710 Claims Processing Jobs - Page 20

Skill required: Group Core Benefits- Claims Case Mgmt. Group Disability Insurance Designation: Claims Management Associate Qualifications: Any Graduation Years of Experience: 1 to 3 years About Accenture Accenture is a global professional services company with leading capabilities in digital, cloud and security.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. We embrace the power of change to create value and shared success for our clients, people, shareholders, partners and communities.Visit us at www.accenture.com What would you do We help insurers redefine their customer experience while accelerating their innovation agenda to drive sustainable growth by transforming to an intelligent operating model. Intelligent Insurance Operations combines our advisory, technology, and operations expertise, global scale, and robust ecosystem with our insurance transformation capabilities. It is structured to address the scope and complexity of the ever-changing insurance environment and offers a flexible operating model that can meet the unique needs of each market segment.Team prepares a case studyGroup disability coverage is tied to employment. If change or loss of job, the coverage is not portable. The cost of group coverage can also change from year to year. It is a sort of insurance that pays out if a policyholder is unable to work and earn an income due to a disability. What are we looking for Problem-solving skillsWritten and verbal communicationCollaboration and interpersonal skillsAbility to meet deadlinesProcess-orientation Roles and Responsibilities: In this role you are required to solve routine problems, largely through precedent and referral to general guidelines Your expected interactions are within your own team and direct supervisor You will be provided detailed to moderate level of instruction on daily work tasks and detailed instruction on new assignments The decisions that you make would impact your own work You will be an individual contributor as a part of a team, with a predetermined, focused scope of work Please note that this role may require you to work in rotational shifts Qualification Any Graduation

Skill required: Supply Chain - Warranty Management Designation: Business Advisory Associate Qualifications: Diploma in Automobile Years of Experience: 1 to 3 years About Accenture Accenture is a global professional services company with leading capabilities in digital, cloud and security.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. We embrace the power of change to create value and shared success for our clients, people, shareholders, partners and communities.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 efficienciesTo 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 efficienciesDefine warranty offerings; run outsourced after-sales warranty support and entitlement programs; evaluate customer feedback and planned versus actual costs of warranty coverage; use warranty data analytics to reduce cost and improve product quality; increase recoveries from suppliers and design and deploy warranty solutions. 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 DealershipMechanical 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 Diploma in Automobile

Skill required: Reinsurance - Life Insurance Designation: Claims Management Analyst Qualifications: BBA/BCom Years of Experience: 3 to 5 years About Accenture Accenture is a global professional services company with leading capabilities in digital, cloud and security.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. We embrace the power of change to create value and shared success for our clients, people, shareholders, partners and communities.Visit us at www.accenture.com What would you do We help insurers redefine their customer experience while accelerating their innovation agenda to drive sustainable growth by transforming to an intelligent operating model. Intelligent Insurance Operations combines our advisory, technology, and operations expertise, global scale, and robust ecosystem with our insurance transformation capabilities. It is structured to address the scope and complexity of the ever-changing insurance environment and offers a flexible operating model that can meet the unique needs of each market segment.Canceling and rewriting insurance policies and endorsementsDevelop and deliver solutions related to life insurance or life assurance-contracts between policy owners and insurers where the insurer agrees to pay a sum of money upon the occurrence of the insured s death or other event such as terminal or critical illness. What are we looking for ReinsuranceStrong analytical skillsAbility to manage multiple stakeholdersDetail orientationThe primary focus is of placing treaties, reviewing high value claims, and policy administration for Life Insurance and reinsurance products. The position will be responsible for ensuring the accuracy and quality on the TAI reinsurance system. Roles and Responsibilities: In this role you are required to do analysis and solving of lower-complexity problems Your day to day interaction is with peers within Accenture before updating supervisors In this role you may have limited exposure with clients and/or Accenture management You will be given moderate level instruction on daily work tasks and detailed instructions on new assignments The decisions you make impact your own work and may impact the work of others You will be an individual contributor as a part of a team, with a focused scope of work Please note that this role may require you to work in rotational shifts Qualification BBA,BCom

Perform end-to-end follow-up on outstanding insurance claims via phone calls and online portals. Analyze claim denials, identify root causes, and take appropriate action to resolve. Ensure accurate and timely submission of claims and appeals.

Project Role : Business Analyst Project Role Description : Analyze an organization and design its processes and systems, assessing the business model and its integration with technology. Assess current state, identify customer requirements, and define the future state and/or business solution. Research, gather and synthesize information. Must have skills : Innovation Strategy & Management Good to have skills : PartnershipsMinimum 2 year(s) of experience is required Educational Qualification : 15 years full time education Summary :As a Business Analyst, you will engage in a dynamic environment where you will analyze organizational processes and systems. Your typical day will involve assessing the current business model, identifying customer requirements, and defining future states or business solutions. You will conduct thorough research, gather relevant information, and synthesize your findings to support strategic decision-making. Collaborating with various stakeholders, you will play a crucial role in ensuring that technology aligns with business objectives, ultimately driving innovation and efficiency within the organization. Roles & Responsibilities:- Expected to perform independently and become an SME.- Required active participation/contribution in team discussions.- Contribute in providing solutions to work related problems.- Facilitate workshops and meetings to gather requirements and feedback from stakeholders.- Develop comprehensive documentation to support project initiatives and ensure clarity in communication. Professional & Technical Skills: - Must To Have Skills: Proficiency in Innovation Strategy & Management.- Strong analytical skills to assess business processes and identify areas for improvement.- Experience in stakeholder management and effective communication.- Ability to synthesize complex information into actionable insights.- Familiarity with project management methodologies and tools. Additional Information:- The candidate should have minimum 2 years of experience in Innovation Strategy & Management.- This position is based at our Bengaluru office.- A 15 years full time education is required. Qualification 15 years full time education

Insurance domain knowledge with Property & Casualty background Hands on experience in at least one of the Guidewire products (Claim/Policy/Billing) Should have knowledge on Admin data loading. Good knowledge in Web services, XML, GxModel, Messaging, Batch implementation, Integrating with 3rd Party Systems and Document composition tools like Xpressions, Thunderhead Experience on any database Oracle / SQL Server and well versed in SQL Designed & modified existing workflows (required for Billing Integration) Experience in SCRUM Agile, prefer Certified Scrum Master (CSM) Good written and oral communication Excellent analytical skills. Works in the area of Software Engineering, which encompasses the development, maintenance and optimization of software solutions/applications.1. Applies scientific methods to analyse and solve software engineering problems.2. He/she is responsible for the development and application of software engineering practice and knowledge, in research, design, development and maintenance.3. His/her work requires the exercise of original thought and judgement and the ability to supervise the technical and administrative work of other software engineers.4. The software engineer builds skills and expertise of his/her software engineering discipline to reach standard software engineer skills expectations for the applicable role, as defined in Professional Communities.5. The software engineer collaborates and acts as team player with other software engineers and stakeholders. - Grade Specific Has more than a year of relevant work experience. Solid understanding of programming concepts, software design and software development principles. Consistently works to direction with minimal supervision, producing accurate and reliable results. Individuals are expected to be able to work on a range of tasks and problems, demonstrating their ability to apply their skills and knowledge. Organises own time to deliver against tasks set by others with a mid term horizon. Works co-operatively with others to achieve team goals and has a direct and positive impact on project performance and make decisions based on their understanding of the situation, not just the rules. Skills (competencies) Verbal Communication

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 Mandatory Skill 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, Skills (competencies) JavaScript API integration Policy Development Critical Thinking Verbal Communication

About the jobKey Responsibilities:Perform day-to-day billing activities with accuracy and adherence to firm policies Conduct thorough reviews of billing activities, ensuring accurate, reliable data Follow-up on billing for managed care/private insurances and Medicare for skilled nursing facilities to resolve outstanding balances, denials and discrepancies Verify claims accuracy by ensuring alignment with Medicaid, Medicare, and private insurance guidelines Process co-insurance, Medicare Part B, and therapy filings Maintain organized records and documentation for audits and compliance purposes Exhibit professionalism, accountability, and a drive for innovation in all tasks Support team goals by taking on additional duties as needed Qualifications:1–5 years of billing experience, with a focus on long-term care facilities or healthcare settings preferred Knowledge of payer processes and claims submission requirements Strong attention to detail and a commitment to accuracy Proficiency in verbal and written communication skills Ability to organize and prioritize tasks in a fast-paced environment Proficiency in organizational skills and time management Ability to maintain confidentiality and handle sensitive information Collaborative skills to work effectively with clients and internal teams at all levels Required Skills and Competencies:Familiarity with insurance industries, managed care programs, Medicaid, and Medicare guidelines Basic knowledge of HIPAA laws and best practices for handling client dataProficiency in medical billing software and related tools

