2028 Claims Processing Jobs - Page 23

Eurofins Assurance India Pvt Ltd is a leading certification body providing Audit & Certification , Inspections , and other services covering the broad spectrum of sustainable supply chain. Eurofins will help the customers to mitigate risks in their supply chain and to ensure the benchmarking performance with operations, processes, systems, people or capabilities. Whether you are in Food, Cosmetics, Consumer products or Health care sector, our global auditor and technical expert network will help to mitigate/eliminate your risks against supply chain and distribution flows: Regulatory and Industrial standards . We have accreditations for a number of different industry standards/memberships to ensure we service the entire supply chain. TC application review "¢ Preparation of draft manual transaction certificate "¢ Issuing TC or rejecting TC "¢ Client Coordination related to the TC application. "¢ Compile the GMO related data for GOTS and TE using applicable templates. "¢ Compile the monthly TC data for TE. Qualifications Any graduate can apply.

Eurofins Assurance India Pvt Ltd is a leading certification body providing Audit & Certification , Inspections , and other services covering the broad spectrum of sustainable supply chain. Eurofins will help the customers to mitigate risks in their supply chain and to ensure the benchmarking performance with operations, processes, systems, people or capabilities. Whether you are in Food, Cosmetics, Consumer products or Health care sector, our global auditor and technical expert network will help to mitigate/eliminate your risks against supply chain and distribution flows: Regulatory and Industrial standards . We have accreditations for a number of different industry standards/memberships to ensure we service the entire supply chain. Responsible for local sales for assurance business for products like (SMETA, BSCI, HIGG "“ FEM, SLCP, WRAP, GOTS, etc.) "¢ Responsible for achieving targeted revenue for North region as defined by Eurofins Management. "¢ Prepare and present sales quotations and proposals to current and prospective clients. "¢ Maintain accurate customer and sales information in CRM. "¢ Provide Monthly Sales reports to Management. "¢ Responsible for supporting marketing activities in region. "¢ Assist in payment collection for region. "¢ Assist in Scheduling the audit. "¢ Commitment to providing a consistently high standard of customer service. "¢ Demonstrable record of success in sales, product or service marketing and sales management Additional Information Good written and verbal communication skills Operational Excellence and demonstrated ability to deliver results in multiple challenging situations. Team-focused with the ability to achieve or exceed objectives while working collaboratively with other team members to achieve mutual success. Good at Presentations High leadership and supervisory skills Result oriented Problem solving Good at Retention

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

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

Warm Greetings from Rivera Manpower Services! We are hiring for the role of Senior Analyst (Service Support Associate) in the US Healthcare Insurance process. Location: [Bangalore] Shift: US Shifts Experience: Minimum 4+ years in International Voice with specific experience in Insurance / Healthcare (mandatory) Qualification: Graduate (15 years of education 10+2+3) Requirements: Minimum 4 years of international voice experience in Insurance / Healthcare domain Strong client servicing and stakeholder management background Excellent verbal & written communication skills In-depth knowledge of US Healthcare Insurance regulations Proactive and self-driven with strong problem-solving skills Advanced computer skills (Outlook, Word, Excel, PowerPoint) Roles & Responsibilities: Act as the primary point of contact for the US onshore branch Provide end-to-end support for policy renewals, including documentation Understand and implement US Health Insurance policies and standards Manage policy lifecycle services and conduct renewal activities Handle client queries effectively to minimize rework Coordinate with internal teams to ensure timely completion of activities Build and maintain strong relationships with stakeholders to ensure customer satisfaction Call & Book Your Interview Slot: 7829336034 /9742630123 / 9380300644 /8884777961

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 varsha.kumari@mediassist.in

