2028 Claims Processing Jobs - Page 29

Responsibilities: * Manage backend operations with focus on health insurance claims processing, TPA billing, MIS reporting, data entry, and basic hospital administration. Provident fund Annual bonus

Candidate should have experience working as a Team Leader OR Quality analyst for US healthcare process. Shift - US rotational shifts Work Location - Hyderabad Required Candidate profile Immediate Joiners OR Max 1 month notice period candidates can apply Call HR Swapna @ 7411718707 for more details.

Greetings from ACP Billing Services! We are hiring for the following roles - Work from Office Charge Posting - Near Madhavaram Location preferred. Experience & Requirements: Minimum 2+ years of experience in US Medical Billing. Candidates who worked in charge entry process for at least 2 years completely are eligible. Good verbal and written communication skills. Charge Posting candidates with good typing skills will have an added advantage. Competitive remuneration as per industry standards. Spot offers for selected candidates. Immediate joiners are needed. Responsibilities: Process medical billing transactions with a 99% or higher accuracy rate. Good knowledge on CPT codes and Modifiers. Patient demographics experience is a add on. Good knowledge on general billing details and Insurance knowledge is required. