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5.0 - 10.0 years
4 - 7 Lacs
noida
Work from Office
About Business Unit: Spartan Technology Services and Solutions Private Limited, a subsidiary of IBM, operates globally across 170 countries. It's a crucial part of IBM Business Process Operations, offering end-to-end services for policy renewal and query resolution in the insurance industry, with a strong commitment to data security and quality. Your Role and Responsibilities As a Process Associate - Insurance (Claims), you will be involved in the Processing of Life and Annuity Insurance, Claims processing. You should be flexible to work in shifts. Your primary responsibilities include Handling claims investigation, processing, and payments Claims document validation, calculating benefit amount, and releasing same to the beneficiary Meet productivity and quality targets on a daily, weekly, and monthly basis Required education Bachelor's Degree Preferred education Master's Degree Required technical and professional expertise Graduate (except B.Tech/Technical Graduation/Law) with a minimum of 1.5 years of experience in Life/Annuities products in Claims Good Communication skills - English (both written & verbal) Proactive and high analytical skills; should foresee issues and suggest solutions, with impactful data Basic Computer knowledge along with typing speed of 35 words/minute Preferred technical and professional experience Proficient in MS Office applications Self-directed and ambitious achiever Meeting targets effectively Demonstrated ability to analyze complex data, complemented by strong interpersonal and organizational skills
Posted 2 weeks ago
5.0 - 7.0 years
9 - 12 Lacs
gurugram
Work from Office
The Medical Billing Supervisor to oversee our daily billing and claims operations. responsible for the performance of the billing team, ensuring accuracy, efficiency, and compliance throughout the revenue cycle, specifically for Medicaid claims. Health insurance Provident fund Annual bonus
Posted 2 weeks ago
5.0 - 10.0 years
2 - 6 Lacs
mumbai, pune, chennai
Work from Office
Role Summary : The ClaimCenter Scrum Master with functional skills will act as a servant leader and guide for Agile teams working on the Guidewire ClaimCenter platform. The role requires strong facilitation and leadership skills to manage Agile practices and ensure team success. Additionally, the role demands functional expertise in ClaimCenter to bridge the gap between business stakeholders and the development team. Key Responsibilities: Scrum Master Responsibilities: Agile Facilitation : Facilitate Scrum ceremonies, including Sprint Planning, Daily Stand-ups, Sprint Reviews, and Retrospectives. Foster a collaborative environment to help teams achieve high performance. Team Support : Coach the team in Agile principles, helping them mature and improve their processes. Identify and remove impediments to the team's progress. Stakeholder Collaboration : Act as a point of contact between the team and external stakeholders. Protect the team from scope creep and ensure adherence to sprint goals. Metrics and Reporting : Track and communicate team performance metrics such as velocity, burn-down, and progress toward sprint goals. Use data to drive continuous improvement initiatives. Functional Responsibilities: Requirements Gathering : Collaborate with business analysts and stakeholders to understand and document functional requirements for ClaimCenter. Translate business needs into actionable user stories with clear acceptance criteria. Guidance and Expertise : Provide functional knowledge of ClaimCenter, including claims processing workflows, data models, and rules. Ensure user stories align with ClaimCenter capabilities and suggest enhancements where needed. Quality Assurance : Collaborate with QA teams to ensure comprehensive testing of functional requirements. Validate that delivered solutions meet business expectations. Collaboration : Work closely with developers to ensure the implementation aligns with business requirements. Provide input during backlog refinement and prioritize tasks based on business value. Qualifications: Required: Bachelors degree in Business, Computer Science, or a related field. 5+ years of experience as a Scrum Master in Agile teams. 2+ years of experience with Guidewire ClaimCenter or other Guidewire products. Strong functional knowledge of ClaimCenter workflows, data structures, and configurations. Proficiency in Agile tools (e.g., Jira, Rally, or Azure DevOps). Preferred: Scrum Master certification (CSM, PSM, or equivalent). Familiarity with Guidewire PolicyCenter or BillingCenter. Knowledge of insurance industry processes, particularly claims management. Experience working with geographically distributed teams. Soft Skills: Excellent communication, facilitation, and interpersonal skills. Strong problem-solving and conflict resolution abilities. Ability to balance technical and functional aspects in discussions. Adept at managing competing priorities and fostering team engagement.