We have two vacancy 1)ARTeam lead 2) AR caller (Senior executive) Drop resume 6239443426

Walk-In Drive on 7th June 2025 at Cotiviti -Pune for Healthcare Audit Walk-In Date: 7-June-2025 (Saturday) Time 9:00 Am 1:00 Pm Venue: Cotiviti India Pvt Ltd Plot C, Podium Floor, Binarius/Deepak Complex, Opposite Golf Course, Yerwada, Pune- 411006. We are hiring for the Healthcare Data Audit process at Cotiviti. Please refer to the information below and required skill set for the same. POSITION SUMMARY: Specialist Payment Accuracy position is an entry level position responsible for auditing client data and validating claim accuracy. Communicates audit recommendations and outcomes to supervisory auditor for evaluation, verification and continuous learning. POSITION REQUIREMENTS: Graduation mandatory. Excellent communication skills. US Healthcare experience is preferred. Computer proficiency in Microsoft Office (Word, Excel, Outlook); Access preferred Strong interest in working with large data sets and various databases Must be flexible working in fixed/rotational shifts Immediate joiners preferred Good energy and Positive attitude Long Term Career Orientation If the above profile interests you then please walk-in for the interview. Please refer to the above mentioned walk-in details. Please bring your updated Resume along with an ID Proof. Best regards, Atish Chintalwar Senior Executive Human Resource COTIVITI About Cotiviti: Cotiviti is a leading healthcare solutions and analytics company headquartered in the United States, with more than 10000 employees in offices across the U U.S., Canada, Australia, India, Nepal, Philippines & Mexico. Cotiviti has been in business for more than two decades (including predecessor companies), and our solutions have been well proven and tested. Our clients are primarily health insurance companies, including U.S. government payers, although healthcare providers, employers, and insurance brokers also use our solutions. In fact, we support almost every major health plan in the U.S. and more than 180 healthcare payers in total. We focus on improving the financial and quality performance of our clients. In healthcare, this means taking in billions of clinical and financial data points, analyzing them, and helping our clients discover ways they can improve efficiency and quality. In addition to healthcare, we support the largest and most influential retailers in the industry, including mass merchandisers, across the U.S., Canada, United Kingdom, Europe and Latin America. Our data management recovery audit services have helped them save hundreds of millions of dollars.

Level : SME Job Location : Chennai Shift : US Shift Experience : 6 Years for SME Notice : Immediate Joiner Qualification : Graduate (non tech) Notice : Immediate Joiner Excellent Communication Share resume on- archi.g@manningconsulting.in Contact-8302372009

