2028 Claims Processing Jobs - Page 26

You are a dedicated and detail-oriented Claims Executive responsible for managing and processing insurance claims for Australian clients at Laverne Fintech, the Indian arm of La Verne Capital Pty Ltd. Your role involves reviewing and processing insurance claims, analyzing policy terms, coordinating with insurance companies, and maintaining effective communication with clients and stakeholders. You will ensure proper documentation, identify potentially fraudulent claims, review settlement outcomes, and deliver outstanding customer service. Key Responsibilities: - Review and process insurance claims accurately and in a timely manner. - Collect necessary documentation from policyholders to support claim evaluation. - Interpret insurance policy terms to determine claim eligibility. - Coordinate with insurance companies to track claim status. - Communicate regularly with policyholders throughout the claim process. - Maintain systematic filing of claim records. - Identify and report potentially fraudulent claims. - Review settlement outcomes and communicate details to policyholders. - Provide exceptional customer service and build trust-based relationships with clients. - Encourage clients to share feedback on their claims experience for continuous improvement. What We Expect from You: - Strong verbal and written communication skills in English. - 2 to 3 years of experience in Claims, customer service, or related roles. - Excellent relationship management and interpersonal skills. - Proficiency in MS Office, especially Advanced Excel. - Ability to work independently and manage multiple claims simultaneously. - Willingness to be proactive, take ownership, and adapt to a dynamic work environment. Preferred Qualifications: - Bachelor's degree in any discipline, preferably in Insurance or Commerce. - Prior experience in claims processing or customer service, especially for foreign insurance firms. - Flexibility with working hours to align with Australian time zones. Job Timing: - Early morning shift from 5:00 AM to 2:00 PM IST to align with Australian business hours. Job Location: - Work From Office only in Vadodara, Gujarat. Compensation and Benefits: - Salary Range: 25000+ per month, based on experience. - Additional Benefits: Health Insurance, Provident Fund (PF), Punctuality Bonus, Petrol Allowance.,