About Us: Medi Assist is India's leading Health Tech and Insure Tech company focused on administering health benefits across employers, retail members, and public health schemes. We consistently strive to drive innovation and participate in such initiatives, to lower health care costs. Our Health Benefits: Administration model is designed to deliver the tools necessary for a health plan to succeed, whether its our modular claims management system, our technology that unveils data to make important decisions, or our service solutions built around the voice of the customer. In short, our goal is to link our success to that of our members Roles and Responsibilities: Check the medical admissibility of a claim by confirming the diagnosis and treatment details. Scrutinize the claims, as per the terms and conditions of the insurance policy. Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiation of open billing and package etc. Understand the process difference between PA and an RI claim and verify the necessary details accordingly. Verify the required documents for processing claims and raise an IR in case of an insufficiency. Coordinate with the LCM team in case of higher billing and with the provider team in case of non-availability of tariff. Approve or deny the claims as per the terms and conditions within the TAT. Handle escalations and responding to mails accordingly. Work from Office only 4th floor, AARPEE Chambers, Off Andheri-Kurla Road Industrail Estate Marol, Andheri East, , Marol Cooperative Next To Times Square, Shagbaug, Gamdevi, Marol, Mumbai, Maharashtra 400059 Interested candidates can share their resumes to sarika.pallap@mediassist.in CV on 8792840500

About Us: Medi Assist is India's leading Health Tech and Insure Tech company focused on administering health benefits across employers, retail members, and public health schemes. We consistently strive to drive innovation and participate in such initiatives, to lower health care costs. Our Health Benefits: Administration model is designed to deliver the tools necessary for a health plan to succeed, whether its our modular claims management system, our technology that unveils data to make important decisions, or our service solutions built around the voice of the customer. In short, our goal is to link our success to that of our members Roles and Responsibilities: Check the medical admissibility of a claim by confirming the diagnosis and treatment details. Scrutinize the claims, as per the terms and conditions of the insurance policy. Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiation of open billing and package etc. Understand the process difference between PA and an RI claim and verify the necessary details accordingly. Verify the required documents for processing claims and raise an IR in case of an insufficiency. Coordinate with the LCM team in case of higher billing and with the provider team in case of non-availability of tariff. Approve or deny the claims as per the terms and conditions within the TAT. Handle escalations and responding to mails accordingly. Work from Office only 4th floor, AARPEE Chambers, Off Andheri-Kurla Road Industrail Estate Marol, Andheri East, , Marol Cooperative Next To Times Square, Shagbaug, Gamdevi, Marol, Mumbai, Maharashtra 400059 Interested candidates can share their resumes to sarika.pallap@mediassist.in CV on 8792840500

About The Role 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 : Microsoft Dynamics CRM Functional Good to have skills : NAMinimum 3 year(s) of experience is required Educational Qualification : 15 years full time education Summary :As a Business Analyst, you will engage in a variety of tasks that involve analyzing organizational processes and systems. Your typical day will include assessing the current state of business models, identifying customer requirements, and defining future states or business solutions. You will conduct research, gather data, and synthesize information to support decision-making and improve operational efficiency. Collaboration with various stakeholders will be essential as you work to align business needs with technological capabilities, ensuring that solutions are both effective and sustainable. 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.- Document business processes and workflows to ensure clarity and alignment across teams. Professional & Technical Skills: - Good exposure on CRM Functional Sales, Customer Service, Field Service and Project Operations- Candidate must have Project Operations experience- Test case creation, Test Execution Plan & coordinating with Technical team- Collaborate with stakeholders and onshore team on daily basis- Having exposure on Azure DevOps Additional Information:- The candidate should have minimum 3 years of experience in Microsoft Dynamics CRM Functional.- This position is based at our Hyderabad office.- A 15 years full time education is required. Qualification 15 years full time education

About The Role Skill required: Operations Support - Pharmacy Benefits Management (PBM) Designation: Health Operations Specialist Qualifications: Any Graduation Years of Experience: 7 to 11 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.The business processes, operations and interactions of third party administrators of prescription drug programs, understanding of the processes used to manage programs for payers, process and pay prescription drug claims, develop and maintain the formulary, contract with pharmacies and negotiate discounts and rebates with drug manufacturers. What are we looking for? People management and client management skillsClient management and people management Roles and Responsibilities: In this role you are required to do analysis and solving of moderately complex problems May create new solutions, leveraging and, where needed, adapting existing methods and procedures The person would require understanding of the strategic direction set by senior management as it relates to team goals Primary upward interaction is with direct supervisor May interact with peers and/or management levels at a client and/or within Accenture Guidance would be provided when determining methods and procedures on new assignments Decisions made by you will often impact the team in which they reside Individual would manage small teams and/or work efforts (if in an individual contributor role) at a client or within Accenture Please note that this role may require you to work in rotational shifts Qualification Any Graduation

