2028 Claims Processing Jobs - Page 16

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 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 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 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 Roles and Responsibilities: 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 Qualification BE,Diploma in Automobile

Project Role : Application Lead Project Role Description : Lead the effort to design, build and configure applications, acting as the primary point of contact. Must have skills : Business Requirements Analysis Good to have skills : Insurance Claims, Guidewire BillingCenter BAMinimum 5 year(s) of experience is required Educational Qualification : 15 years full time education Summary :As an Application Lead, you will lead the effort to design, build, and configure applications, acting as the primary point of contact. Your typical day will involve collaborating with various stakeholders to gather requirements, ensuring that the applications meet business needs, and overseeing the development process to deliver high-quality solutions. You will also engage in problem-solving and decision-making to guide your team effectively, fostering an environment of collaboration and innovation. Roles & Responsibilities:- Expected to be an SME.- Collaborate and manage the team to perform.- Responsible for team decisions.- Engage with multiple teams and contribute on key decisions.- Provide solutions to problems for their immediate team and across multiple teams.- Facilitate knowledge sharing and mentoring within the team to enhance overall performance.- Monitor project progress and ensure alignment with business objectives. Professional & Technical Skills: - Must To Have Skills: Proficiency in Business Requirements Analysis.- Good To Have Skills: Experience with Guidewire BillingCenter BA, Insurance Claims.- Strong analytical skills to assess business needs and translate them into technical requirements.- Ability to communicate effectively with both technical and non-technical stakeholders.- Experience in project management methodologies to ensure timely delivery of projects. Additional Information:- The candidate should have minimum 5 years of experience in Business Requirements Analysis.- This position is based at our Hyderabad office.- A 15 years full time education is required.- Resource need to work in Shift B(12:30pm till 10:00pm) Qualification 15 years full time education

Job Responsibilities and Expectations - Assist in onboarding new individual and corporate clients by collecting and verifying documentation. - Support the BD team in preparing customized health insurance proposals and quotations. - Maintain accurate records of client interactions and proposal submissions. - Coordinate with underwriting and policy servicing teams to ensure timely processing of new applications. - Respond to basic client queries related to product features, benefits, and application status. - Ensure compliance with Hong Kong Insurance Authority (IA) guidelines during client interactions. - Assist in scheduling meetings and presentations for BD executives. - Generate reports on lead conversion and client engagement metrics. - Support digital onboarding and CRM data entry processes. - Collaborate with marketing teams to distribute promotional materials and campaigns. Academic and Additional Qualifications Needed - Bachelors degree in Business Administration, Insurance, or related field. - Basic understanding of health insurance products and services. - Proficiency in CRM systems and Microsoft Office tools. - Strong communication and organizational skills. Quality Review Role Job Responsibilities and Expectations - Review BD support documentation for accuracy and completeness before submission to underwriting. - Ensure proposals and quotations comply with IA regulations and internal quality standards. - Audit CRM entries and client records for consistency and compliance. - Provide feedback to processors on documentation errors and improvement areas. - Monitor turnaround times and escalate delays to supervisors. - Support training initiatives for new BD support staff. - Assist in preparing quality assurance reports for management review. - Coordinate with compliance teams to ensure adherence to regulatory updates. - Participate in internal audits and implement corrective actions. - Maintain confidentiality and data protection standards in client communications. Academic and Additional Qualifications Needed - Bachelor’s degree in Insurance, Business, or related discipline. - Minimum 4 years of experience in health insurance operations or BD support. - Strong knowledge of Hong Kong IA regulations and compliance standards. - Attention to detail and analytical skills. Supervisor Role Job Responsibilities and Expectations - Oversee daily operations of BD support staff and ensure timely client onboarding. - Manage workload distribution and monitor performance metrics. - Liaise with BD executives to align support activities with sales strategies. - Ensure team compliance with IA regulations and internal SOPs. - Conduct regular training and mentoring sessions for team development. - Resolve escalated client issues and documentation discrepancies. - Review and approve proposals and quotations before submission. - Coordinate with underwriting, claims, and policy servicing teams for seamless client experience. - Prepare monthly performance and compliance reports for senior management. - Drive process improvements and automation initiatives in BD support workflows. Academic and Additional Qualifications Needed - Bachelor’s degree in Insurance, Business Administration, or related field. - 8+ years of experience in health insurance BD support or operations. - Leadership and team management experience. - Strong understanding of Hong Kong health insurance market and IA regulations. Manager Role Job Responsibilities and Expectations - Lead strategic planning and execution of BD support operations across Hong Kong. - Develop and implement policies to ensure regulatory compliance and operational efficiency. - Collaborate with BD leadership to support revenue growth and client retention. - Manage cross-functional coordination with underwriting, claims, and servicing teams. - Oversee recruitment, training, and performance evaluation of BD support staff. - Represent BD support function in regulatory audits and industry forums. - Analyze market trends and client feedback to enhance support services. - Drive digital transformation and CRM optimization initiatives. - Ensure alignment of BD support activities with corporate goals and IA standards. - Prepare executive-level reports and presentations on BD support performance. Academic and Additional Qualifications Needed - Bachelor’s or Master’s degree in Insurance, Business, or Healthcare Administration. - 10+ years of experience in health insurance BD support or related functions. - Proven leadership in managing large teams and strategic initiatives. - Expert knowledge of Hong Kong IA regulations and health insurance products.