At Liberty Mutual, progress happens when individuals feel secure. By offering protection for the unexpected and delivering it with care, we assist people in embracing today and confidently pursuing tomorrow. Liberty Mutual has been in business since 1912 and is headquartered in Boston. As the fifth largest global property and casualty insurer based on 2022 gross written premium, we also hold the 86th position on the Fortune 100 list of largest corporations in the US based on 2022 revenue. With an annual consolidated revenue of $50 billion as of December 31, 2022, we operate in 29 countries and economies worldwide, employing over 50,000 individuals. Our comprehensive range of insurance products and services includes personal automobile, homeowners, specialty lines, reinsurance, commercial multiple-peril, workers compensation, commercial automobile, general liability, surety, and commercial property. The role of Senior Vice President - Strategic BPO Partnerships & Modernization, GRS at Liberty Mutual is to act as a global enterprise leader and strategic architect responsible for shaping, leading, and modernizing the third-party BPO ecosystem strategy for Liberty Mutual's Global Risk Solutions (GRS). This position is crucial in driving modernization across Liberty's global insurance operations, particularly within the commercial, specialty, and global risk segments, by unlocking enterprise-wide value through vendor partnerships, digital capabilities, and intelligent operations. The ideal candidate for this role should possess deep domain expertise in the insurance industry, including a nuanced understanding of underwriting, claims, policy servicing, finance, and regulatory landscapes. Working across global business units in North America, EMEA, APAC, and LATAM, the leader will navigate regional CEO agendas, global capability centers, and matrixed functional teams to drive integrated modernization. As a trusted advisor to GRS leadership, the SVP will lead strategic engagements with senior executives, combining operational strategy, partner governance, and digital transformation to enable agility, cost-efficiency, innovation, and scalability. This role requires a strong executive presence, profound insurance process knowledge, and experience with both traditional and emerging delivery models in regulated industries. **Job Duties:** 1. **Insurance-Aligned Global BPO Strategy & Modernization Integration** - Design and execute a multi-year BPO modernization strategy tailored to insurance, covering commercial, specialty, and reinsurance domains within Liberty GRS. - Partner with global and regional business heads to align modernization efforts with underwriting, claims, operations, and finance transformation agendas. - Develop future-ready delivery models optimizing cost, risk, agility, and customer experience in the insurance value chain. - Lead business cases and investment plans based on insurance-specific KPIs like combined ratio impact, claims cycle time, and regulatory compliance. 2. **Partner Capability & Insurance-Relevant Performance Management** - Conduct partner capability reviews focusing on insurance operating maturity, regulatory awareness, data privacy, and licensing requirements across jurisdictions. - Deploy insurance-aligned, outcome-based performance metrics including service levels tied to loss adjustment expenses, renewals, and operational ratios. - Build governance frameworks reflecting insurance risk controls, business continuity, and audit preparedness to ensure vendor alignment with Liberty's compliance and operational resilience standards. 3. **Domain-Led Innovation through Strategic Partnerships** - Embed insurance domain accelerators such as GenAI-powered claims triaging, policy analytics, and AI-driven underwriting support within vendor ecosystems. - Advocate modern platform solutions across the policy lifecycle, integrating with core systems like Guidewire, Duck Creek, and other PAS platforms. - Establish co-innovation forums with vendors focused on BFSI/insurance, creating tailored digital interventions for underwriting, risk evaluation, and service operations. 4. **Executive Engagement Across Insurance Value Chain** - Collaborate directly with regional COOs and Global Leaders across Liberty's insurance businesses to co-develop modernization roadmaps. - Act as a strategic partner to senior insurance stakeholders, translating operational opportunities into transformation initiatives with measurable P&L and customer outcomes. - Lead cross-regional insurance forums to harmonize modernization across legacy systems, compliance obligations, and regional business needs. 5. **Cross-Functional & Matrix Leadership in the Insurance Context** - Lead cross-functional engagement with actuarial, product, compliance, legal, and digital innovation teams to ensure seamless modernization of insurance operations. - Harmonize modernization efforts across multiple regional and global insurance entities within Liberty's complex matrix structure. - Resolve competing priorities and siloed initiatives by driving shared KPIs and coordinated execution across underwriting, claims, finance, and shared services. **Ideal Experience and Qualifications:** - 20+ years of experience, with at least 10+ years in the insurance industry, preferably in commercial lines, specialty, global risk, or reinsurance, and a proven track record of leading modernization and operations strategy in BFSI environments. - Deep expertise in insurance operations, including policy lifecycle, underwriting, claims, and regulatory frameworks in global markets. - Demonstrated success in managing large-scale BPO/vendor ecosystems supporting insurance operations, with responsibility for cost, quality, innovation, and transformation. - Proven ability to drive enterprise-wide modernization through global third-party partnerships, including automation, GenAI, and platform-led operating models. - Executive gravitas and experience influencing C-level insurance stakeholders, regional CEOs, and enterprise boards in global organizations. - Hands-on familiarity with insurance systems (e.g., Guidewire, Duck Creek, core PAS) and data platforms relevant to policy, billing, and claims. - Experience working in or with regulated environments, ensuring partner compliance with insurance laws, data residency, privacy, and risk obligations. - Strong cultural dexterity and ability to lead across multi-geography, multi-function, matrixed enterprise structures. **Leadership Competencies:** - Strategic & Commercial Acumen - with a profound understanding of the insurance business model. - Insurance Modernization & Innovation - a track record of evolving legacy systems and operations into future-ready digital ecosystems. - Executive Stakeholder Influence - capability to align underwriting, claims, and operational leadership to modernization goals. - Global Engagement & Cultural Fluency - effective leadership across geographies, especially in regulatory-heavy insurance jurisdictions. - Operational Resilience & Regulatory Understanding - capable of embedding compliance, data protection, and risk frameworks in vendor delivery. - Cross-Functional Collaboration - especially with actuarial, finance, legal, and claims teams.,

As an experienced professional in the insurance domain, specifically in Property & Casualty claims processing and operations, you will play a crucial role in creating, updating, and maintaining operational and SOP documents. Your responsibilities will include managing system access for the Claims leadership team, providing accurate data, and ensuring effective communication at all levels within the organization. You will be tasked with identifying and implementing process improvements within an operations environment, managing operational inventory to meet Service Level Agreements (SLAs), and accurately documenting all activities in the appropriate client systems. Collaboration with Global Claims Relationship Managers to execute global claims strategies and maintain engagement with assigned carriers will be a key aspect of your role. Handling and processing claims related to Auto Liability, property damage, personal injury, and liability will be a core responsibility. This will involve investigating claims, verifying coverage and claim details, and ensuring accurate and fair claim submission. Additionally, you will collaborate with adjusters, legal teams, and clients to efficiently resolve claims while reviewing policy details with clients to ensure clarity and compliance. To excel in this role, you must possess strong verbal and written communication skills, be familiar with claims processing tools such as FileHandler, and effectively communicate with onsite teams and stakeholders. Your ability to operate at all organizational levels, from managing frontline staff to interacting with executives, will be essential. Demonstrated experience in identifying and implementing process improvements within an operations environment, managing operational inventory, and collaborating with Global Claims Relationship Managers will be valuable assets. If you are looking for a permanent position in the IT Services industry, based in Pune, Maharashtra, India, and resonate with the responsibilities and requirements outlined above, we encourage you to apply for Job Opening ID RRF_5609 opened on 29/07/2025.,