Ready to shape the future of work? At Genpact, we don't just adapt to change we drive it. AI and digital innovation are redefining industries and were leading the charge. Genpacts AI Gigafactory, our industry-first accelerator, is an example of how were scaling advanced technology solutions to help global enterprises work smarter, grow faster, and transform at scale. From large-scale models to agentic AI, our breakthrough solutions tackle companies most complex challenges. If you thrive in a fast-moving, tech-driven environment, love solving real-world problems, and want to be part of a team that's shaping the future, this is your moment. Genpact (NYSE: G) is an advanced technology services and solutions company that delivers lasting value for leading enterprises globally. Through our deep business knowledge, operational excellence, and cutting-edge solutions we help companies across industries get ahead and stay ahead. Powered by curiosity, courage, and innovation , our teams implement data, technology, and AI to create tomorrow, today. Get to know us at genpact.com and on LinkedIn, X, YouTube, and Facebook Genpact is hiring | Underwriting | Noida | physical drive on 31st May Interview Location: Genpact Headstrong Office, Noida sector 59, D-4, D Block, Sector 59, Noida, Uttar Pradesh 201301, near to sector 59 Metro Station. Date: 31-MAy-25 Time: 11:00 Am to 2:00 PM Skill Sets - US Mortgage, Underwriting, US Brokerage, Insurance, Backend Ops, Insurance, Property and Casualty, P&C Insurance, In this role, you will be responsible for Provide expert advice on commercial insurance products, risk management strategies, and regulatory requirements. Your expertise will be required to ensure that team members receive the best possible advice and solutions tailored to their specific needs. You will be required to interact and work with the client partners for all process/business knowledge related documents are updated periodically and team is made aware of the same in a timely manner. Should be open to work in any shift as per the business requirement Your role will require you to utilize your experience in and knowledge of insurance/reinsurance and underwriting processes to process transactions for the Underwriting Support Teams and communicate with the Onsite Team. Responsibilities * Perform necessary activities to support broking teams in collaborating with account management to initiate a renewal, preparing and submitting marketing proposals to underwriters, processing endorsements and policy checking along with other requests * Identify and retrieve relevant compliance documentation necessary to process new policies and policy renewals, changes, additions, deletions and cancellations. * Calculating adjustments and premiums on policies and other insurance documents. * Ensure repository of record is accurate and current to ensure outputs and client deliverables will be produced according to guidelines and policy detail. * Communicating directly with underwriters/brokers/account executives to follow up or obtain additional information. * Monitor and attend to requests via client service platform that require action in a timely manner. * Help colleagues troubleshoot and resolve basic issues and perform other related duties as required. Qualifications we seek in you! Minimum Qualifications * Graduate with an excellent interpersonal, communication and presentation skills, both verbal and written * Relevant and meaningful years of experience of working in US P&C insurance lifecycle - pre-placement, placement, and post-placement activities (such as endorsements processing, policy administration, policy checking, policy issuance, quoting, renewal prep, submissions, surplus lines, licensing, agency admin, inspections and so on. * Demonstrate and cultivate customer focus, collaboration, accountability, initiative, and innovation. * Proficient in English language- both written (Email writing) and verbal * A strong attention to detail; analytical skills and the ability to multi-task are important Preferred Qualification and Experience * Relevant years of insurance experience and domain knowledge, especially P&C insurance * Candidate having Broker (US P&C insurance) experience would be an asset * Proficient with Microsoft Office (Word, PowerPoint, Excel, OneNote) * A strong attention to detail; analytical skills and the ability to multi-task are important * Should be a team player with previous work experience in an office environment required * Client focused with proven relationship building skills * Ability to work collaboratively as a key member of a team and independently with minimum supervision * Highly organized with a proven ability to prioritize competing requirements and deadlines under pressure Why join Genpact? Be a transformation leader Work at the cutting edge of AI, automation, and digital innovation Make an impact Drive change for global enterprises and solve business challenges that matter Accelerate your career Get hands-on experience, mentorship, and continuous learning opportunities Work with the best Join 140,000+ bold thinkers and problem-solvers who push boundaries every day Thrive in a values-driven culture Our courage, curiosity, and incisiveness - built on a foundation of integrity and inclusion - allow your ideas to fuel progress Come join the tech shapers and growth makers at Genpact and take your career in the only direction that matters: Up. Lets build tomorrow together. Genpact is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, religion or belief, sex, age, national origin, citizenship status, marital status, military/veteran status, genetic information, sexual orientation, gender identity, physical or mental disability or any other characteristic protected by applicable laws. Genpact is committed to creating a dynamic work environment that values respect and integrity, customer focus, and innovation. Furthermore, please do note that Genpact does not charge fees to process job applications and applicants are not required to pay to participate in our hiring process in any other way. Examples of such scams include purchasing a 'starter kit,' paying to apply, or purchasing equipment or training.