Posted 2 weeks ago
1.0 - 6.0 years
4 - 6 Lacs
gurugram
Work from Office
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
Posted 2 weeks ago
0.0 - 3.0 years
1 - 3 Lacs
hyderabad/secunderabad
Work from Office
Quantuspro Solutions is seeking a candidate with good analytical skills with understanding of US Health care/ Revenue Cycle Management/Accounts Receivables/ Claims processing. **EXCELLENT COMMUNICATION SKILLS IN ENGLISH IS VERY IMPORTANT** ** FRESHERS ARE WELCOME ** Job Description: - US Healthcare / Dental Billing Process - Accounts Receivables Calls - Denials and Appeals Management - End to End Billing Cycle Management - Posting Payments - Knowledge of Provider Credentialing - Knowledge of Insurance Eligibility verification - Knowledge in Dental Billing is a Plus - Excellent Communication Skills - Must be flexible to work in Day / Night Shifts - Good Typing Speed - Must be willing to work in Voice / Non-voice process Day Shift timings: 9 AM to 6 PM (IST) Night Shift timings: 8: 30 PM to 5: 30 AM (IST) FRESHERS ARE WELCOME ** Candidates with no experience but excellent communication, analytical skills, computer skills may also apply for this position. For further details please contact 7801017313/04035683890 Regards, HR Team Quantuspro Solutions
Posted 2 weeks ago
12.0 - 20.0 years
0 Lacs
noida, uttar pradesh, india
On-site
Choosing Capgemini means choosing a company where you will be empowered to shape your career in the way you'd like, where you'll be supported and inspired by a collaborative community of colleagues around the world, and where you'll be able to reimagine what's possible. Join us and help the world's leading organizations unlock the value of technology and build a more sustainable, more inclusive world. Primary Responsibilities Team Handling Handle a team of 100 - 200-member team, including SMEs, leads and managers Effectively monitor the team's performance Mentor team and middle management in complex and business situations Should be to strategically plan team structures for better business outcomes Track team's performance through intelligent reporting Resolve team's issues in a timely manner and motivate team to deliver in a highly complex and dynamic environment Should be able to convey leadership messaging Growth centric approach and continue to do account mining Should be in position to manage P&L for the manage account Able to work in complex environments and should be able to multitask Prepare executive dashboards for monthly and client reporting Be able to prepare and run presentations in boardroom, Executive presence Track and report Risk and Compliance matters promptly Excellent leadership, facilitation and conflict resolution Excellent in logical and reasoning skills, ability to analyse the requirements Be innovative, open minded and progressive in thinking Can coordinate and do follow ups with stakeholders and the executive level Excellent communication skills, both written and verbal Provide extended support to our Sales and Solutions teams in new business deals Respond to RFP/RFIs Should be a competent user of MS Office including Word, Excel, PowerPoint, SharePoint, Teams and Outlook Understands the business use of automations methodologies like - RPA/AI/Gen AI Required Skills 12 - 20 years experience in the P&C Auto US insurance industry Should have managed and have good knowledge of the P&C Insurance incl. Auto value chain and its sub processes including and not limited to - Triaging Process, Underwriting Support and Policy quote generation, Policy Amendments, Claims Processing, Compliance, Data Analysis and Reporting Process Improvement : Identified opportunities for process enhancements within policy administration workflows, implementing innovative solutions to improve efficiency and accuracy leveraging new technologies Ability to multitask and handle multiple work types Ability to adapt quickly in a fast-paced, ever-changing environment Experience working with customers digitally Good understanding of business finance Excellent time management skills Superior and demonstrated ability to communicate clearly, professionally, and effectively in writing Ability to apply initiative and judgment to define and perform complex tasks and see the bigger picture Excellent team player proven ability to apply innovative ideas and critical thinking Skills (competencies) Abstract Thinking Active Listening Agile (Software Development Framework) Analytical Thinking Backlog Grooming Business Architecture Modeling Business Process Modeling (e.g. BPMN) Change Management Coaching Collaboration Commercial Acumen Conceptual Data Modeling Conflict Management Confluence Critical Thinking CxO Conversations Data Analysis Data Requirements Management Decision-Making Emotional Intelligence Enterprise Architecture Modelling Facilitation Functional IT Architecture Modelling Giving Feedback Google Cloud Platform (GCP) (Cloud Platform) Influencing Innovation Jira Mediation Mentoring Microsoft Office Motivation Negotiation Networking Power BI Presentation skills Prioritization Problem Solving Project Governance Project Management Project Planning Qlik Relationship-Building Requirements Gathering Risk Management Scope Management SQL Stakeholder Management Story Mapping Storytelling Strategic Management Strategic tThinking SWOT Analysis Systems Requirement Analysis (or Management) Tableau Trusted Advisor UI-Design / Wireframing UML User Journey User Research Verbal Communication Written Communication Capgemini is a global business and technology transformation partner, helping organizations to accelerate their dual transition to a digital and sustainable world, while creating tangible impact for enterprises and society. It is a responsible and diverse group of 340,000 team members in more than 50 countries. With its strong over 55-year heritage, Capgemini is trusted by its clients to unlock the value of technology to address the entire breadth of their business needs. It delivers end-to-end services and solutions leveraging strengths from strategy and design to engineering, all fueled by its market leading capabilities in AI, generative AI, cloud and data, combined with its deep industry expertise and partner ecosystem.
