2028 Claims Processing Jobs - Page 2

Positions General Duties and Tasks: Process Insurance Claims timely and qualitativelyMeet & Exceed Production, Productivity and Quality goals Review medical documents, policy documents, policy history, Claims history, system notes and apply the trained client level business rules to make appropriate Claims decisions, call out claims trends and flag fraud activities Stay up to date on new policies, processes, and procedures impacting the outcome of Claims processing Be a team player and work seamlessly with other team members on meeting customer goals Requirements for this role include: Both Under Graduates and Post Graduates can apply. Excellent communication (verbal and written) and customer service skills. Able to work independently; strong analytic skills. Detail-oriented; ability to organize and multi-task. Ability to make decisions. Required computer skills: must have experience with data entry and word processing, possess a working knowledge of MS Office applications, and understand how to navigate through web-based applications. Demonstrate strong reading comprehension and writing skills. Cognitive Skills include language, basic math skills, reasoning ability and verbal communication skills. Ability to work in a team environment. Handling different Reports - IGO/NIGO and Production/Quality. Tobe in a position to handle training for new hires Work together withthe team to come up with process improvements Strictly monitor the performance of all team members and ensure to report in case ofany defaulters. Encourage the team to exceed their assigned targets.**Required schedule availability for this position is Monday-Friday 6PM/4AM IST. The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekends basis business requirement. Requirements for this role include: Candidate should be flexible & support team during crisis period Should be confident, highly committed and result oriented Experience on working in an office environment set up utilizing Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools Experience in a professional/office related role that required you to communicate (oral/written) effectively with internal team members and external customers Experience in a role that required a focus on quality including attention to detail, accuracy, and accountability for your work product Candidate should be flexible to work from home and office environment. Broadband connection is must while working from home. Preferences for this role include: 3+ years of experience processing insurance claims in the health, life, or disability disciplines that required knowledge of CPT, HCPCS, ICD9/10, CDT. 2+ year(s) of experience in role that required understanding and interpreting complex documents such as medical records and legal contracts.

Positions General Duties and Tasks: Process Insurance Claims timely and qualitatively Meet & Exceed Production, Productivity and Quality goals Review medical documents, policy documents, policy history, Claims history, system notes and apply the trained client level business rules to make appropriate Claims decisions, call out claims trends and flag fraud activities Stay up to date on new policies, processes, and procedures impacting the outcome of Claims processing Be a team player and work seamlessly with other team members on meeting customer goals Requirements for this role include: Both Under Graduates and Post Graduates can apply. Excellent communication (verbal and written) and customer service skills. Able to work independently; strong analytic skills. Detail-oriented; ability to organize and multi-task. Ability to make decisions. Required computer skills: must have experience with data entry and word processing, possess a working knowledge of MS Office applications, and understand how to navigate through web-based applications. Demonstrate strong reading comprehension and writing skills. Cognitive Skills include language, basic math skills, reasoning ability and verbal communication skills. Ability to work in a team environment. Handling different Reports - IGO/NIGO and Production/Quality. Tobe in a position to handle training for new hires Work together withthe team to come up with process improvements Strictly monitor the performance of all team members and ensure to report in case ofany defaulters. Encourage the team to exceed their assigned targets. **Required schedule availability for this position is Monday-Friday 6PM/4AM IST. The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekends basis business requirement. Requirements for this role include: Candidate should be flexible & support team during crisis period Should be confident, highly committed and result oriented Experience on working in an office environment set up utilizing Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools Experience in a professional/office related role that required you to communicate (oral/written) effectively with internal team members and external customers Experience in a role that required a focus on quality including attention to detail, accuracy, and accountability for your work product Candidate should be flexible to work from home and office environment. Broadband connection is must while working from home. Preferences for this role include: 3+ years of experience processing insurance claims in the health, life, or disability disciplines that required knowledge of CPT, HCPCS, ICD9/10, CDT. 2+ year(s) of experience in role that required understanding and interpreting complex documents such as medical records and legal contracts.