Responsible for preparing Variation Instruction, Variation Order, Recommendation to the Employer for approval / rejection of Variations. Responsible for assessment of Contractor s/Employer s Claims for Agreement/Determination also providing notification to the Employer and Contractor of any Claim Agreement. Assessment and determination of the Employer s Claims/ Counterclaims, taking into account the actual work done, related events encountered in the project & confirming to the Contract provisions. Evaluation and submission of Interim Claims (Cost), under the relevant Contract norms attributable to the Employer. Checking for submitting Price Adjustment/ Variations Bills, in terms of Contract conditions.

TATA AIG General Insurance Company Limited is looking for Manager - Health Claims to join our dynamic team and embark on a rewarding career journey Delegating responsibilities and supervising business operations Hiring, training, motivating and coaching employees as they provide attentive, efficient service to customers, assessing employee performance and providing helpful feedback and training opportunities. Resolving conflicts or complaints from customers and employees. Monitoring store activity and ensuring it is properly provisioned and staffed. Analyzing information and processes and developing more effective or efficient processes and strategies. Establishing and achieving business and profit objectives. Maintaining a clean, tidy business, ensuring that signage and displays are attractive. Generating reports and presenting information to upper-level managers or other parties. Ensuring staff members follow company policies and procedures. Other duties to ensure the overall health and success of the business.

Role & responsibilities Processing of pre-authorization/cashless claim. Maintain processing TAT for pre-auth/cashless claim Must be able to analyze large amount of data, Identify patterns and draw conclusions from that data Must have previous experience of conducting audit, sampling and preparing reports Reviewing insurance policy documents to determine coverage limits, exclusions that may affect the claim. Reviewing medical bills, medical records, and other documentation to determine medical necessity and appropriate treatment. Preferred candidate profile Any Medical degree (Mandatory) Good communication skills Ability to multi-task Good interpersonal skills Should know internal systems Good understanding of processes Problem Solving ability and Positive Attitude

Job description Role & responsibilities Quickly and efficiently respond to incoming calls and faxes, identify how best to assist. Conduct outbound calls of insurance verifications to understand if patients prescribed therapy is eligible for coverage. Document results in appropriate tracking system. Document calls in appropriate tracking systems, and handle/escalate calls per established procedures. Process patient applications and follow the program's specifications to determine their eligibility. Document results in appropriate tracking system and manage follow-ups as appropriate. Place follow-up calls and respond to enquiries from patients and/or healthcare providers as necessary. Maintain a professional, calm and friendly demeanor. Express thoughts and instructions clearly in both verbal and written communication; i.e. uses grammatically correct and concise language. Coordinate the order and transfer of prescriptions based on their degrees of urgency to specialty pharmacies as appropriate. Be familiar with the market place and the insurance options available for patients. Educate patients on the available options as appropriate. Strict adherence to follow the process SOPs Preferred candidate profile The Program Specialist ideally should have two or more years of prior customer service, volunteering, or other customer-facing experience. Prior experience in the US healthcare industry is a must , and the Program Specialist must be a proven problem solver with the ability, drive, and initiative to learn the required healthcare, reimbursement, and customer service skills necessary to support the assigned program(s). Experience in handling sensitive data in US healthcare with high degree of proficiency. Must be familiar with HIPAA guidelines. Candidates should be flexible in working from home or in an office setting per business needs.