Posted 2 weeks ago
5.0 - 9.0 years
0 Lacs
karnataka
On-site
At Swiss Re Solutions, we provide a comprehensive suite of tools and services to support businesses in the ever-evolving industry landscape. Our offerings range from risk consulting, leading software solutions, advanced data insights, automated claims processing, to SAAS platforms. With the aim of enhancing efficiency and competitiveness, Swiss Re Solutions leverages our global insurance expertise to empower our clients. By granting access to a dedicated team of experts and specialized solutions, we enable our clients to remain agile and competitive. As the leader of the end-to-end business service teams in Bangalore Servicing Sales, Products, and Operations within Solutions Operations, you will directly report to the Chief Operating Officer and be an integral part of the global Operations Management Team. Your responsibilities will include leading and managing business service teams for pre-sales, onboarding, and post-sales activities. It is crucial to ensure the stable and reliable delivery of business services across the entire value chain within Solutions. Capacity and budget planning for the Business Service Teams will fall under your purview. Defining service catalogues, key performance indicators, and ensuring their delivery will be essential tasks. You will engage with various business stakeholders to address internal and external customer queries, concerns, and feedback. Managing quality, capacity, and productivity of the business service teams will be a key focus. Additionally, operational efficiency and continuous process optimization with the Business Process Excellence function will be paramount. You will also be responsible for knowledge transition and onboarding of new business processes as Solutions expands its presence in Bangalore. Creating an engaging and motivating environment for the team and addressing key HR-related matters will be part of your role as a people manager. Job Requirements: Education: - A minimum of 5 years of relevant experience in the Financial Services industry, preferably in SAAS and Consulting or primary insurance sectors - A degree from a recognized university or equivalent qualification Professional Experience: - Proven track record in end-to-end operations management with extensive knowledge in technical accounting and international program business - Experience in leading teams through change and implementing change effectively - Passion for people development and talent management - Strong interpersonal and communication skills with the ability to influence and gain buy-in for new ideas - Client-oriented mindset and adept at dealing with diverse counterparts and cultures - Ability to navigate ambiguity and drive progress despite uncertainty - Proficiency in switching between detailed technical discussions and strategic problem-solving About Swiss Re: Swiss Re is a global leader in reinsurance, insurance, and other forms of insurance-based risk transfer, working towards enhancing global resilience. With expertise in managing risks ranging from natural catastrophes to cybercrime, we cover both Property & Casualty and Life & Health domains. Through innovative thinking and collaboration among our 14,000+ employees worldwide, we create new opportunities and solutions for our clients. If you are an experienced professional looking to re-enter the workforce after a career break, we encourage you to apply for open positions that align with your skills and experience. Reference Code: 133867,
Posted 2 weeks ago
3.0 - 6.0 years
13 - 17 Lacs
bengaluru
Work from Office
Your tasks Design and implement applications within Microsoft Technology Stack Resolve incidents and implement change requests Conduct testing and quality control perform deployments and release management regularly meet/align with IT PM/PO and DevOps Team Your Qualifications Computer Science studies and/or similar education Deep and longterm Experience of 4-7 years with Microsoft Technologies on-prem/cloud MS Office Products SharePoint Power Platform (Power Apps, Power Automate, Power BI) Azure Services Dataverse Deep Experience with Web and Cloud Technologies (e g AWS, Azure, ) Deep Experience with Web Programming, HTML, JavaScript, CSS, React, Angular Experience with third party tools like Nintex, Sharegate, Plumsail Interested We are looking forward to receiving your application! Ideally, you should apply online with the reference number If you have any questions, please feel free to contact your recruiting contact via LinkedIn or XING, We promote equal opportunities and welcome applications from people with and without disabilities We offer an inclusive work environment where all individuals can develop their skills and talents regardless of gender, nationality, ethnic and social background, religion, worldview, age, sexual orientation, identity, and other characteristics, reference number Recruiting Contact Rohde & Schwarz is a global technology company with approximately 14,000 employees and three divisions Test & Measurement, Technology Systems and Networks & Cybersecurity For 90 years, the company has been developing cutting-edge technology, pushing the boundaries of what is technically possible and enabling customers from various sectors such as business, government and public authorities to maintain their technological sovereignty Rohde & Schwarz is a leading supplier of solutions in the fields of Test and Measurement, Broadcasting, Radio monitoring and Radiolocation as well as Mission-critical Radio communications For more than 80 years, company has been developing, producing and