Positions General Duties and Tasks: Process Insurance Claims timely and qualitatively Meet & Exceed Production, Productivity and Quality goals Review medical documents, policy documents, policy history, Claims history, system notes and apply the trained client level business rules to make appropriate Claims decisions, call out claims trends and flag fraud activities Analyze customer queries to provide timely response that are detailed and ordered in logical sequencing Cognitive Skills include language, basic math skills, reasoning ability with excellent written and verbal communication skills Stay up to date on new policies, processes, and procedures impacting the outcome of Claims processing Continuous learning to ramp up on the knowledge curve to be the SME and to be compliant with any certification as required to perform the job Be a team player and work seamlessly with other team members on meeting customer goals Developing and maintaining a solid working knowledge of the insurance industry and of all products, services and processes performed by Claims function Handle reporting duties as identified by the team manager Handle claims processing across multiple products/accounts as per the needs of the business Requirements for this role include: Both Under Graduates and Post Graduates can apply. Excellent communication (verbal and written) and customer service skills. Able to work independently; strong analytic skills. Detail-oriented; ability to organize and multi-task. Ability to make decisions. Required computer skills: must have experience with data entry and word processing, possess a working knowledge of MS Office applications, and understand how to navigate through web-based applications. Demonstrate strong reading comprehension and writing skills. Cognitive Skills include language, basic math skills, reasoning ability and verbal communication skills. Ability to work in a team environment. Handling different Reports - IGO/NIGO and Production/Quality. To be in a position to handle training for new hires Work together with the team to come up with process improvements Strictly monitor the performance of all team members and ensure to report in case of any defaulters. Encourage the team to exceed their assigned targets. Candidate should be flexible & support team during crisis period Should be confident, highly committed and result oriented Experience on working in an office environment set up utilizing Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools Experience in a professional/office related role that required you to communicate (oral/written) effectively with internal team members and external customers Experience in a role that required a focus on quality including attention to detail, accuracy, and accountability for your work product Candidate should be flexible to work from home and office environment. Broadband connection is must while working from home. Preferences for this role include: 5+ years of experience processing insurance claims in the health, life, or disability disciplines that required knowledge of CPT, HCPCS, ICD9/10, CDT. 2+ year(s) of experience in role that required understanding and interpreting complex documents such as medical records and legal contracts. ***Required schedule availability for this position is Monday-Friday 6PM/4AM IST. The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekends basis business requirement."

Roles and Responsibilities Detailed analysis and processing of commercial insurance applications Making updates to certificate management system and issuing certs Premium calculations and generation of quotes & binders using carrier quote management systems Detailed loss analysis & preparation of loss projections and client reviews Issuance of policies using carrier policy management systems; endorsements to existing policies throughout the policy term Policy administration using agency management systems with adherence to service calendars Make relevant updates in certificate management system and issuance of proof of coverage and other certs Conducting policy and premium audits at expiration / cancellation Resolution of queries through interaction with on-site team Generation of reporting & analytics for use in future decision-making. Desired Candidate Profile Freshers or candidates with less than 3 years experience. Work from office. Good communication skills. Should be comfortable to work in night shifts.

Quality executive is responsible to perform activities outlined in the Service Quality Plan and identify agent / program level improvement opportunities. Executive is required to work closely with the production resource to ensure adherence to the client and process specific requirements. Ensure that regular feedback and error sharing sessions are conducted to avoid repetition of errors and help improve overall performance. Other activities of the quality executive include reporting, calibrations, process analysis and attending client and internal meetings. Responsibilities: Responsible for call/data quality monitoring. Provide feedback to agents using prescribed feedback model. Mentoring and coaching agents on process level issues. Monitor adherence to compliance procedures and processes. Responsible for reporting program level quality score to the process owners. Responsible for conducting calibration and performance review call in terms of quality with the internal team. (Initially will be assisting the senior quality analyst, training and guidance will be provided to be able to lead such meetings in future). Conduct refresher training on the basis of the errors identified. Communicate process updates by conducting a session as and when required. Maintaining update log and sharing it with the team on a regular basis. Perform brainstorming and root cause analysis to analyze data and provide tips or suggestions to operations/management team. Identify and highlight potential risk areas and recommend preventive action. Interested candidates can share their resumes on atish.chintalwar@cotiviti.com

Inviting applications for the role of Dispute Management Analyst/OTC Note- This is Night Shift Office- Onsite Role- (Return to office) Must have experience in Advance Excel. Note- Only Apply if you have Effective Communication Skills In this role associate will work with a team to provide analytical support on deductions recovery. Such analytical support may include data management, data interpretation, reporting, structuring an analysis, interpreting the results in a business context, and providing insights to team to drive deduction recovery. The analyst should be able to identify pattern emerging from data and reports and establish the linkage for the same with business problems. Incumbent should know pricing process - price change to process communication. & able to identify leakages at each stage in value chain and work with stakeholders to fix it. Also, able to work on pricing claims, independently validate them and clear with in timelines. Responsibilities * Prepares and analyses data. This can include locating, profiling, cleansing, extracting, mapping, importing, validating, or modelling. * Performs validation and testing to confirm the accuracy of the information built. * Interprets results of analyses, identifies trends and issues, and develops recommendations to support business objectives. * Communicates valuable information so that it is easy to understand and influences other to act based on the useful information provided. * Think strategically about data as a core enterprise asset and assist in all phases of the advanced analytic development process. * Slice and dice through the database and come up with actionable analytical insights. Qualification we seek in you! Minimum Qualification * Graduate or equivalent * Relevant experience in Dispute Management, OTC * Analytical aptitude - problem solving, quantitative. Preferred Qualification * Knowledge on Collections, Cash & Trade Promotion in CPG / heavy manufacturing industry * Analytical skills, problem solving ability and attention to detail. * Should have ability to handle large data sets on excel & in arriving at meaningful findings. * Proficiency with Microsoft Office and well versed in Excel. * Work in a dynamic and fast-paced environment without compromising the quality. * Excellent communication/ interpersonal skills * Exposure to ERP systems (SAP).

Required experience : 5 + years, GW CC experience 2+ years Experience of working as a business analyst in a major consultancy and the ability to demonstrate core consulting values Experience in GW ClaimCenter is a must Excellent client facing skills/collaboration Experience and understanding of end-to-end system integration deliveries A sound approach to problem solving, knowledge of the change control process and the ability to analyse change to minimise impact on requirements and implementation. Analysing, documenting and managing business requirements and providing functional assurance Workshop planning and facilitation Change planning, delivery planning, impact assessment, deliverables and acceptance definition Producing and presenting reports, presentations, business cases and other client deliverables Soft Skills: Excellent written and verbal communication skills Excellent teamwork and interpersonal skills Works well as a member of a group Ability to work in a semi-structured environment where requirements and priorities are dynamic Self-Motivated to perform without outside help Worked in onsite/offshore model Mentor other engineers while raising the bar on the teams technical excellence

Role: Guidewire ClaimCenter Business Analyst Position Type: Full-Time Contract (40hrs/week) Contract Duration: 6-12 months+ Work Hours: Standard IST Work Schedule: 8 hours/day (Mon-Fri) Location: Hybrid - India (3x days onsite/week in India) 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. Their role also includes planning and conducting User Acceptance Testing to guarantee that the systems meet the necessary specifications. Additionally, the Claims Business Analyst provides analytical support for various projects and initiatives aimed at enhancing the claims management processes within the organization. Role Responsibilities: 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 Requirements: 3+ years of business analysis experience, including defining functional and reporting requirements and conducting user acceptance testing for business-critical solutions in complex environments. Possess 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: The candidate has 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. The candidate is 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 Requirments: B.A. / B.S. Degree. Certified Business Analyst Professional (CBAP) is a plus but not required. ",

Review, analyze, adjudicate US healthcare claims in line with payer policies regulations Handle complex claims adjustments, ensuring compliance with guidelines Collaborate with cross-functional teams to ensure NSA compliance in claims processing Required Candidate profile Investigate and resolve discrepancies in claims data and documentation Support audit and quality assurance functions related to claims Stay updated with NSA regulations healthcare compliance standards Perks and benefits Perks and Benefits

Roles and Responsibilities: Process Adjudication claims and resolve for payment and Denials Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process Knowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of pocket, maximum inside limits and exclusions, state variations Ensuring accurate and timely completion of transactions to meet or exceed client SLAs Organizing and completing tasks according to assigned priorities. Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team Resolving complex situations following pre-established guidelines Requirements: 1-3 years of experience in processing claims adjudication and adjustment process Experience of Facets is an added advantage. Experience in professional (HCFA), institutional (UB) claims (optional) Both under graduates and post graduates can apply Good communication (Demonstrate strong reading comprehension and writing skills) Able to work independently, strong analytic skills Required schedule availability for this position is Monday-Friday 5.30PM/3.30AM IST (AR SHIFT). The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekends basis business requirement.