Job Opportunity: AR Caller Locations: Hyderabad | Mumbai | Chennai | Bangalore Package: Up to 4.5 LPA + 2-Way Cab Facility Interview Mode: Virtual / Walk-in (based on location) Position Overview We are seeking experienced AR Callers with a minimum of 1 year of expertise in Accounts Receivable (AR) calling. The ideal candidate will be responsible for following up with insurance companies, resolving denials, handling appeals, and ensuring accuracy in claim management processes. Experience Required Minimum 1+ year of AR Calling experience (mandatory) Key Responsibilities Follow up with insurance companies regarding claim status Handle denials, appeals, and billing issue resolution Ensure accuracy in claim processing and achieve productivity targets Escalate unresolved issues in a timely manner Maintain professional communication and client satisfaction Work Mode Work from Office Job Locations Hyderabad Mumbai Chennai Bangalore Qualification Intermediate or Graduation(any discipline) Notice Period Immediate Joiners Preferred (030 Days) How to Apply Interested candidates can share their updated resume via WhatsApp: HR Contact: Ramya – +91 76800 03242 Availability: 9:30 AM – 6:30 PM Refer your friends and help them explore this opportunity!

Job Summary: The Business Analyst will play a key role in supporting finance and management information (MI) systems for an insurance company. The individual will bridge the gap between business operations, finance, and IT, ensuring the successful implementation and optimization of finance-related systems and management reporting tools. The role involves gathering business requirements, facilitating communication between stakeholders, and analyzing data to improve decision-making processes within the insurance domain. Key Responsibilities: Requirements Gathering: Collaborate with stakeholders (finance teams, insurance operations, and IT) to gather, document, and translate business requirements into functional specifications. Process Improvement: Identify inefficiencies in finance and reporting processes, recommending and implementing improvements to streamline workflows in the current system Data Analysis: Analyze finance and MI data of the current state systems System Implementation & Support: Support the implementation, integration, and optimization of finance and reporting systems, ensuring alignment with business processes for the new system. Reporting & MI Development: Design & Develop financial reports and dashboards using MI tools, providing detailed analysis and insights into key performance indicators (KPIs) on the new system Stakeholder Communication: Act as a liaison between finance, insurance operations, and IT teams, ensuring clear communication and alignment on project goals and timelines. Documentation: Create detailed documentation including business requirements, process flows, and functional specifications. Compliance & Risk Management: Ensure that finance and MI systems adhere to regulatory and compliance standards within the insurance industry. Required Qualifications: Bachelors degree in Finance, Accounting, Business, or a related field. Proven experience as a Business Analyst in the insurance domain, with a focus on finance and MI. Strong understanding of insurance products, underwriting, claims processes, and financial reporting. Proficiency in data analysis tools (e.g., Excel, Power BI, Tableau) Experience with Agile methodologies and familiarity with project management tools (e.g., JIRA, Confluence). Excellent problem-solving skills and the ability to analyze complex data sets. Strong communication skills to work with cross-functional teams and present findings to stakeholders. Preferred Qualifications: Experience with regulatory reporting (e.g., Solvency II, IFRS 17) in the insurance industry. Knowledge of management information systems and their role in insurance operations. Familiarity with financial modeling and forecasting techniques. Key Competencies: Analytical thinking and attention to detail. Strong business acumen with the ability to understand the financial implications of insurance operations. Ability to work in a fast-paced environment and manage multiple priorities. Collaborative mindset with the ability to influence and negotiate with stakeholders.