marketing a wide range of electronic products Headquarters in Munich with subsidiaries and representatives active in over 70 countries around the world, Rohde & Schwarz has achieved its global presence greatly In India the company is present as Rohde & Schwarz India Pvt Ltd (RSINDIA) which is 100% owned subsidiary of Rohde & Schwarz GmbH KG & Co, Germany, whose head office is located in New Delhi and branch offices in Bangalore, Hyderabad, Mumbai and Field presence at Ahmedabad, Chennai and Pune With more than 10 channel partners situated at key industrial locations we serve across the country Our emphasis is to provide outstanding sales, service and support to our customers The company has invested sustainably to increase the local support capability as well as to provide a fully automated Calibration facility for most of the products sold Rohde & Schwarz India has ISO 9001 2015 certified Quality Management Systems and ISO 17025 NABL Accreditation The company continuously invests in training its service and sales personnel regularly to maintain a high level of technical competence in preand post-sales support and outstanding quality in services viz Repairs, Calibration, Product support & Project management Rohde & Schwarz India is a financially stable company rated by CRSIL as SME 1 for more than 5 years now This rating is the highest in its category Rohde & Schwarz India is committed to 100% customer satisfaction through innovative product offerings and outstanding support and services Our comprehensive and continuously growing range of services are designed to provide customers with the highest level of quality and value throughout the life cycle of our products, Our offer Allowance for home office equipment Flexible working hour models Possibility of car leasing Sports promotion Health care (Group) accident insurance Online medical counselling Life insurance Corporate/team events Gifts for special life events
Posted 2 weeks ago
4.0 - 7.0 years
6 - 9 Lacs
mumbai
Work from Office
We are seeking a seasoned Procurement Business Process Owner to Accounts Payable accounting and monitoring. General Ledger scrutiny. Working knowledge of Direct and Indirect taxes. Roles & Responsibilities: a) Responsible for accurate, timely processing and posting of both Purchase Order Based and Non-Purchase Order Based invoices. b) Responsible for creation of asset codes, CAPEX Internal Orders based on authorizations and invoicing. c) Responsible for GRIR and Payable GL monitoring and control.. d) Maintaining control of advances paid, prepaid expenses and relevant automated process developed for the activity of prepaid expenses. e) Responsible for Schedule preparation of ledgers relating to expenses and Vendors. f) Responsible for proper and timely response to all vendors and internal customer requests and inquiries. g) Assist in month end closing and preparations. h) Developing new reports and customizing reports in SAP for enabling better analysis and extraction of data. i) Assisting Direct tax team with providing income tax assessment data for all relevant items following under the AP & expense GL scope. j)Assisting the Indirect tax team with GST reconciliation related follow-up and credit claim process. Educational Qualification: B.com, M.com Graduates
Posted 2 weeks ago
0.0 - 2.0 years
3 - 4 Lacs
mumbai
Work from Office
About Us: Medi Assist is India's leading Health Tech and Insure Tech company focused on administering health benefits across employers, retail members, and public health schemes. We consistently strive to drive innovation and participate in such initiatives, to lower health care costs. Our Health Benefits: Administration model is designed to deliver the tools necessary for a health plan to succeed, whether its our modular claims management system, our technology that unveils data to make important decisions, or our service solutions built around the voice of the customer. In short, our goal is to link our success to that of our members Roles and Responsibilities: Check the medical admissibility of a claim by confirming the diagnosis and treatment details. Scrutinize the claims, as per the terms and conditions of the insurance policy. Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiation of open billing and package etc. Understand the process difference between PA and an RI claim and verify the necessary details accordingly. Verify the required documents for processing claims and raise an IR in case of an insufficiency. Coordinate with the LCM team in case of higher billing and with the provider team in case of non-availability of tariff. Approve or deny the claims as per the terms and conditions within the TAT. Handle escalations and responding to mails accordingly. Work from Office only 4th floor, AARPEE Chambers, Off Andheri-Kurla Road Industrail Estate Marol, Andheri East, , Marol Cooperative Next To Times Square, Shagbaug, Gamdevi, Marol, Mumbai, Maharashtra 400059 Interested candidates can share their resumes to abhilasha.dutta@mediassist.in CV on 8050700698
Posted 2 weeks ago
0.0 - 2.0 years
3 - 4 Lacs
mumbai
Work from Office