You are Rakshati FinServ's next Insurance Sales & Operations Associate, a role based in Gurugram that offers an exciting opportunity to kickstart your career in the insurance and financial services industry. Your primary responsibilities will include handling insurance quotations, claims processing, and providing operational support to ensure a seamless experience for our clients. In this role, you will be tasked with generating accurate quotes for various types of insurance such as vehicle, health, travel, home, and life insurance. Additionally, you will be responsible for negotiating with insurers to secure competitive terms. You will also play a key role in claims management and delivering prompt after-sales service to our clients, ensuring their needs are met efficiently. Maintaining strong vendor relationships and facilitating communication between internal teams and partners will be crucial aspects of your role. You will also be expected to manage renewals, sales records, and documentation, providing essential support to backend operations to enhance closure rates. Using your proficiency in MS Excel and CRM tools, you will streamline workflows and provide administrative assistance to the sales team to drive operational efficiency. To excel in this position, you should hold a graduate degree in any discipline, with a preference for Finance or Commerce. A minimum of 01 year of experience in financial services or insurance is required, along with strong skills in MS Excel and CRM tools. Excellent verbal and written communication skills, as well as negotiation abilities, are essential for success in this role. Your ability to multitask and prioritize tasks in a dynamic environment will be key to meeting the demands of the position. As a valued member of our team, you will receive a total compensation package of 6,60,000, which includes a base salary of 3,50,000, health & personal accident cover of 14,000, and a performance bonus of up to 2,96,000. Join us at Rakshati FinServ and be part of a fast-paced growth environment with an innovative and collaborative culture. This position is based in Gurugram, Haryana, and requires on-site presence. For more information, visit www.rakshati.in.,

As a Claims Management Associate at Accenture, you will be responsible for assessing claims to determine coverage eligibility and benefit entitlements in accordance with policy terms and regulatory guidelines. Your role will involve conducting comprehensive research to validate policy details, supporting documentation, and calculating the correct benefit amount. Additionally, you will review proof of employment, salary history, and other relevant information needed to calculate benefits for Pensions claims. To excel in this role, you must have a minimum of 2 years of experience in the UK Life, Pensions, and Investment domain, specifically in Claims processing. Equivalent experience in U.S. retirement services will also be considered. Strong analytical and comprehension skills are essential, as you will be required to interpret information accurately and draw meaningful insights. You should be proficient in Microsoft Office tools, including Excel, Word, and Outlook, for reporting, documentation, and daily operations. Good verbal and written communication skills, along with attention to detail and excellent time management skills are crucial for success in this position. You must also be open to working flexible shifts based on business requirements and demonstrate the ability to work independently. As part of the UK Life and Pensions-Claims Processing tower, you will play a key role in verifying information and eligibility for Pensions claims, ensuring compliance with all regulatory requirements, procedures, and state/local regulations. Your responsibilities will also include researching queries and requests from Business Partners/Client Support Teams, participating in process improvements and automation, and upholding Quality Control standards. In this dynamic role, you will be expected to demonstrate excellent organizational skills, prioritize high-value transactions effectively, and complete assigned responsibilities and projects within timelines while managing daily business as usual tasks. By embracing change and leveraging your expertise in Claims Management, you will contribute to creating shared success for clients, shareholders, partners, and communities. If you meet the qualifications and possess the required skills and experience, we encourage you to explore this opportunity further and be part of Accenture's global professional services team dedicated to delivering technology-driven solutions and human ingenuity. Visit www.accenture.com for more information on how you can make a difference with us.,

We are seeking a dynamic Intelligent Automation (IA/RPA) Project Manager to join our Business Transformation Team. With a relentless focus on driving results for our customers and enhancing their customer care experience, you will play a crucial role in automating customer operations. Proficiency in RPA Projects is a key requirement for this position. As the Project Manager, you will lead end-to-end project management for US healthcare clients, encompassing scoping, budgeting, scheduling, risk, and stakeholder management. Your responsibilities will include coordinating cross-functional teams, ensuring project deliverables meet quality standards, managing communication with stakeholders, identifying and mitigating risks, and tracking project KPIs. Moreover, you will be expected to drive governance meetings, support pre-sale activities, review testing strategies, guide developers, and foster a collaborative environment across all lines of business. Your role will involve building and leading a collaborative environment to promote best practices in RPA operations and project delivery. The ideal candidate will have a Bachelor's degree (Engineering / Healthcare / Life Sciences preferred), along with certifications such as PMP, CSM, or equivalent. You should have strong exposure to claims processing, enrollment, provider data management, or care management workflows, as well as hands-on experience in managing multi-million-dollar projects/programs in a global delivery model. Exceptional communication, stakeholder management, and team leadership skills are essential, along with familiarity with compliance standards and healthcare technologies. Join us for continuous professional development, a diverse and inclusive work culture, empowerment to make a difference, a focus on people returning to work, and recognition and rewards for your contributions. Regards, Chetan Gurudev Email: chetan.gurudev@sagility.com,

As a valued member of the Infosys delivery team, you will be responsible for collaborating with clients to resolve quality assurance issues and ensuring their utmost satisfaction. Your key duties will include comprehending requirements, designing and reviewing solutions, validating architectures, and delivering top-notch service offerings in the technology sector. Furthermore, you will play a crucial role in project estimation, contribute to solution delivery, conduct technical risk assessments, oversee code reviews and unit test plan evaluations. Your leadership will be instrumental in guiding your teams towards creating optimized, high-quality code deliverables, promoting continuous knowledge enhancement, and ensuring adherence to organizational protocols and standards. Your expertise will be pivotal in developing efficient programs and systems that cater to the needs of our clients, aiding them in their digital transformation journey. If you possess the necessary skills and passion to drive our clients towards success in the digital realm, this opportunity is tailor-made for you. In terms of technical requirements, we are seeking individuals with domain experience in clinical RCM, pharmacy benefit management, healthcare business analysis with Agile and Safe Agile experience, as well as expertise in Medicaid and FHIR HL7 data analysis. Additionally, familiarity with healthcare digital transformation, cloud data solutions design, data analysis, analytics, and RPA solution design will be highly advantageous. If you are equipped with the aforementioned skills and are enthusiastic about contributing to the digital evolution of healthcare, this role presents an exciting opportunity for you to make a meaningful impact.,

As a Claims Management Specialist at Accenture, you will be part of the Tower: UK Life and Pensions team, focusing on Claims processing within the UK Life, Pensions, and Investment domain. With over 8 years of experience in this field, you will be responsible for managing end-to-end service delivery, leading high-performing teams, and driving operational improvements. Your expertise in Claims processing and ability to deliver results will be crucial in ensuring accurate and timely administration of insurance policies. To excel in this role, you must possess a Bachelor's degree in any discipline and have a proven track record of successfully managing and leading teams in Life and Pensions Services. Strong leadership skills, effective communication abilities, and excellent problem-solving capabilities are essential. Proficiency in MS Office applications such as Word, Excel, and PowerPoint is required, along with strong organizational skills to manage multiple projects simultaneously. Your role will involve managing complex processes within the UK Life and Pensions sector, leading teams of professionals, and overseeing remote process transitions. You will be responsible for analyzing key process metrics, ensuring operational excellence, and implementing process improvements to optimize performance. Additionally, you will lead teams through challenging scenarios, maintain regulatory compliance, and foster a culture of continuous improvement. Key responsibilities include team leadership, process oversight, training and compliance, customer relationship management, regulatory adherence, reporting and continuous improvement, and cross-functional collaboration. By leveraging your domain expertise and leadership skills, you will drive individual and team success, maintain high-quality standards, and contribute to the overall success of the organization. Join Accenture's global professional services team and be part of a dynamic environment where technology and human ingenuity come together to create value and shared success. Visit www.accenture.com to explore exciting career opportunities and make a difference in the world of Claims Management.,

The role of a Claim Operations professional in Pune/Hybrid is pivotal in the insurance domain, especially in Property & Casualty claims processing and operations. Your responsibilities will include creating, updating, and managing operational and SOP documents, overseeing system access for the Claims leadership team, and ensuring the provision of accurate data. You should be adept at working effectively across all organizational levels, from frontline employees to executives. Your capacity to identify and implement process enhancements within an operational setting will be crucial. Additionally, you must possess the skills to manage operational inventory to meet defined Service Level Agreements (SLAs) and ensure accurate documentation in client systems. As a Claim Operations specialist, you will be required to collaborate with Global Claims Relationship Managers to facilitate the execution of global claims strategies and maintain continuous engagement with assigned carriers. Handling and processing claims related to Auto Liability, property damage, personal injury, and liability will be part of your daily tasks. This role will also involve investigating claims, verifying coverage and claim details, and ensuring the submission of accurate and fair claims. Effective communication with adjusters, legal teams, and clients to expedite claims resolution will be essential. Moreover, reviewing policy specifics with clients to ensure comprehension and adherence is a critical aspect of this role. Maintaining meticulous and precise records of policies, claims, communications, and associated documentation is paramount to the successful fulfillment of your duties. The ideal candidate for this position should possess strong verbal and written communication skills, familiarity with claims processing tools like FileHandler, and the ability to engage effectively with onsite teams and stakeholders. You must demonstrate proficiency in operating at various organizational levels, from frontline staff management to executive interaction. A track record of identifying and implementing operational process improvements, managing inventory to meet SLAs, and ensuring accurate documentation in client systems is highly desirable. Collaboration with Global Claims Relationship Managers to uphold global claims strategies and sustain carrier engagement will be a fundamental aspect of this role.,