Job Summary: The Business Analyst will play a key role in supporting finance and management information (MI) systems for an insurance company. The individual will bridge the gap between business operations, finance, and IT, ensuring the successful implementation and optimization of finance-related systems and management reporting tools. The role involves gathering business requirements, facilitating communication between stakeholders, and analyzing data to improve decision-making processes within the insurance domain. Key Responsibilities: Requirements Gathering: Collaborate with stakeholders (finance teams, insurance operations, and IT) to gather, document, and translate business requirements into functional specifications. Process Improvement: Identify inefficiencies in finance and reporting processes, recommending and implementing improvements to streamline workflows in the current system Data Analysis: Analyze finance and MI data of the current state systems System Implementation & Support: Support the implementation, integration, and optimization of finance and reporting systems, ensuring alignment with business processes for the new system. Reporting & MI Development: Design & Develop financial reports and dashboards using MI tools, providing detailed analysis and insights into key performance indicators (KPIs) on the new system Stakeholder Communication: Act as a liaison between finance, insurance operations, and IT teams, ensuring clear communication and alignment on project goals and timelines. Documentation: Create detailed documentation including business requirements, process flows, and functional specifications. Compliance & Risk Management: Ensure that finance and MI systems adhere to regulatory and compliance standards within the insurance industry. Required Qualifications: Bachelors degree in Finance, Accounting, Business, or a related field. Proven experience as a Business Analyst in the insurance domain, with a focus on finance and MI. Strong understanding of insurance products, underwriting, claims processes, and financial reporting. Proficiency in data analysis tools (e.g., Excel, Power BI, Tableau) Experience with Agile methodologies and familiarity with project management tools (e.g., JIRA, Confluence). Excellent problem-solving skills and the ability to analyze complex data sets. Strong communication skills to work with cross-functional teams and present findings to stakeholders. Preferred Qualifications: Experience with regulatory reporting (e.g., Solvency II, IFRS 17) in the insurance industry. Knowledge of management information systems and their role in insurance operations. Familiarity with financial modeling and forecasting techniques. Key Competencies: Analytical thinking and attention to detail. Strong business acumen with the ability to understand the financial implications of insurance operations. Ability to work in a fast-paced environment and manage multiple priorities. Collaborative mindset with the ability to influence and negotiate with stakeholders.

Role: Claims Adjudicators/Sr. Claims Adjudicators Location: Noida Key Skills: Knowledge of US Health Insurance domain, Claims Adjudication, Providers and Members Enrolment, MS Office and good keyboard skills. Experience: 3 + years in Claims Adjudication or in relevant field Job Description: We are seeking a detail-oriented and analytical Claims Adjudicator to review, evaluate, and process insurance claims in accordance with policy guidelines and regulatory standards. The ideal candidate will have a strong understanding of claims procedures, excellent decision-making skills, and a commitment to accuracy and compliance. Prior experience in claims processing or adjudication preferred. Familiarity with insurance policies and regulatory requirements. Strong attention to detail and organizational skills. Proficiency in claims management systems and MS Office. Candidate should be ready to work night shift (US Shift). Interested candidates may share their resumes @madhulika.sharma@4aisoft.com and Gargi.gupta@4aisoft.com

Job Summary Clinical claim Review Responsibilities Oversee the claims adjudication process to ensure accuracy and compliance with industry standards. Provide expertise in claims and payer domains to enhance operational efficiency. Analyze claims data to identify trends and areas for improvement. Collaborate with team members to streamline claims processing workflows. Ensure timely resolution of claims issues to maintain customer satisfaction. Develop and implement strategies to optimize claims adjudication procedures. Monitor performance metrics to ensure adherence to service level agreements. Communicate effectively with stakeholders to address claims-related inquiries. Utilize technical skills to troubleshoot and resolve claims processing challenges. Maintain up-to-date knowledge of industry regulations and best practices. Contribute to the development of training materials for claims processing staff. Support continuous improvement initiatives to enhance claims operations. Document and report on claims processing activities for management review. Qualifications Possess strong analytical skills to evaluate claims data and identify improvement opportunities. Demonstrate proficiency in claims adjudication processes and techniques. Exhibit excellent communication skills to interact with stakeholders effectively. Show a keen understanding of payer domain requirements and regulations. Have the ability to work independently in a remote work environment. Display strong problem-solving skills to address claims processing challenges. Maintain a detail-oriented approach to ensure accuracy in claims adjudication. Certifications Required BSC Nursing with minimum 2 + years of Clinical experience

We are hiring for International Healthcare Customer Support. Role & responsibilities : Handle outbound calls related to healthcare services within the US healthcare system. Proactively reach out to members to provide support, resolve issues, and ensure a positive experience. Identify and address varying levels of member complexity and communicate effectively. Ensure strict compliance with HIPAA regulations and other healthcare-related guidelines. Resolve member inquiries efficiently and professionally, escalating complex cases as required. Preferred candidate profile Proven experience in outbound voice processes, preferably in the US healthcare sector. Strong verbal and written communication skills with a focus on empathy and professionalism. International Customer support experience is a must. Should be comfortable to work from office Should be comfortable working in US shift. To apply share your cv at sophiya.massey@careernet.in or Call/ Whatsapp @ Sophiya on 7042266439

Dear Candidate, Please find below details for your interview. Interview Details: Interview Mode: Face-to-Face Interview Walk-in Days: 22nd August, Friday Walk in Timings: 1:00 PM to 3:00 PM Walk in Address: Candor Tech Space Tower No. 3, 6th Floor, Plot 20 & 21, Sector 135, Noida, Uttar Pradesh 201304 Please carry a copy of Updated Resume along with Aadhaar Card and PAN Card. Contact Person-Nasar Arshi/ Narshi87@r1rcm.com

Job Summary Join our dynamic team as a Specialist in Provider Credentialing where you will leverage your expertise in healthcare products and credentialing processes to ensure compliance and efficiency. With 4 to 6 years of experience you will play a crucial role in maintaining the integrity of our provider network. This hybrid role offers the flexibility of night shifts allowing you to balance work and personal commitments effectively. Responsibilities Oversee the credentialing and re-credentialing processes for healthcare providers to ensure compliance with industry standards and regulations. Collaborate with cross-functional teams to streamline credentialing workflows and improve operational efficiency. Analyze provider data to identify discrepancies and implement corrective actions to maintain data accuracy. Develop and maintain comprehensive documentation of credentialing procedures and policies. Provide support and guidance to providers throughout the credentialing process to ensure a smooth and efficient experience. Monitor and report on credentialing metrics to identify trends and areas for improvement. Implement best practices in credentialing to enhance the quality and reliability of provider information. Coordinate with external agencies and stakeholders to facilitate timely credentialing approvals. Utilize healthcare product knowledge to optimize credentialing processes and ensure alignment with organizational goals. Conduct regular audits of credentialing files to ensure compliance with internal and external standards. Assist in the development and delivery of training programs for new team members on credentialing procedures. Participate in continuous improvement initiatives to enhance the overall effectiveness of the credentialing department. Ensure all credentialing activities are conducted in accordance with company policies and regulatory requirements. Qualifications Possess a strong understanding of healthcare products and their application in credentialing processes. Demonstrate expertise in credentialing and re-credentialing within the healthcare domain. Exhibit excellent analytical skills to assess provider data and identify discrepancies. Show proficiency in developing and maintaining documentation of credentialing procedures. Display strong communication skills to support providers and collaborate with cross-functional teams. Have experience in monitoring and reporting on credentialing metrics. Be adept at coordinating with external agencies for credentialing approvals. Certifications Required Certified Provider Credentialing Specialist (CPCS)

Urgent requirement for BHMS,BAMS,BDS -Badodara(Gujrat )candidate with TPA experience. Interested candidates can call on 9371762436 or share their updated resumes to career@mdindia.com Job Description: Scrutiny of medical documents and adjudication. Assess the eligibility of medical claims and determine financial outcomes. Identification of trigger factors of insurance related frauds and inform the concerned department. Determine accuracy of medical documents. Need to Visit the Hospitals Should have own Bike Required Candidate profile: BHMS,BAMS,BDS graduate. Male candidate prefer. Good Medical & basic computer knowledge Should have completed internship (Permanent Registration number is mandatory) Experience in of 1 year in Field Investigation in TPA Work from office. Only Male Candidates Required

Urgent requirement for BHMS,BAMS,BDS -Badodara(Gujrat )candidate with TPA experience. Interested candidates can call on 9371762436 or share their updated resumes to career@mdindia.com Job Description: Scrutiny of medical documents and adjudication. Assess the eligibility of medical claims and determine financial outcomes. Identification of trigger factors of insurance related frauds and inform the concerned department. Determine accuracy of medical documents. Need to Visit the Hospitals Should have own Bike Required Candidate profile: BHMS,BAMS,BDS graduate. Male candidate prefer. Good Medical & basic computer knowledge Should have completed internship (Permanent Registration number is mandatory) Experience in of 1 year in Field Investigation in TPA Work from office. Only Male Candidates Required