About Us: Medi Assist is India's leading Health Tech and Insure Tech company focused on administering health benefits across employers, retail members, and public health schemes. We consistently strive to drive innovation and participate in such initiatives, to lower health care costs. Our Health Benefits: Administration model is designed to deliver the tools necessary for a health plan to succeed, whether its our modular claims management system, our technology that unveils data to make important decisions, or our service solutions built around the voice of the customer. In short, our goal is to link our success to that of our members Roles and Responsibilities: Check the medical admissibility of a claim by confirming the diagnosis and treatment details. Scrutinize the claims, as per the terms and conditions of the insurance policy. Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiation of open billing and package etc. Understand the process difference between PA and an RI claim and verify the necessary details accordingly. Verify the required documents for processing claims and raise an IR in case of an insufficiency. Coordinate with the LCM team in case of higher billing and with the provider team in case of non-availability of tariff. Approve or deny the claims as per the terms and conditions within the TAT. Handle escalations and responding to mails accordingly. Work from Office only 4th floor, AARPEE Chambers, Off Andheri-Kurla Road Industrail Estate Marol, Andheri East, , Marol Cooperative Next To Times Square, Shagbaug, Gamdevi, Marol, Mumbai, Maharashtra 400059 Interested candidates can share their resumes to abhilasha.dutta@mediassist.in CV on 8050700698
Posted 2 weeks ago
0.0 - 3.0 years
1 - 4 Lacs
bengaluru
Work from Office
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 WORK FROM OFFICE ONLY Thanks & Regards Ronojoy Bagchi ronojoy.bagchi@mediassist.in 8050017356
Posted 2 weeks ago
4.0 - 9.0 years
1 - 4 Lacs
gurugram
Work from Office
1. Looking after the corporate client & their empanelment’s 2. Preparing bills of TPA, ESIC, ECHS, CGHS and other Private clients Independently. 3. Handling all queries related to patients. Call me on +91 97739 85718
Posted 2 weeks ago
0.0 - 1.0 years
1 - 5 Lacs
bengaluru
Work from Office
Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years About Accenture Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. Visit us at www.accenture.com What would you do 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.Claim processing team collects end-end data dataDevelop and deliver business solutions that support the claims process across its lifecycle, including first notice of loss, claims investigation, payment administration or adjudication, provider reimbursement (health care), subrogation and recovery. What are we looking for Ability to establish strong client relationshipAbility to handle disputesAbility to manage multiple stakeholdersAbility to meet deadlinesAbility to perform under pressureNA Roles and Responsibilities: In this role you are required to solve routine problems, largely through precedent and referral to general guidelines Your primary interaction is within your own team and your direct supervisor In this role you will be given detailed instructions on all tasks The decisions that you make impact your own work and are closely supervised You will be an individual contributor as a part of a team with a predetermined, narrow scope of work Please note that this role may require you to work in rotational shifts Qualification Any Graduation
Posted 2 weeks ago
5.0 - 10.0 years
11 - 21 Lacs
hyderabad, pune, bengaluru
Hybrid
Role & responsibilities Job Summary: A Guidewire Billing Center Developer is responsible for designing, developing, and maintaining Guidewire Billing Center applications. This role involves working closely with business analysts, project managers, and other developers to ensure the successful implementation and integration of Guidewire solutions. Key Responsibilities: Configuration and Integration: Develop and configure Guidewire Billing Center applications to meet business requirements. Customize and extend the BillingCenter data model and business rules using Gosu and PCF. Development: Write code using GOSU, Java, and other relevant programming languages. Testing: Perform unit testing and support QA testing to ensure the quality of the developed solutions. Support performance tuning, code reviews, and quality assurance processes. Troubleshooting: Identify and resolve issues related to Guidewire Billing Center applications. Troubleshoot and resolve complex issues across the billing lifecycle. Documentation: Create and maintain technical documentation for developed solutions. Document generation and integration Collaboration: Work with cross-functional teams to understand requirements and deliver solutions. Lead the end-to-end design, configuration, and customization of Guidewire BillingCenter. Take ownership of functional modules, including: Invoicing and delinquency management Payments, Payment Requests, and Disbursements Billing Instructions and Commission processing Trouble Tickets (setup, workflows, resolution tracking) Mentor junior developers and ensure adherence to coding standards and best practices. Required Skills: Technical Expertise: Proficiency in Guidewire Billing Center, GOSU, Java, and web services (SOAP/REST). Develop and maintain custom plugins and support integrations with policy, claims, finance, and external systems via web services (SOAP/REST). Experience: Hands-on experience with Guidewire applications, preferably Billing Center. Problem-Solving: Strong analytical and troubleshooting skills. Communication: Excellent verbal and written communication skills. Agile Methodologies: Experience working in agile environments using tools like Jira and Rally. Collaborate with cross-functional Agile teams, guiding solution design and ensuring alignment with business needs Preferred Qualifications: Certifications: Guidewire certification in Billing Center or other Guidewire modules. BC ACE is a plus Domain Knowledge: Understanding of property and casualty insurance.
