claims Identify denial patterns and execute appropriate appeal strategies Collaborate with clinicians and practice owners to correct claim data Manage assigned receivables portfolio and ensure resolution of outstanding claims Perform denial follow-ups and initiate appeals as required Escalate complex collection issues to Team Leaders and seek guidance Perks & Benefits Meal allowance Annual Leave Performance based Incentives Medical insurance Additional Information This is a performance-based role with clear targets and quality benchmarks. Successful candidates will receive comprehensive training and mentorship to grow within the organization. If you'd like to learn more about this role, or if you're ready to apply, please contact Careers@maxernahealth.com . We look forward to hearing from you.

Greetings!! Openings for " Immediate Openings-Claims Adjudication-Quality Analyst " -Coimbatore Required Skills: Subject matter expert in Claims process. Able to perform Quality Audits. Exceptional interpersonal, customer service, problem-solving, verbal and written communication, and conflict resolution skills. Proficiency with the necessary technology, including computers, software applications, phone systems, etc. Ability to improve and/or transform teams processes across functions within the organization. Ability to understand basic data and take appropriate action. Ability to drive individual and team efficiency and productivity through effective and efficient metric management. Ability to coach, train, and motivate employees and evaluate their performance. Ability to strategically lead and develop team towards improved performance. Ability to delegate and manage work loads and projects across functions within the organization. Ability to successfully drive continuous improvement efforts by leading various work streams related to call center metrics and monitoring tools. Ability to problem solve, handle conflict, anticipate issues/concerns, troubleshoot problems, and proactively institute creative solutions. *Candidate must be ready to work in US shifts(Both way cab will be provided) Interested Candidates can share your CV - anitha.c@sagilityhealth.com.