The role of a Non-EB claims supporting staff in the insurance industry involves assisting in the management of claims that do not pertain to employee benefits (EB). These claims encompass a variety of general insurance categories such as property, engineering, marine, liability, and other miscellaneous lines of insurance. As part of the supporting team, you may be responsible for tasks including claims processing, policy servicing, and other related duties. This is a full-time and permanent position with benefits that include cell phone reimbursement, health insurance, paid sick time, and Provident Fund. Proficiency in English is preferred for effective communication within the team and with clients. The preferred shift availability is during the day, and the work location is in person, ensuring a collaborative work environment for efficient claim handling and customer service.,

Roles and Responsibilities: Responsible for Analysing both insurance and patient follow-ups Work on Rejections, Denials, and outstanding AR/Aging Call and speak with insurances for following up on unpaid or denied claims Detail-oriented and possess exceptional analytical skills. Experience in working on Rejections, Denials and outstanding AR/Aging Ability to analyse claim thoroughly and take needed correction action for claims payments Ability to check claim status from various insurance portals Ability to independently analyse and resolve denials Shift: Night Shift Shift for male candidates : 6.30 PM to 3.30 AM Shift for Female candidates : 7.30 PM to 5 AM Location: Chennai - Nungambakkam 5 days working (Monday to Friday) Only direct interview. Education UG: Graduation Not Required

Job Title: Manager - Legal Claims Role Overview: As a Manager - Legal Claims, you will be responsible for managing the life cycle of MACT (Motor Accident Claims Tribunal) and WC (Workmen's Compensation) claims from start to finish. You will ensure effective coordination with advocates, timely referrals of awards, and take all necessary actions to ensure prompt claim settlements and legal defenses. Key Responsibilities: Handle MACT and WC claims life cycle end to end, including claim review, timely referral of awards, compromise referrals, payment release, and coordination with advocates for settlements and defenses. Issue a clear line of action for claims and ensure all steps are taken to achieve favorable outcomes. Attend court hearings to lead evidences and take necessary steps to secure Exonerations for the organization. Travel for settlement discussions and advocate performance reviews, ensuring optimal claim resolutions. Review claims cases, categorize them into defense and compromise categories, and maintain appropriate reserves. Aim to settle cases promptly after thorough review and analysis to mitigate potential losses. Maintain and report monthly closure data for the assigned location, ensuring timely resolution and tracking of ongoing claims. Skills & Qualifications: Bachelors degree in Law (LLB); additional certifications in insurance law or related fields will be an advantage. Minimum of 5 years of experience in handling legal claims within the General Insurance industry, with strong expertise in MACT and WC claims. Thorough understanding of insurance regulations, claim processes, and legal proceedings. Proven experience in attending court hearings, leading evidence presentation, and coordinating settlements. Ability to travel for settlements and performance reviews as required. Strong analytical and negotiation skills, with the ability to categorize claims and make timely decisions. Proficiency in MS Office, with excellent reporting and communication skills.

Job title Trainee (Tr.) Transaction Processing Officer Claims Registration (Band 5, Level 1) Reports to Unit Manager / Asst Unit Manager Provides customer service support for third party administrators, Health Maintenance organizations, preferred provider organizations, managed care organizations and many more in US healthcare insurance market by identifying and updating information. The ultimate motive is to ensure commendable service standards and maintain very high customer satisfaction. Technical Skills: Medical claims processing knowledge Proficiency with computers. Process Skills: Listed below are the primary job duties and responsibilities that are required: Primary responsibility is to key claim details from claim images into the healthcare software. Staying current with knowledge of products/ processes & services offered by the client. Ensure full adherence to all the quality parameters. Ensure 100% adherence to schedule. Meeting all defined targets like Productivity, quality, Maintenance of required reports in Excel. Behavioral Skills: Look up for relevant information and update (type into) the client systems as per set procedures and policies. Attention to detail while accomplishing tasks, meeting Weekly / Daily targets with required quality in the given timelines. Enter updates relating to pertinent healthcare data into the computer system in a timely manner ensuring accuracy, completeness, and adherence to department procedures. Review data for deficiencies or errors, correct any incompatibilities if possible. Adhere to the team norms for making the overall team a cohesive one. Ability to prioritize and manage workload. Must be ready to work in night shifts. Certification: Undergraduate (10+2)/Diploma / Graduate (Only Arts or Science) - Non-Technical Only Typing speed 35 to 40 wpm with 95% accuracy (without looking at the keyboard) Knowledge in US Healthcare will be an added advantage. Good communication skills. Proficiency with computers