Posted 2 weeks ago
1.0 - 3.0 years
4 - 6 Lacs
hyderabad
Work from Office
Educational Requirements: Medical Degree or Related Field: BAMS/BHMS only Understanding of Medical Terminology: Proficiency in medical terminology, procedures, and diagnoses. Certification: Certification in medical coding (such as CPC, CCS, or equivalent) can be advantageous. Experience: Healthcare Experience: Experience working in a non- clinical setting can be beneficial, providing a solid understanding of medical procedures and billing practices. Claims Processing Experience: Prior experience in medical billing, coding, or claims processing is required. Familiarity with Insurance Policies: Understanding of various health insurance policies and coverage criteria. Skills: Analytical Skills: Ability to review and analyze medical records and claims. Attention to Detail: Ensuring accuracy in claim adjudication to prevent errors and fraud. Communication Skills: Strong verbal and written communication skills for interacting with stakeholders and insureds etc. Technical Proficiency: Familiarity with claims processing software and electronic health records (EHR) systems. Regulatory Knowledge: Understanding of healthcare regulations and compliance standards (such as HIPAA in the U.S.). Other Requirements : Problem-Solving Skills: Ability to resolve discrepancies and handle complex claim issues. Additional Certifications (Optional but Beneficial): Certified Professional Coder (CPC): Certified Coding Specialist (CCS): Certified Medical Reimbursement Specialist (CMRS):
Posted 2 weeks ago
2.0 - 5.0 years
2 - 3 Lacs
faridabad
Work from Office
Role & responsibilities review and verify TPA deductions made from hospital bills. Cross-check claims, pre-authorizations, and payment details from TPAs to identify discrepancies. Reconcile payment and deduction reports with hospital billing and accounting records. Coordinate with insurance companies, TPAs, and internal departments to resolve deduction-related issues. Follow up on pending claims and deductions to expedite payments. Prepare regular reports on TPA deductions and highlight areas of concern or delay. Assist in audits and compliance checks related to TPA billing and deductions. Maintain accurate documentation and records of all deduction transactions. Provide support to the billing and finance teams regarding TPA-related queries. Stay updated on insurance policies, TPA guidelines, and regulatory requirements. Preferred candidate profile experience in hospital billing, insurance claims, or TPA deduction management preferred. Understanding of healthcare insurance processes and TPA operations. Strong analytical and reconciliation skills. Good communication and coordination abilities. Proficiency in MS Office (Excel, Word) and hospital billing software. Attention to detail and accuracy.
Posted 2 weeks ago
3.0 - 4.0 years
3 - 6 Lacs
gurugram
Work from Office
Job description We are seeking a dynamic and detail-oriented Insurance Professional for the Legal Department to manage end-to-end insurance policy administration, claims processing, and risk management across multiple sites. The ideal candidate will have experience in insurance handling, preferably in the solar sector, and the ability to manage and coordinate across teams and insurance partners. COMPENSATION & BENEFITS: Medical Insurance Performance Incentives Cool Work Environment Travel Reimbursement (as per company policy) Exposure to challenging legal and insurance portfolios Supportive team and professional development ABOUT SADBHAV FUTURETECH LIMITED: Company Size - ~100 employees Headquarters - Gurgaon, Haryana Company Turnover 300 to 350 Cr. Founded Since - Year 2020 Sadbhav Futuretech is committed to providing comprehensive and end to end solutions for farmers across India. Sadbhav addresses the major challenges of farmers through its three service verticals while ensuring value creation for all stakeholders. Our endeavor is to establish Sadbhav Futuretech as Indias first choice for solar project execution, co-operative farming, and cold chain management. We project to become the largest aggregator of farmers in India over the next 5 years. VISION: To be the largest Renewable and Agri-Tech based platform in the country impacting the lives of more than 1 million farmers over the next 10 years. OUR SPECIALITIES: Solar Agricultural Pumps, PM KUSUM Scheme, Kusum Component C, Kusum Component B, FaaS - Farming as a Service, Empowering Farmers, Solar Rooftop Solutions, Solar EPC, Solar Ground Mounted, Solar Rooftop, and Solar Solutions JOB RESPONSIBILITY: Manage complete insurance policy lifecycle, including issuance, renewals, and cancellations for company assets and projects Handle insurance claims for assets, equipment, and warehouse-related incidents Coordinate with internal stakeholders and insurance service providers for smooth claims resolution Ensure timely documentation and submission of all claims and follow-ups until settlement Analyze claim trends and risk exposure and recommend strategies for risk mitigation Maintain updated insurance-related records and compliance documentation Assist in risk assessments and inspections at warehouses and project sites Generate periodic reports and MIS on insurance coverage, claims status, and premium schedules Support internal legal compliance initiatives related to insurance law and statutory obligations DESIRED PROFILE: Minimum 3 to 4 years of experience in insurance handling and claim settlements Must hold a Diploma in Insurance or equivalent certification Experience in the solar sector or renewable energy is preferred Willingness to travel across India (30% to 40%) for on-site inspections and audits Proficient in Hindi and English (spoken and written) Strong coordination and analytical skills DESIRED SKILLS: Knowledge of general & property insurance policies (fire, asset, liability, etc.) Excellent written and verbal communication Hands-on experience in claims documentation and settlement Sound understanding of insurance laws, contracts, and coverage terms Proficient in MS Excel, Word, and reporting tools Strong negotiation and relationship management skills WHY JOIN US? Work with a fast-growing leader in renewable energy Be part of an organization making a sustainable impact across India Dynamic and inclusive work culture Opportunity to lead key insurance and legal operations independently PREFERENCE: Corporate Office; Unicorn Start-Up; Young Energetic Person
Posted 2 weeks ago
1.0 - 5.0 years
1 - 3 Lacs
bengaluru
Work from Office
Key Responsibilities: Review and process incoming healthcare or insurance claims accurately and efficiently. Verify patient, provider, and policy details to ensure claims meet all requirements. Investigate discrepancies, missing information, or potential fraud indicators. Coordinate with internal departments or external providers for claim clarification. Maintain accurate records and ensure compliance with regulatory and company standards. Meet daily productivity and quality targets while maintaining confidentiality. MAXIMUM CTC :3.5 Lakhs WORK FROM OFFICE Anyone who attended interview before 30 days are not eligible to attend walk-in. Disclaimer: Firstsource follows a fair, transparent, and merit-based hiring process. We never ask for money at any stage. Beware of fraudulent offers and always verify through our official channels or @firstsource.com email addresses.