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

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

About The Role 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. About The Role - 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.

About The Role 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. About The Role - 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.

Looking for experienced Guidewire professional to join our team! Open Roles: Guidewire PC, BC & CC InfoCenter, DataHub, Contact Manager, Agent Connect Support Developer (Any TechM location) Guidewire Data Hub InfoCenter & Data Platform Support Specialist (Any TechM Locations) Guidewire PC, BC & CC InfoCenter, DataHub, Contact Manager, Agent Connect Support Developer (Offshore - Pune) Join us and be a part of an innovative and dynamic team at Tech Mahindra! Can you start immkdiately? Please Email your resume to RS00813886@Techmahindra.com with your latest date to start.

Coordination with TPAs File Management Query Handling Claims processing and settlement

Medical Billing (Airoli) US Shift | Sat-Sun Off Work from Office | One Side Drop Basic English is enough to apply! Trainee: HSC/Grad Freshers Associate: HSC/Grad + 6m Exp Salary: 10.7k–17k + 5k Inc Growth & Incentives await! Join ASAP!

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

Role & responsibilities We are hiring for the position of Trainee Process Consultant for our International Voice Process in the US Healthcare sector. As a Trainee Process Consultant, you will be responsible for processing claims, handling customer inquiries, and ensuring customer satisfaction through timely and accurate resolutions. BTECH NOT ALLOWED REACH OUT TO HR SUSMITA - 9903486610 Preferred candidate profile - Process claims according to established guidelines and procedures. - Maintain customer satisfaction ratings by adhering to client SLAs. - Utilize company policies to resolve customer issues efficiently. - Input and update customer records in the company platform. - Ensure quick and accurate decision-making to resolve customer queries. Perks and benefits Skills Required: Excellent Communication Candidate should be willing to work in US shift. Eligibility Criteria: - Must have completed 10+2/Intermediate schooling from an English medium school. (pass out year Only 2019 to 2022) - Candidates should not be pursuing any higher education. - Freshers or with a maximum of 1 year of experience in a BPO are eligible. - Graduates only REACH OUT TO HR SUSMITA - 9903486610 - Pursuing Graduation or Graduation Backlog holders are not eligible. Shifts: Candidate should be flexible with any given shifts. Working Days: Five days working (Saturday & Sunday fixed week off) Transportation: Two Way Cab provided