You are a skilled SPE-Claims HC professional with 3 to 5 years of experience in the Life and Annuity domain. Your role will involve utilizing your strong technical expertise in Life and Annuity Domain Knowledge to analyze and process claims efficiently, ensuring timely resolution and customer satisfaction. You will collaborate with team members to identify process improvements, communicate effectively with stakeholders, and maintain compliance with company policies and industry regulations. Working night shifts from the office, you will provide exceptional customer service, maintain accurate records, and contribute to team meetings and discussions. Your responsibilities will include: - Efficiently analyzing and processing claims to ensure timely resolution and customer satisfaction. - Identifying and implementing process improvements in claims handling. - Utilizing Life and Annuity Domain Knowledge to accurately assess and manage claims. - Communicating effectively with stakeholders and providing updates. - Ensuring compliance with company policies and industry regulations. - Maintaining accurate records and documentation for all claims processed. - Providing exceptional customer service by addressing inquiries promptly. - Contributing to team meetings and discussions to share insights. - Monitoring claim trends and providing feedback to management. - Assisting in training and mentoring junior team members. - Participating in quality assurance activities. - Supporting the development and implementation of new claims management systems. - Adapting to changes in processes and technology to improve efficiency. Qualifications: - Strong technical expertise in Life and Annuity Domain Knowledge. - Experience in Life and Annuities Insurance preferred. - Excellent analytical and problem-solving skills. - Proficiency in claims management software and tools. - Strong communication and interpersonal skills. - Attention to detail and accuracy in all tasks. - Ability to work independently and as part of a team. Certifications Required: Certified Life and Annuity Professional (CLAP) or equivalent certification preferred.,

You will be responsible for companies overall business development, sales & marketing in Andhra Pradesh & Telangana region. Your key responsibilities will include Customer Relationship Management, New Customer acquisition, Internal stakeholder relationship, and Co-ordination for all claims processing. To excel in this role, you should have at least 10-12 years of experience in Sales & Marketing, with a focus on TMT Bars. A Graduate degree is required, and a Postgraduate qualification in Marketing is preferred. The ideal candidate will possess strong analytical skills, concept selling tactics, and the ability to work under pressure. Proficiency in Advanced MS Excel, MS PowerPoint & MS Word is necessary. Excellent Communication and Interpersonal Skills are essential to effectively lead the marketing team, develop partnerships, and collaborate with senior marketing leaders to devise marketing strategies and plans.,

JD: Designing or upgrading new computer systems and frameworks. - Troubleshooting technical issues. - RISK mitigation planning. - collaborating with business Analysts, Project Leads and IT team to resolve issues and ensuring solutions are viable and consistent. - creating system guidelines and manuals for The organization. - Running training sessions and workshops on system processes. - Conducting regular reviews of systems and generating reports on efficiencies and improvement areas. - Running necessary queries against databases to understand current state structure and future state structure for The database. Strong experience in Healthcare Payer data management, claims processing, provider data, eligibility workflows Location = pan India years of experience = 5 to 8 yrs Domain SME System Analyst Show more Show less

Description We are seeking a dedicated Unit Manager for our Health Insurance team, responsible for overseeing operations, driving performance, and ensuring exceptional service delivery in accordance with health insurance regulations. Responsibilities Manage and oversee health insurance operations within the unit. Develop and implement strategic plans to achieve unit goals and targets. Supervise and mentor team members to ensure high performance and compliance with company policies. Analyze data and reports to identify trends and areas for improvement. Build and maintain relationships with clients, providers, and stakeholders in the health insurance sector. Conduct regular training sessions for staff to enhance their knowledge and skills in health insurance products. Skills and Qualifications Bachelor's degree in Any fied 1-2 years of experience in health insurance or general insurance Strong knowledge of health insurance policies and regulations in India. Excellent communication and interpersonal skills. Proficient in data analysis and reporting tools. Ability to work in a team and manage multiple tasks effectively. Strong problem-solving skills and attention to detail. Age Upto 34 Years