Warm Greetings from RIVERA MANPOWER SERVICES!!!! Kindly Note : We are looking @ Minimum 4 Years of an experience into International Voice Process(Health Care/ US Insurance) Excellent Communication Skills. We are looking @ only Immediate Joiners! CHETHANA @ 7829336034 rivera.chethana@gmail.com Primary Responsibilities Act as the primary point of contact for the branch (US onshore), providing comprehensive support Understanding and implementation of US Health Insurance regulatory standards, guidelines, policies and procedures Ensure end-to-end support of the policy lifecycle services. Conduct end-to-end renewal activities as a US Health Insurance domain expert. Coordinate with internal operations teams to complete renewal activities on time. Handle queries effectively to minimize rework at the service center. Identify risks and issues and navigate them to successful resolution. Maintain strong time management and organizational skills. Foster a positive relationship with onshore branch staff to enhance the overall customer experience. Strong time management and organizational skills; ability to work independently and effectively managing multiple tasks at once Preferred candidate profile : Skills and Competencies • Excellent Written and Oral communication skills • Advanced computer skills (Outlook, Word, Excel, PowerPoint). • Interpersonal skills to foster strong relationships. • Insurance domain knowledge. • Proactive and self-reliant approach to problem-solving. • Strong organizational and time-management skills Perks and benefits :Night Shift Allowance 2 ways cabs

Company: Casagrand Builder Private Limited Location: Thiruvanmiyur, Chennai Experience Required: 1 - 3 years About Casagrand: Casagrand Builder Private Limited is a leading real estate developer in South India, known for delivering high-quality residential projects that cater to the aspirations of homebuyers. With a strong presence in Chennai, Bengaluru, and Coimbatore, Casagrand is committed to excellence and customer satisfaction. Key Responsibilities: Query Resolution: Serve as the first point of contact for employees' queries related to medical insurance, benefits, and policies. Communication: Effectively communicate with employees to understand their concerns and provide timely and accurate information. Collaboration: Work closely with Employees to address and resolve employee issues. Documentation: Maintain records of employee queries and resolutions to identify trends and areas for improvement. Desired Skills & Qualifications: Education: Graduate in any discipline. Experience: Minimum 1 year of experience in TPA, Medical insurance Communication: Excellent verbal and written communication skills in English and Tamil. Technical Skills: Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint). Organizational Skills: Strong ability to manage multiple tasks and prioritize effectively. Problem-Solving: Ability to identify issues and implement effective solutions. Attention to Detail: High level of accuracy and attention to detail in all tasks. Interested candidate can share your updated resume to b.sangeetha@casagrand.co.in

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 varsha.kumari@mediassist.in

About Us: Medi Assist is India's leading Health Tech and Insure Tech company focused on administering health benefits across employers, retail members, and public health schemes. We consistently strive to drive innovation and participate in such initiatives, to lower health care costs. Our Health Benefits: Administration model is designed to deliver the tools necessary for a health plan to succeed, whether its our modular claims management system, our technology that unveils data to make important decisions, or our service solutions built around the voice of the customer. In short, our goal is to link our success to that of our members Roles and Responsibilities: Check the medical admissibility of a claim by confirming the diagnosis and treatment details. Scrutinize the claims, as per the terms and conditions of the insurance policy. Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiation of open billing and package etc. Understand the process difference between PA and an RI claim and verify the necessary details accordingly. Verify the required documents for processing claims and raise an IR in case of an insufficiency. Coordinate with the LCM team in case of higher billing and with the provider team in case of non-availability of tariff. Approve or deny the claims as per the terms and conditions within the TAT. Handle escalations and responding to mails accordingly. Work from Office only 4th floor, AARPEE Chambers, Off Andheri-Kurla Road Industrail Estate Marol, Andheri East, , Marol Cooperative Next To Times Square, Shagbaug, Gamdevi, Marol, Mumbai, Maharashtra 400059 Interested candidates can share their resumes to sarika.pallap@mediassist.in

Role Objective: To bill out medical accounts with accuracy within defined timelines and reduce rejections for payers. Essential Duties and Responsibilities: Process Accounts accurately basis US medical billing within defined TAT Able to process payer rejection with accuracy within defined TAT. 24*7 Environment, Open for night shifts Good analytical skills and proficiency with MS Word, Excel, and PowerPoint Qualifications: Graduate in any discipline from a recognized educational institute. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Good communication Skills (both written & verbal)Skill Set: Candidate should have good healthcare knowledge. Candidate should have knowledge of Medicare and Medicaid. Ability to interact positively with team members, peer group and seniors.