Job Description About Client Hiring for One of the Most Prestigious Multinational Corporations! Job Title Guidewire Policy Center / Claim Center Developer Location Chennai/Hyderabad Employment Type: Full-time Experience Level: 5+ Years Job Summary: We are seeking a highly skilled and motivated Guidewire Policy Center/Claim Center Developer to join our growing team. The ideal candidate will have extensive experience in Guidewire Policy Center and Claim Center, and will play a key role in the design, development, and implementation of insurance applications for our clients. This role offers the opportunity to work on complex business solutions, contribute to software design, and enhance the performance of core applications. Key Responsibilities: Design and Development : Customize and configure Guidewire PolicyCenter and ClaimCenter to meet the clients business requirements. Write efficient, scalable, and reusable code for Guidewire applications, focusing on configuration (entity model, business logic, rules, and UI). Integrate PolicyCenter/ClaimCenter with third-party systems (billing systems, rating engines, etc.). System Analysis & Requirement Gathering : Collaborate with business analysts and clients to gather functional requirements and propose efficient solutions within the Guidewire ecosystem. Perform detailed system analysis and contribute to solution design in alignment with business needs. Testing and Troubleshooting : Participate in unit, integration, and regression testing to ensure the quality and stability of customizations and enhancements. Troubleshoot and debug issues within the Guidewire applications to ensure smooth functioning of PolicyCenter and ClaimCenter. Deployment and Configuration : Ensure timely deployment of software and updates to production environments. Configure and optimize Guidewire applications for improved performance and user experience. Support and Maintenance : Provide ongoing support for the policy and claims management applications, resolving issues promptly. Monitor system performance and troubleshoot any operational issues that arise. Collaboration & Documentation : Work closely with cross-functional teams, including business users, project managers, and QA teams, to ensure successful delivery. Document technical specifications, code changes, and processes as per the company's standards. Required Qualifications: Education : Bachelor's degree in Computer Science, Information Technology, Engineering, or related field. Experience : 5 to 10 years of hands-on experience in Guidewire PolicyCenter and/or ClaimCenter development. Strong experience in Guidewire Studio for customizing and configuring Guidewire applications. Proficiency in Guidewire ClaimCenter and/or PolicyCenter modules, including configuration of Business Rules, Entities, and UI. Experience with Gosu programming language for customizations and rule configuration in Guidewire applications. Technical Skills : Expertise in Guidewire ClaimCenter , PolicyCenter , and BillingCenter (if applicable). Proficient in Gosu , SQL , XML , Web Services (SOAP/REST), and related technologies. Hands-on experience with Guidewire product installation, upgrades, and troubleshooting. Additional Skills : Knowledge of the insurance domain is a plus, with understanding of policy management and claims management processes. Strong problem-solving and debugging skills. Excellent communication and collaboration skills. Preferred Qualifications: Certifications : Guidewire certifications (e.g., Guidewire Certified Developer ). Experience with integrations : Integration experience with third-party applications like payment gateways, underwriting systems, or external databases. Familiarity with Agile methodologies is a plus. Exposure to Guidewire Cloud or experience working in cloud-based Guidewire environments. Chandra M Senior Staffing Analyst - IT Recruiter Black and White Business Solutions Pvt. Ltd. Bangalore, Karnataka, INDIA chandra@blackwhite.in | www.blackwhite.in +91 8067432463

About Client Hiring for One of the Most Prestigious Multinational Corporations! Job Description Job Title : Guidewire Integration Developer Qualification : BE / B.Tech / Engineering Relevant Experience : 5+ Years Must Have Skills : Position No. of Position Experience GW CC Integration Developer 8 5yrs+ GW PC Integration Developer 5 5yrs+ GW PC Config Lead Developer 5 5yrs+ GW PC Config Lead Developer 3 10yrs+ GW BC Lead Developer - ACE Certified 3 7yrs+ GW BC Developer 2 5yrs+ GW PC Rating Developer 2 5yrs+ Good to Have Skills : Certification Location : Bangalore/Hyderabad/Chennai/Pune/Kolkata/Remote CTC Range : As per market standards Notice period : Immediate Shift Timing : General Shift Mode of Interview : Virtual Mode of Hire : Contract to Hire Mode of Work : Hybrid Preethi Senior Analyst Black and White outsourcing Pvt Ltd Bangalore, Karnataka,INDIA. preethi@blackwhite.in | www.blackwhite.in

Greetings from The Job Factory !! Job Summary: We are seeking highly motivated and enthusiastic undergraduate or graduate freshers/ experience to join our team as International Process Associates. The successful candidates will work on international processes, providing exceptional service to our global clients. For more details Call : HR Smitha 9880964847(call or whatsapp) Role & Responsibilities: 1. Handle customer inquiries and resolve issues via phone, email, or chat 2. Provide product information and support to customers 3. Manage and document customer interactions 4. Meet productivity and quality standards 5. Collaborate with internal teams to resolve complex issues Preferred Candidate Profile: 1. Undergraduate or graduate degree in any discipline 2. Excellent communication and interpersonal skills 3. Ability to work in a fast-paced environment and manage multiple priorities 4. Strong analytical and problem-solving skills 5. Willingness to learn and adapt to new processes and technologies What We Offer: 1. Competitive salary and benefits 2. 2-way cab facility for commute 3. Opportunities for growth and development in a global company 4. Collaborative and dynamic work environment 5. Training and support to help you succeed in your role 6. Incentives and Allowance's Skills: 1. Good communication skills (written and verbal) 2. Basic computer knowledge and typing skills 3. Ability to work independently and as part of a team 4. Strong attention to detail and organizational skills REGARDS, SMITHA HR TEAM