As a Dedicated Claims Specialist, you will be responsible for handling end-to-end processing of reimbursement claims for group medical corporate policies. You should possess a strong background in medical and health insurance, with a focus on group medical corporate policies. The ideal candidate for this role will have 2-4 years of experience in claims processing or CRM roles. Your key responsibilities will include providing excellent customer service by addressing claims-related queries via platforms such as Freshchat, Ozontel, and Freshdesk. You will be required to analyze medical documentation, policy terms, and conditions to ensure accurate claim assessment and processing. Additionally, you will need to liaise with internal teams, insurers, TPAs, and hospitals to facilitate seamless claims settlement and timely resolutions. Managing claims escalations and ensuring prompt resolution while maintaining a customer-centric approach will also be part of your role. To excel in this position, you must have in-depth knowledge of corporate group medical insurance policies and claims processing. Understanding medical terminology, treatment procedures, and health-related documentation is essential. Proficiency in customer support and claims management tools like Ozontel, Freshdesk, or similar platforms is required. Strong communication and problem-solving skills are necessary to effectively manage customer relationships and resolve issues. Attention to detail is crucial to ensure accuracy in claim processing and documentation review. Collaboration with cross-functional teams, including insurance partners and hospital networks, is key to success in this role. Qualifications for this position include a Bachelor's degree in healthcare, insurance, or a related field. A minimum of 2-4 years of experience in claims processing or CRM roles, preferably within group medical corporate policies, is preferred.,

Join our dynamic team as a Claims Processing Specialist where you will play a crucial role in ensuring the accuracy and efficiency of claims adjudication. With a focus on Medicare and Medicaid claims, you will contribute to the seamless processing of claims enhancing our service delivery. This hybrid role offers the flexibility of working both remotely and on-site during night shifts. Responsibilities Process claims with precision ensuring adherence to Medicare and Medicaid guidelines. Analyze claims data to identify discrepancies and resolve issues promptly. Collaborate with team members to streamline claims adjudication processes. Utilize claims adjudication software to enhance processing efficiency. Provide feedback on process improvements to enhance service delivery. Maintain up-to-date knowledge of industry regulations and compliance standards. Communicate effectively with stakeholders to ensure clarity and resolution of claims issues. Document claims processing activities accurately for audit and reporting purposes. Support the team in achieving departmental goals and objectives. Participate in training sessions to stay informed about the latest claims processing techniques. Ensure confidentiality and security of sensitive claims information. Contribute to a positive work environment by supporting colleagues and fostering teamwork. Adapt to changing priorities and work effectively under pressure. Qualifications Demonstrate proficiency in claims adjudication processes and software. Possess strong analytical skills to identify and resolve claims discrepancies. Exhibit excellent communication skills for effective stakeholder interaction. Show a keen understanding of Medicare and Medicaid claims requirements. Display attention to detail in processing and documenting claims activities. Have the ability to work independently and collaboratively in a hybrid work model. Certifications Required Not required,

As an Executive in the Insurance Department at Meditrina Hospital, Kollam, a prestigious NABH-accredited healthcare facility, you will play a vital role in managing ECHS Inpatient (IP) and Outpatient (OP) billing and claims processes. Your dedication and experience will contribute to the seamless operation of insurance-related procedures in our hospital. Your key responsibilities will include handling ECHS IP & OP claims processing and documentation, coordinating with ECHS authorities for approvals and follow-ups, ensuring timely submission and settlement of insurance claims, maintaining accurate records of all insurance transactions, and liaising with patients and internal departments to streamline insurance-related procedures. To excel in this role, you should possess a minimum of 1-2 years of relevant experience in a hospital insurance department, sound knowledge of ECHS procedures and documentation, good communication and coordination skills, as well as proficiency in MS Office and hospital management systems. At Meditrina Hospital, we offer a full-time, permanent position with benefits such as a flexible schedule, leave encashment, and paid sick time. The work schedule may include day shifts, evening shifts, and rotational shifts. The educational requirement for this role is a Bachelor's degree, and a mandatory experience of 1 year in ECHS & TPA Claim Processing is essential. If you are looking to make a meaningful contribution to the healthcare industry and are located in Kollam, Kerala, we welcome you to join our team in person at Meditrina Hospital.,

The US Healthcare Recruiter position at Allime Tech Solutions Pvt. Ltd. in Hyderabad requires a minimum of 4 years of experience in recruitment. As a US Healthcare Recruiter, your primary responsibility will be to source, screen, and recruit qualified candidates for various healthcare roles. These roles include Medical Billing Specialists, Accounts Receivable (AR) Follow-up Specialists, Coding and Compliance Officers, Healthcare Business Analysts, Project Managers, and more. You will collaborate with hiring managers and department heads to understand recruitment needs thoroughly. Please refrain from applying if your profile does not align with the job description or the required qualifications. We value relevant applications to ensure a productive recruitment process. Feel free to share this opportunity with potential candidates to broaden our reach to job seekers. Allime Tech Solutions is dedicated to fostering innovation through technology and connecting talent with opportunities. Our mission is to create a future where everyone can thrive by providing tailored solutions for our clients. We uphold values of integrity and excellence in all our endeavors. Thank you for considering a career at Allime Tech Solutions Pvt. Ltd.,