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

Hiring for US Healthcare - Claims & Premium Billing Education: BE/B.Tech/MCA/M.Tech/MSc./MS ,Bcom Responsibilities A day in the life of an Infoscion As part of the Infosys consulting team, your primary role would be to actively aid the consulting team in different phases of the project including problem definition, effort estimation, diagnosis, solution generation and design and deployment You will explore the alternatives to the recommended solutions based on research that includes literature surveys, information available in public domains, vendor evaluation information, etc. and build POCs You will create requirement specifications from the business needs, define the to-be-processes and detailed functional designs based on requirements. You will support configuring solution requirements on the products; understand if any issues, diagnose the root-cause of such issues, seek clarifications, and then identify and shortlist solution alternatives You will also contribute to unit-level and organizational initiatives with an objective of providing high quality value adding solutions to customers. If you think you fit right in to help our clients navigate their next in their digital transformation journey, this is the place for you!

Looking for US Healthcare - Claims & Premium Billing with experience range 2 to 3 years Education: BE/B.Tech/MCA/M.Tech/MSc./MS ,B.com Responsibilities A day in the life of an Infoscion As part of the Infosys consulting team, your primary role would be to actively aid the consulting team in different phases of the project including problem definition, effort estimation, diagnosis, solution generation and design and deployment You will explore the alternatives to the recommended solutions based on research that includes literature surveys, information available in public domains, vendor evaluation information, etc. and build POCs You will create requirement specifications from the business needs, define the to-be-processes and detailed functional designs based on requirements. You will support configuring solution requirements on the products; understand if any issues, diagnose the root-cause of such issues, seek clarifications, and then identify and shortlist solution alternatives You will also contribute to unit-level and organizational initiatives with an objective of providing high quality value adding solutions to customers. If you think you fit right in to help our clients navigate their next in their digital transformation journey, this is the place for you!

Greetings from Niva Bupa! Job Location- Noida Sector-59 Department- Customer Servicing 6 Days working Must be a BPT graduate. JOB SUMMARY: Answering customer who are disputing over claim rejection or claim related query, also able to provide relevant information to the customer, floor support for team for any query related medical documents, Walk-in customer for claims. KEY RESPONSIBILITIES: Handling of claim rejections/ claim related query over calls and emails Floor support Walk-in customers Interested candidate can share their CV on 7430802568 or consultant.anjalijha@nivabupa.com with a subject "CV for Claim Adjuticator"

About Client Hiring for One of the Most Prestigious Multinational Corporations! Job Description Job Title : Guidewire Policy Center Integration Developer Qualification : BE / B.Tech / Engineering Relevant Experience : 5+ Years Must Have Skills : Languages & Frameworks : Gosu, Java/J2EE, .NET (optional) Data Formats : XML, JSON Integration Tools : SOAP/REST web services, Guidewire Messaging, Event Messaging Database Knowledge : SQL Guidewire Expertise : Edge APIs, PCFs (Page Configuration Files), Rating Engine, Rules Framework Good to Have Skills : • Strong understanding of Property & Casualty insurance lifecycle • Experience working in Agile/Scrum environments • Excellent communication and problem-solving skills to collaborate across cross-functional teams Roles and Responsibilities : Integration Design & Development Build scalable, reusable integration solutions using Guidewire Edge APIs, messaging queues, and batch processes Develop domain-based APIs to expose Guidewire functionality (e.g., account, policy, user management) to external systems Technical Implementation Configure and customize PolicyCenter workflows, entities, and business rules using Gosu (Guidewires proprietary language) Ensure code quality through G-unit testing, peer reviews, and continuous integration practices Collaboration & Requirements Gathering Work closely with business analysts, QA teams, and stakeholders to translate business needs into technical solutions Participate in sizing and assessment of configuration and integration efforts during implementation phases Lifecycle Support Provide production support and maintenance post-implementation Troubleshoot and resolve integration-related issues across environments 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/Remote Preethi Senior Analyst Black and White outsourcing Pvt Ltd Bangalore, Karnataka,INDIA. preethi@blackwhite.in | www.blackwhite.in