Location: Ahmedabad Profile: US Voice Process (AR Caller , Dental Billing , Medical Billing ) Shift: Night shift Salary for Freshers : 20,000 Experienced : Upto 31KCTC Benefits: 1 way Cab Working Days: 5 days

1. 3-8 years of hands-on experience in working denials, correspondence, and follow-up for US Health care clients - Physician/ Hospital billing . 2. Strong Domain knowledge in End to end AR process . 3. Should have good experience in checking claims through web portals, Insurance websites. 4. Good Communication skills is required. 5. Review AR claims, understand the denial reason, resolve the issue and take the claim to closure 6.Take corrective actions covering re submission of claims, transferring to correct payer 7. Looking for Immediate joiners Interview Process Level 1: TL Interview - Direct Walk in Level 2: Face to Face Manager level Interview Level 3: CEO Interview - Telephonic Level 4: HR discussion Shift: 9 :00 a.m to 6:00 p.m - Day shift only Full Time, Permanent For more details call to HR: 7305-991-117 Keerthana Or Whats app your resume to 7305-991-117 Or email your resume to hr@atshealth.com

Location: Ahmedabad Profile: US Voice Process (AR Caller , Dental Billing , Medical Billing ) Shift: Night shift Salary for Freshers : 20,000 Experienced : Upto 40K(Relevant in RCM Process ) Benefits: 1 way Cab Working Days: 5 days

Lead support transition activities including process mapping, SOP creation, and knowledge transfer in the insurance domain Deliver coordinate training sessions for new team members or during process migrations Work across various insurance functions Required Candidate profile Liaise with client internal stakeholders to ensure effective communication and process alignment Ensure documentation of best practices continuous process improvement post-transition Monitor training Perks and benefits Perks and Benefits

About Us: Medi Assist is India's leading Health Tech and Insure Tech company focused on administering health benefits across employers, retail members, and public health schemes. We consistently strive to drive innovation and participate in such initiatives, to lower health care costs. Our Health Benefits: Administration model is designed to deliver the tools necessary for a health plan to succeed, whether its our modular claims management system, our technology that unveils data to make important decisions, or our service solutions built around the voice of the customer. In short, our goal is to link our success to that of our members Roles and Responsibilities: 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 non-availability of tariff. Approve or deny the claims as per the terms and conditions within the TAT. Handle escalations and responding to mails accordingly. Work from Office only 4th floor, AARPEE Chambers, Off Andheri-Kurla Road Industrail Estate Marol, Andheri East, , Marol Cooperative Next To Times Square, Shagbaug, Gamdevi, Marol, Mumbai, Maharashtra 400059 Interested candidates can share their resumes to sarika.pallap@mediassist.in CV on 8792840500

About Us: Medi Assist is India's leading Health Tech and Insure Tech company focused on administering health benefits across employers, retail members, and public health schemes. We consistently strive to drive innovation and participate in such initiatives, to lower health care costs. Our Health Benefits: Administration model is designed to deliver the tools necessary for a health plan to succeed, whether its our modular claims management system, our technology that unveils data to make important decisions, or our service solutions built around the voice of the customer. In short, our goal is to link our success to that of our members Roles and Responsibilities: 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 non-availability of tariff. Approve or deny the claims as per the terms and conditions within the TAT. Handle escalations and responding to mails accordingly. Work from Office only 4th floor, AARPEE Chambers, Off Andheri-Kurla Road Industrail Estate Marol, Andheri East, , Marol Cooperative Next To Times Square, Shagbaug, Gamdevi, Marol, Mumbai, Maharashtra 400059 Interested candidates can share their resumes to abhilasha.dutta@mediassist.in CV on 8050700698