GREETINGS FROM PERSONAL NETWORK !!!! TOP US MULTINTIONAL COMPANY @ Marthalli, BANGALORE IS LOOKINGOUT FOR Healthcare Professional FOT THEIR International Voice Health Care PROCESS. REQUIREMENTS :- POST :- CUSTOMER SUPPORT - HEALTHCARE PROCESS :- VOICE - INTERNATIONAL QUAL :- Graduates / BE / MCA EXP :- 1 to 4 Years SALARY :- 5 LAKH Location :- BANGALORE Shift :- US Shift / ROTATIONAL SHIFT CAB :- 2 WAY FOOD :- AVAILABLE Contact Tinna @ 76192 81864 RAJ @ 98451 62196 Anu @ 98450 43512 Best Wishes - Personal Network

Qualification: Any Graduation Years of Experience: Fresher Education: BA & B.com are priority but we can look for BBA, BMS, BBI, BMM as well Work Location: MDC-7 (Candidates should be located near the location and be comfortable with face-to-face interviews.) Job Summary: You 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. In Payer Claims Processing, you will be responsible for delivering business solutions that support the healthcare claim function, leveraging knowledge of the processes and systems to receive, edit, price, adjudicate, and process payments for claims. Job Description: Utilize analytics, technology, domain, and healthcare industry expertise to enhance operational efficiency for healthcare clients. Deliver operational improvements for members Candidate Requirements: Immediate joiners with excellent communication skills. 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. 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 part of a team with a predetermined, narrow scope of work. Please note that this role may require you to work in rotational shifts.

Mandatory Points : 1. Good English Communication is required. 2. Should be Flexible with Night shits. 3. Looking for 2023 and 2024 Freshers. 3. Must have original Degree marksheets with PDC. US Consultant: is responsible for meeting individual key performance metrics related to business processes assigned while adhering to quality standards under the guidance/supervision of an identified mentor/lead. The employee is accountable for following process standard operating procedures. Also needs to identify various process related scenarios, perform proactive analysis around it and propose a solution or process improvement. Competencies: Ability to understand the basic nature of the domain and relating that to the entire value chain of mortgage and title insurance solutions, Time Share property, Claims Servicing & Claims Prevention etc. Should have basic knowledge of Australian Mortgage and Title Insurance Concepts Ability to Retrieve relevant information using appropriate Online Business-related Websites Ability to use these tools to perform required search and collate information. Ability to Process Simple, Medium and High complexity tasks o Follow the set guidelines/framework while structuring all work products o Maintain compliance to the Quality metrics o Ability to display the culture of FTR (First Time Right) While processing orders o Ability to quickly unlearn / learn various tools, processes and controls to deliver effectively Technical Skills: Educational Qualification and Experience: Minimum of 15 years of formal education Diploma/Graduate (Commerce/Art/Business Administration)

The purpose of the Claims Role is to effectively manage the claims process for clients, ensuring a smooth and fair settlement of claims. Your responsibilities will include reviewing and validating claims, liaising with insurers, advocating for clients" interests, and guiding them through the claims process to achieve a satisfactory outcome. You will be expected to accurately review and process claims in adherence to established protocols and guidelines. Furthermore, you will ensure that all necessary documentation is collected and maintained for each claim, including client statements, accident reports, and relevant records. As the main point of contact for clients during the claims process, you will provide timely updates and information, advocate for clients" interests and rights, and ensure a fair and just settlement of claims. Additionally, you will engage in substantiating the claim to the insurers to secure optimal claim settlements for clients, considering policy terms, legal requirements, and clients" expectations. In addressing client concerns, disputes, and inquiries related to claims, you will demonstrate professionalism and timely responses. Conflict resolution and maintaining positive client relationships throughout the claims process will be crucial aspects of the role. To excel in this role, you should possess a strong understanding of insurance policies, coverages, and claims processing. Familiarity with insurance regulations, industry standards, and claims-related legal aspects is necessary. Clear and effective communication skills, both written and verbal, will be essential to convey complex information to clients and internal stakeholders. Your interpersonal skills will be key in managing client interactions with empathy and professionalism. Your analytical skills will be utilized to assess claim details, policy information, and relevant documents to make informed decisions. Identifying potential challenges and developing effective solutions to ensure smooth claims processing will be part of your responsibilities. Effective negotiation skills will also be required to achieve optimal claim settlements for clients and persuasively present clients" cases and arguments to insurers. A bachelor's degree in business, insurance, finance, or a related field is preferred for this role. Prior 10 years of work experience in claims processing, claims handling, or related roles within the insurance industry is advantageous. Relevant certifications in claims management or insurance claims will be beneficial. Proficiency in using claims management systems, CRM software, and the Microsoft Office suite (Word, Excel, Outlook, etc.) is required for this position.,