Ready to shape the future of work? At Genpact, we don't just adapt to change we drive it. AI and digital innovation are redefining industries and were leading the charge. Genpacts AI Gigafactory, our industry-first accelerator, is an example of how were scaling advanced technology solutions to help global enterprises work smarter, grow faster, and transform at scale. From large-scale models to agentic AI, our breakthrough solutions tackle companies most complex challenges. If you thrive in a fast-moving, tech-driven environment, love solving real-world problems, and want to be part of a team thats shaping the future, this is your moment. Genpact (NYSE: G) is an advanced technology services and solutions company that delivers lasting value for leading enterprises globally. Through our deep business knowledge, operational excellence, and cutting-edge solutions we help companies across industries get ahead and stay ahead. Powered by curiosity, courage, and innovation , our teams implement data, technology, and AI to create tomorrow, today. Get to know us at genpact.com and on LinkedIn, X, YouTube, and Facebook Genpact Mega Walk-In drive for Insurance & Underwriting roles on 31st May 2025 (Saturday)_ Noida location *Walkin Date: 31-May-2025 (Saturday) *Walkin time: 12 PM - 1 PM *Venue details: Genpact Headstrong Office, Noida sector 59, D-4, D Block, Sector 59, Noida, Uttar Pradesh 201301 *Graduation: Any graduate is eligible except law *Work experience: 0 - 4 yrs (previous exp. in insurance is required) *Shift: US Only work from office Skill Sets - US Mortgage, Underwriting, US Brokerage, Insurance, Backend Ops, Insurance, Property and Casualty, P&C Insurance, In this role, you will be responsible for Provide expert advice on commercial insurance products, risk management strategies, and regulatory requirements. Your expertise will be required to ensure that team members receive the best possible advice and solutions tailored to their specific needs. You will be required to interact and work with the client partners for all process/business knowledge related documents are updated periodically and team is made aware of the same in a timely manner. Responsibilities Manage and resolve basic inquiries associated with all aspects of Client Services and service delivery (e.g. output delivery, basic broking inquiries, etc.). Communicating directly with underwriters/brokers/account executives to follow up or obtain additional information. Conduct training sessions for employees to enhance their understanding of commercial insurance principles and practices. Act as a liaison between clients and team members to ensure smooth communication related to updates, and inquiry responses received from client SMEs. Maintain accurate records of client interactions and knowledge material Conduct monthly knowledge assessment tests and TNI (training need identification) Ensure all controls are followed, existing exceptions are reviewed, and duplicate policies are reported before processing any transaction. Ability to handle varied volumes of workloads and to reach targets and deadlines on a timely basis. Lead by example by demonstrating and sharing knowledge with all lines of business the importance of best practices and acting as the subject matter expert to all operational and procedural activities for the Broking operations team Qualifications we seek in you! Minimum qualifications Graduate in any stream (except law) Relevant and meaningful years of experience of working in US P&C insurance lifecycle pre-placement, placement, and post-placement activities (such as endorsements processing, policy administration, policy checking, policy issuance, quoting, renewal prep, submissions, surplus lines, licensing, agency admin, inspections and so on. Demonstrate and cultivate customer focus, collaboration, accountability, initiative, and innovation. Proficient in English language- both written (Email writing) and verbal A strong attention to detail; analytical skills and the ability to multi-task are important Preferred Qualification and Experience An Insurance Certification would be an edge Awareness about Property & Casualty insurance regulation and anomalies will be preferred Relevant years of insurance experience and domain knowledge, especially P&C insurance Candidate having Broker (US P&C insurance) experience would be an asset Proficient with Microsoft Office (Word, PowerPoint, Excel, OneNote) A strong attention to detail; analytical skills and the ability to multi-task are important Should be a team player with previous work experience in an office environment required Client focused with proven relationship building skills Ability to work collaboratively as a key member of a team and independently with minimum supervision Highly organized with a proven ability to prioritize competing requirements and deadlines under pressure Why join Genpact? Be a transformation leader Work at the cutting edge of AI, automation, and digital innovation Make an impact Drive change for global enterprises and solve business challenges that matter Accelerate your career Get hands-on experience, mentorship, and continuous learning opportunities Work with the best Join 140,000+ bold thinkers and problem-solvers who push boundaries every day Thrive in a values-driven culture Our courage, curiosity, and incisiveness - built on a foundation of integrity and inclusion - allow your ideas to fuel progress Come join the tech shapers and growth makers at Genpact and take your career in the only direction that matters: Up. Lets build tomorrow together. Genpact is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, religion or belief, sex, age, national origin, citizenship status, marital status, military/veteran status, genetic information, sexual orientation, gender identity, physical or mental disability or any other characteristic protected by applicable laws. Genpact is committed to creating a dynamic work environment that values respect and integrity, customer focus, and innovation. Furthermore, please do note that Genpact does not charge fees to process job applications and applicants are not required to pay to participate in our hiring process in any other way. Examples of such scams include purchasing a 'starter kit,' paying to apply, or purchasing equipment or training.