Job Title: TPA Manager Location: Miri Piri Institute of Medical Science & Research, Shahabad Markanda, Kurukshetra (Haryana) Hospital Strength: 420+ bedded upcoming super-specialty hospital & upcoming medical college (100 MBBS seats) Position Overview We are seeking an experienced and detail-oriented TPA Manager to lead and manage all Third-Party Administrator (TPA), insurance, CGHS, ECHS, and Ayushman cases. The role involves overseeing pre-authorization, billing, claims settlement, and ensuring smooth coordination between patients, TPAs, and hospital departments while maintaining compliance and accuracy. Key Responsibilities Handle end-to-end TPA, Insurance, Ayushman, CGHS, and ECHS cases. Coordinate with patients, TPA representatives, and consultants for pre-authorization approvals. Monitor real-time admission intimation, approval status, and treatment cost estimates. Ensure accurate preparation and timely submission of claims to TPAs/Insurance companies. Follow up on pending claims, resolve queries, and minimize claim rejections. Maintain updated records of approvals, discharges, and settlement status. Collaborate with billing, finance, and medical teams for seamless case management. Train and guide TPA executives in documentation and claim processing. Ensure compliance with NABH requirements, audit standards, and hospital policies. Generate MIS reports on approvals, rejections, pending claims, and revenue flow. Eligibility Qualification: Graduate/Postgraduate in Healthcare Administration, Finance, or related field. Experience: Minimum 5 years of experience in TPA/Insurance management in a multi-specialty hospital. Skills: Strong knowledge of insurance/TPA processes, claim settlement, negotiation, MIS reporting, patient handling, and excellent communication. Why Join Us? Be part of an upcoming medical college with 100 MBBS seats backed by the credibility of SGPC . Opportunity to work in a 420+ bedded super-specialty hospital with advanced facilities. Supportive work culture, timely salary , and ethical governance. Significant scope to grow in hospital operations and insurance management. Contact for Queries: +91 9650779097 Email: miripirihr@gmail.com

Location: Ahmedabad (On-Site) Shift Timing: US Shift Working Days: 5 Days Working Salary - Freshers: 20,000K CTC/month Medical Billing / Dental Billing / RCM Process Benefits:- 1) Retention Bonus: 25,000K

Mega Walk-in Drive US Healthcare (Claims Adjudication) Date: 19th & 20th September 2025 Time: 11:30 AM 4:00 PM Venue: Sagility, KCT Tech Park, Thudiyalur Rd, Saravanampatti, Coimbatore, Tamil Nadu 641049 We Are Hiring Experienced Professionals! Join our growing team in US Healthcare Claims Adjudication Minimum Requirement 3.6+ years of experience in US Healthcare (Claims Processing & Adjudication) Additional Opportunities in Sagility : We have openings for WFM & Training functions Also for Internal Contact Center Operations (Inbound calls) Open Positions Team Leader Operations Quality Specialist Subject Matter Expert (SME) Process Trainer Quality Team Leader Assistant Manager Operations Deputy Manager Operations Senior Manager Operation Documents to Carry: Updated Resume (2 copies) Govt. ID Proof (Aadhar/PAN/Passport) Recent Passport-size Photographs Why Join Us? Work with a leading US Healthcare brand Fast-track career growth across leadership roles Attractive benefits & rewards Interested folks please Walkin directly to Sagility office and connect with our recruitment team on : 9597910418 / 8309217838