Posted 2 weeks ago
1.0 - 3.0 years
2 - 3 Lacs
new delhi, faridabad
Work from Office
Key Responsibilities: Counsel students and parents regarding educational programs, career options, and admission procedures. Conduct one-on-one sessions, group counseling, and seminars/webinars. Handle inquiries (walk-ins, calls, emails, online leads) and follow up for conversions. Provide detailed information about courses, fee structures, eligibility, and career opportunities. Guide students in application and documentation processes for admissions. Maintain accurate records of student interactions and admissions data. Build strong relationships with students, parents, and academic institutions. Achieve individual and team enrollment/admission targets. Stay updated with education trends, new courses, and career opportunities.
Posted 2 weeks ago
2.0 - 5.0 years
1 - 4 Lacs
bengaluru
Work from Office
Greeting from Kotak Life Insurance Interested candidate can share their cv on 8828395189 or Mail: kli.nishmitha-kotian@kotak.com Job Title: Executive Group Insurance Operations (CSG) Job Description: We are looking for a detail-oriented professional to manage end-to-end operations of Group Insurance policies, including policy issuance, endorsements, premium calculations, underwriting coordination, and claims processing. Key Responsibilities: Manual premium calculation based on the benefit structure of the policy Preparation of Proforma Invoice and follow-up for client payments Follow-up for new business and renewal documents Policy conversion coordination and quality check of policy documents Sharing policy documents with brokers and clients Underwriting requirements follow-up and arranging medical check-ups Tracking medical reports and underwriting decisions Updating system records to accept or reject member coverage based on underwriting decisions Handling monthly endorsement data requests and performing data sanity checks Coordinating endorsement requests with Head Office and verifying premium summaries Sharing premium summaries with brokers/clients and ensuring correctness of premium charged Following up for PDF copies of endorsements and rated-up letters Sharing medical reports with employees post underwriting completion Handling gratuity requests and refund details after QC Sharing UTR details with clients for transactions Managing death claim process: locking member records, sharing document requirements, registering claims, and following up on settlement details Required Skills: Strong knowledge of Group Insurance Operations Familiarity with Policy Servicing, Endorsements, Premium Calculations, and Claims Processing Good coordination and follow-up skills with clients, brokers, and internal teams Proficiency in MS Excel and data management Strong attention to detail and process orientation Thanks, Nishmitha.
Posted 2 weeks ago
1.0 - 3.0 years
3 - 4 Lacs
ahmedabad
Work from Office
About Company Injala is a leading enterprise software company revolutionizing the insurance industry with our cutting-edge technology solutions. As a multi-national corporation headquartered in Dallas, USA, and with a significant presence in India, we are committed to transforming risk management through innovative software. Our growth trajectory has been impressive, achieving 30+% annual growth for the last five years. Company Website : https://www.injala.com / We are looking for a detail-oriented and proactive Client Service Specialist to support our administrative and operational activities. This internship offers hands-on experience in office management, coordination, and day-to-day business support functions in a professional corporate environment. Responsibilities: Assist in managing business documentation related to insurance, finance, or legal sectors. Work closely with senior team members to learn and support business processes and client interactions. Handle customer support inquiries and provide assistance as needed. Support the team in managing software systems for business process operations. Use Microsoft Office tools such as Word, Excel, and PowerPoint to create reports, presentations, and documentation. Participate in training sessions to improve knowledge of business processes and BPO operations. Requirements: Basic understanding or interest in administrative operations and business support services. Familiarity with Microsoft Office tools Word, Excel, Outlook, and PowerPoint. Good written and verbal communication skills in English. Ability to handle documentation, coordination, and follow-up tasks effectively. Prior internship or part-time work experience in admin, operations, or customer support is a plus. Benefits: Open Door working culture Recognition and rewards Festival and team celebrations Flexible work timings No Sandwich Leave Policy Referral Bonus Program Medical Insurance.