Graduation is mandatory (any stream expect B.Tech & B.E). Shift Time:5:30 PM to 2:30 AM IST Fixed Saturday and Sunday Off. Basic computer proficiency. Excellent communication skill Work from office Location: Nagpur

Role & responsibilities Manage insurance claims from receipt to settlement, ensuring timely processing and resolution. Coordinate with TPAs (Third Party Administrators) for claim adjudication and settlement. Handle mediclaim claims, health insurance claims, and other types of general insurance policies. Ensure accurate billing and reconciliation of patient accounts. Maintain records of all interactions with patients, providers, and insurers. Preferred candidate profile 5-8 years of experience in insurance coordination or TPA coordination role. Strong knowledge of insurance billing, claims processing, and claims settlement procedures. Proficiency in handling multiple tasks simultaneously under tight deadlines. Excellent communication skills for effective interaction with customers (patients), providers (hospitals), and insurers. Perks and benefits As per industry

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? Us shiftsQuick learner 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 Qualifications Any Graduation

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

Skill required: Delivery - Warranty Management Designation: I&F Decision Sci Practitioner Sr Analyst Qualifications: Any Graduation Years of Experience: 5 to 8 years What would you do? Data & AIIn Warranty Management, you will be working on defining warranty offerings; run outsourced after-sales warranty support and entitlement programs; evaluate customer feedback and planned versus actual costs of warranty coverage; use warranty data analytics to reduce cost and improve product quality; increase recoveries from suppliers and design and deploy warranty solutions. The team also works on the verification and analysis of warranty claims based on available and external resources - a portal with supporting information. What are we looking for? Warranty/ Analytics/ Automobile Data Analysis Business Intelligence Reporting Scripting Adaptable and flexible Ability to work well in a team Commitment to quality Agility for quick learning Written and verbal communicationPython, SQL, ML Roles and Responsibilities: In this role you are required to do analysis and solving of increasingly complex problems Your day-to-day interactions are with peers within Accenture You are likely to have some interaction with clients and/or Accenture management You will be given minimal instruction on daily work/tasks and a moderate level of instruction on new assignments Decisions that are made by you impact your own work and may impact the work of others In this role you would be an individual contributor and/or oversee a small work effort and/or team Qualifications Any Graduation

Check the medical admissibility of claim by confirming diagnosis and treatment details Verify the required documents for processing claims and raise an information request in case of an insufficiency Approve or deny claims as per T&C within TAT If candidates are interested please drop your update resume/CV on my Mail ID - varsha.kumari@mediassist.in Thanks & Regards Varsha Kumari Email - varsha.kumari@mediassist.in

The Digital :Guidewire ClaimCenter, Guidewire :ClaimCenter - Domain role involves working with relevant technologies, ensuring smooth operations, and contributing to business objectives. Responsibilities include analysis, development, implementation, and troubleshooting within the Digital :Guidewire ClaimCenter, Guidewire :ClaimCenter - Domain domain.

TPA Empanelment's Claim Processing Corporate Tie- ups

Job Title: Pega Senior System Architect (SSA) with SCE Experience Experience: 5 + yrs Key Responsibilities: Pega Application Development: Assist in the design and development of Pega applications for claims processing, ensuring alignment with business requirements and best practices. Configure and customize Pega applications using Pega BPM and case management capabilities, working under the guidance of senior architects. Smart Claims Engine (SCE) Integration: Support the integration of Pega applications with Smart Claims Engine (SCE) and other third-party healthcare systems. Participate in the design and implementation of workflows and decision rules within the claims management lifecycle. Technical Problem Solving: Troubleshoot issues within Pega applications and SCE integrations, identifying root causes and proposing effective solutions. Participate in debugging and resolving defects in the claims processing workflow. Collaboration with Teams: Collaborate with business analysts, developers, and testers to ensure the successful delivery of features related to SCE. Work closely with senior architects to design technical solutions that meet project requirements and ensure system scalability and reliability. Code Quality & Best Practices: Adhere to coding standards and best practices set by senior architects and the development team. Participate in code reviews and contribute to the development of reusable components and frameworks. Agile Development: Participate in Agile ceremonies, including sprint planning, daily stand-ups, and retrospectives, to ensure timely delivery of product features. Documentation: Assist in the creation and maintenance of technical documentation, including design specifications, user stories, and test cases. Document system changes, configurations, and enhancements to ensure transparency and ease of knowledge transfer. Qualifications: Experience: Minimum of 6 years of experience in Pega development, with a focus on case management and business process management (BPM). Experience with Smart Claims Engine (SCE) or similar healthcare claims management systems is highly preferred. Technical Skills: Hands-on experience with Pega 8.x or later, including configuration and customization of Pega applications. Knowledge of integrating Pega applications with third-party systems, including healthcare data exchange standards (e.g., HL7, FHIR). Experience with decision rules, user interface design, and business logic in Pega. Strong problem-solving skills and experience debugging Pega applications. Soft Skills: Ability to collaborate effectively with cross-functional teams and communicate complex technical issues to non-technical stakeholders. Strong analytical skills, attention to detail, and ability to adapt to changing requirements. Willingness to learn and grow within the Pega platform and healthcare domain. Healthcare Knowledge: Familiarity with healthcare claims processing, payer systems, and industry regulations (e.g., HIPAA) is a plus. Certifications: Pega Certified Senior System Architect (SSA) or equivalent certification is a plus Preferred Skills: Experience with Agile methodologies (e.g., Scrum, Kanban). Familiarity with Pega integration frameworks and tools (e.g., Pega REST API, SOAP services). Experience with SQL and relational databases (e.g., Oracle, MySQL).

The Guide Wire Policy Center role involves working with relevant technologies, ensuring smooth operations, and contributing to business objectives. Responsibilities include analysis, development, implementation, and troubleshooting within the Guide Wire Policy Center domain.

Role Description Overview: The AR Associate / Associate - RCM (AR) is accountable to manage day to day activities of Denials Processing/ Claims follow-up/ Customer Service Responsibility Areas: To review emails for any updates Call Insurance carrier document the notes in software and spreadsheet and take appropriate action Identify issues and escalate the same to the immediate supervisor Update Production logs Required Qualification: Any Graduates / Non-Graduates (Graduation Not Mandatory) / 10th (SSLC) + 12th (HSC) / 10th (SSLC) + Diploma (3 years) can apply Note: Students with backlogs in UG can also apply. College dropouts can also apply. Desired Profile: Understand the client requirements and specifications of the project Meet the productivity targets of clients within the stipulated time. Ensure that the deliverable to the client adhere to the quality standards. Ensure follow up on pending claims. Prepare and Maintain status reports Should be comfortable to work in night shifts Skills Required: Excellent Communication Skills Basic Computer Skills RCM Knowledge (PB/HB) Greetings from CorroHealth !! We have huge openings for Experienced Charge Entry Candidates. (1 - 5 Years). Interview Process : Walk-In Experience : 1 year to 5 years (Should have relevant experience in Charge Entry) Salary: Best In Industry Responsibility Areas : To review emails for any updates Correcting Claims and Charges. Required Qualification : Any Graduates / Non-Graduates (Graduation Not Mandatory) / 10th (SSLC) + 12th (HSC) / 10th (SSLC) + Diploma (3 years) can apply Note: Students with backlogs in UG can also apply. College dropouts can also apply. Desired Profile: Understand the client requirements and specifications of the project Meet the productivity targets of clients within the stipulated time. Ensure that the deliverable to the client adhere to the quality standards. Must have experience with Charge Entry Role. Skills Required: Good Communication Skills Basic Computer Skills RCM Knowledge *If Interested kindly reach out to us : HR Sama Parveen- Sama.Parveen@corrohealth.com HR Atul Kumar Singh- Atulkumar.Singh@corrohealth.com/ 9150095046

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. * 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 Cigna Group Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.