Role & responsibilities We are looking for an accomplished Doctors with significant ICU experience and a strong ability to manage both clinical and non-clinical responsibilities. The ideal candidate will excel in patient care, clinical documentation, and possess in-depth knowledge of medical documentation essential for insurance claims processing. Key Responsibilities: Patient Documentation: Manage patient medical history and progress notes with precision. Claims Processing: Handle preauthorization and reimbursement claims, including validation and processing. Clinical Records: Maintain accurate clinical documentation in compliance with healthcare standards. Collaboration: Work closely with consultant surgeons and physicians on treatment management. Diagnostic Insights: Provide valuable insights on diagnostic tests, laboratory results, and imaging to support treatment decisions. Real-Time Support: Collaborate with bedside teams to offer real-time critical care expertise. Regulatory Updates: Stay informed on the latest medical guidelines, insurance policies, and healthcare regulations. TPA experience is a plus Preferred candidate profile

Assistant Manager / Deputy Manager - Claims -2+ Years - Pune Are you a highly motivated claims professional looking to make an impact in the insurance industry? We are seeking an experienced Assistant Manager / Deputy Manager - Claims with over 2 years of expertise in managing and processing claims. This is your chance to work in a role where you can bring value, drive process improvements, and enhance customer satisfaction. If you are ready to embark on an exciting journey of professional growth, this is the perfect opportunity for you! Location:- Pune Your Future Employer A leading organization in the insurance domain, known for its dynamic work environment and commitment to professional excellence. The company consistently values employee development and fosters inclusivity, diversity, and innovation across all levels. Working with this employer promises a fulfilling career with ample growth opportunities. Responsibilities As the Assistant Manager / Deputy Manager - Claims, your primary responsibilities will include: Reviewing and processing insurance claims with precision, ensuring compliance with company policies and regulations. Investigating claim discrepancies and coordinating with stakeholders for resolution. Managing a team to assess loss and mitigate risks effectively. Working closely with internal teams to ensure smooth claim adjudication and timely settlements. Maintaining relevant documentation and claim process records. Delivering quality customer service to ensure client satisfaction and retention. Analyzing claim trends to provide valuable insights for process improvement. Requirements Experience : Minimum of 2+ years in insurance claims handling, investigations, or related functions. Education : Bachelors degree in any field. A certification or training in insurance will be an added advantage. Skills : Strong analytical and problem-solving skills. Excellent communication and interpersonal abilities. Expertise in working with claim management systems and tools. Knowledge of insurance policies, procedures, and regulatory compliance. A keen eye for detail and a customer-centric mindset. Ability to work collaboratively and lead a team effectively. Proactive and goal-oriented approach to tasks. Whats in it for you? Opportunity to work with a highly reputed organization in the insurance sector. Ample avenues for professional learning and career advancement. Inclusive and diverse work culture that promotes work-life balance. Competitive salary with employee benefits and perks. Recognition and rewards for exceptional performance. Reach Us If you feel this opportunity is well-aligned with your career progression plans, please feel free to reach us with your updated profile at prachi.gupta@crescendogroup.in Disclaimer Crescendo Global specializes in Senior to C-level niche recruitment. We are passionate about empowering job seekers and employers with an engaging and memorable job search and leadership hiring experience. Crescendo Global does not discriminate on the basis of race, religion, color, origin, gender, sexual orientation, age, marital status, veteran status, or disability status. Note We receive a lot of applications on a daily basis, so it becomes a bit difficult for us to get back to each candidate. Please assume that your profile has not been shortlisted in case you don't hear back from us in 1 week. Your patience is highly appreciated. Profile Keywords Insurance, Claims Management, Assistant Manager, Deputy Manager, Insurance Claims, Compliance, Client Servicing, Risk Mitigation, Claim Investigations, Pune Jobs, Insurance Domain, Claims Processing, Leadership in Insurance, Insurance Regulatory Compliance.

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

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. **Only immediate joiners with Graduates and Undergraduates can apply** **Only candidates who have excellent communication can apply** For More Details Call : HR smitha @ 9880964847 (Call or Whatsapp) Email id : smitha@thejobfactory.co.in 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

We are hiring Part-time / Freelance Field Executives – Insurance Investigation for Bihar Locations: Begusarai, Bhagalpur, Bihar Sharif, Darbhanga, Gaya, Madhubani, Muzaffarpur, Nawada, Purnia Required Candidate profile Visit places to check insurance claims. Collect and write down information clearly. Talk to patients, hospital staff, and others. Make sure the claim details are true and correct.