Posted 2 weeks ago
0.0 - 2.0 years
3 - 4 Lacs
mumbai
Work from Office
About Us: Medi Assist is India's leading Health Tech and Insure Tech company focused on administering health benefits across employers, retail members, and public health schemes. We consistently strive to drive innovation and participate in such initiatives, to lower health care costs. Our Health Benefits: Administration model is designed to deliver the tools necessary for a health plan to succeed, whether its our modular claims management system, our technology that unveils data to make important decisions, or our service solutions built around the voice of the customer. In short, our goal is to link our success to that of our members Roles and Responsibilities: Check the medical admissibility of a claim by confirming the diagnosis and treatment details. Scrutinize the claims, as per the terms and conditions of the insurance policy. Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiation of open billing and package etc. Understand the process difference between PA and an RI claim and verify the necessary details accordingly. Verify the required documents for processing claims and raise an IR in case of an insufficiency. Coordinate with the LCM team in case of higher billing and with the provider team in case of non-availability of tariff. Approve or deny the claims as per the terms and conditions within the TAT. Handle escalations and responding to mails accordingly. Work from Office only 4th floor, AARPEE Chambers, Off Andheri-Kurla Road Industrail Estate Marol, Andheri East, , Marol Cooperative Next To Times Square, Shagbaug, Gamdevi, Marol, Mumbai, Maharashtra 400059 Interested candidates can share their resumes to abhilasha.dutta@mediassist.in CV on 8050700698
Posted 2 weeks ago
1.0 - 6.0 years
20 - 25 Lacs
mumbai
Work from Office
Position Purpose Manage the company's Accounts Payable approval workflow to ensure invoices are properly coded, routed to approvers, and timely paid Responsibilities Direct Responsibilities 1. Process expense claims or invoices as per given process & policies 2 Process invoices with high accuracy & TAT. 4 Should be able to identify process risk & provide desire solutions to mitigate the risk. 5 Able to manage clients query & provide them solutions to their issues 6. Have the ability to think creatively on process improvements. 7. Knowledge of India accounting & SAP will be advantage. Contributing Responsibilities Willingness to take initiatives and take ownership of work Have the ability to think creatively on process improvements Flexible to work in shift Technical & Behavioral Competencies 1) Eye for details 2) Email Communication is mandatory 3) Ability to work under pressure 4) Comfortable with basic office tools (MS Word, Outlook) Specific Qualifications (if required) - B.Com Skills Referential Behavioural Skills : (Please select up to 4 skills) Communication skills - oral & written Ability to synthetize / simplify Choose an item. Decision Making Transversal Skills: (Please select up to 5 skills) Ability to anticipate business / strategic evolution Ability to understand, explain and support change Ability to develop and adapt a process Choose an item. Choose an item. Education Level: Bachelor Degree or equivalent Experience Level At least 1 year
Posted 2 weeks ago
0.0 - 2.0 years
3 - 4 Lacs
mumbai
Work from Office
About Us: Medi Assist is India's leading Health Tech and Insure Tech company focused on administering health benefits across employers, retail members, and public health schemes. We consistently strive to drive innovation and participate in such initiatives, to lower health care costs. Our Health Benefits: Administration model is designed to deliver the tools necessary for a health plan to succeed, whether its our modular claims management system, our technology that unveils data to make important decisions, or our service solutions built around the voice of the customer. In short, our goal is to link our success to that of our members Roles and Responsibilities: Check the medical admissibility of a claim by confirming the diagnosis and treatment details. Scrutinize the claims, as per the terms and conditions of the insurance policy. Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiation of open billing and package etc. Understand the process difference between PA and an RI claim and verify the necessary details accordingly. Verify the required documents for processing claims and raise an IR in case of an insufficiency. Coordinate with the LCM team in case of higher billing and with the provider team in case of non-availability of tariff. Approve or deny the claims as per the terms and conditions within the TAT. Handle escalations and responding to mails accordingly. Work from Office only 4th floor, AARPEE Chambers, Off Andheri-Kurla Road Industrail Estate Marol, Andheri East, , Marol Cooperative Next To Times Square, Shagbaug, Gamdevi, Marol, Mumbai, Maharashtra 400059 Interested candidates can share their resumes to abhilasha.dutta@mediassist.in CV on 8050700698
Posted 2 weeks ago
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