About Client Hiring for One of the Most Prestigious Multinational Corporations! Job Description Job Title : Guidewire Policy Center Integration Developer Qualification : BE / B.Tech / Engineering Relevant Experience : 5+ Years Must Have Skills : Languages & Frameworks : Gosu, Java/J2EE, .NET (optional) Data Formats : XML, JSON Integration Tools : SOAP/REST web services, Guidewire Messaging, Event Messaging Database Knowledge : SQL Guidewire Expertise : Edge APIs, PCFs (Page Configuration Files), Rating Engine, Rules Framework Good to Have Skills : • Strong understanding of Property & Casualty insurance lifecycle • Experience working in Agile/Scrum environments • Excellent communication and problem-solving skills to collaborate across cross-functional teams Roles and Responsibilities : Integration Design & Development Build scalable, reusable integration solutions using Guidewire Edge APIs, messaging queues, and batch processes Develop domain-based APIs to expose Guidewire functionality (e.g., account, policy, user management) to external systems Technical Implementation Configure and customize PolicyCenter workflows, entities, and business rules using Gosu (Guidewires proprietary language) Ensure code quality through G-unit testing, peer reviews, and continuous integration practices Collaboration & Requirements Gathering Work closely with business analysts, QA teams, and stakeholders to translate business needs into technical solutions Participate in sizing and assessment of configuration and integration efforts during implementation phases Lifecycle Support Provide production support and maintenance post-implementation Troubleshoot and resolve integration-related issues across environments 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/Remote Bhuvaneshwari S Senior Specialist Black and White outsourcing Pvt Ltd Bangalore, Karnataka,INDIA. bhuvaneshwari@blackwhite.in | www.blackwhite.in

Positions General Duties and Tasks: Process Insurance Claims timely and qualitatively Meet & Exceed Production, Productivity and Quality goals Review medical documents, policy documents, policy history, Claims history, system notes and apply the trained client level business rules to make appropriate Claims decisions, call out claims trends and flag fraud activities Analyze customer queries to provide timely response that are detailed and ordered in logical sequencing Cognitive Skills include language, basic math skills, reasoning ability with excellent written and verbal communication skills Stay up to date on new policies, processes, and procedures impacting the outcome of Claims processing Continuous learning to ramp up on the knowledge curve to be the SME and to be compliant with any certification as required to perform the job Be a team player and work seamlessly with other team members on meeting customer goals Developing and maintaining a solid working knowledge of the insurance industry and of all products, services and processes performed by Claims function Handle reporting duties as identified by the team manager Handle claims processing across multiple products/accounts as per the needs of the business Contribute effectively to process improvements that would improve Quality, Productivity & Customer Experience Actively engage on strategic initiatives as identified by the team manager Requirements for this role include: Both Under Graduates and Post Graduates can apply. Excellent communication (verbal and written) and customer service skills. Able to work independently; strong analytic skills. Detail-oriented; ability to organize and multi-task. Ability to make decisions. Required computer skills: must have experience with data entry and word processing, possess a working knowledge of MS Office applications, and understand how to navigate through web-based applications. Demonstrate strong reading comprehension and writing skills. Cognitive Skills include language, basic math skills, reasoning ability and verbal communication skills. Ability to work in a team environment. Handling different Reports - IGO/NIGO and Production/Quality. Tobe in a position to handle training for new hires Work together withthe team to come up with process improvements Strictly monitor the performance of all team members and ensure to report in case ofany defaulters. Encourage the team to exceed their assigned targets.**Required schedule availability for this position is Monday-Friday 6PM/4AM IST. The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekends basis business requirement. Requirements for this role include: Candidate should be flexible & support team during crisis period Should be confident, highly committed and result oriented Experience on working in an office environment set up utilizing Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools Experience in a professional/office related role that required you to communicate (oral/written) effectively with internal team members and external customers Experience in a role that required a focus on quality including attention to detail, accuracy, and accountability for your work product. Candidate should be flexible to work from home and office environment. Broadband connection is must while working from home. Preferences for this role include: 7+ years of experience processing insurance claims in the health, life, or disability disciplines that required knowledge of CPT, HCPCS, ICD9/10, CDT. 2+ year(s) of experience in role that required understanding and interpreting complex documents such as medical records and legal contracts.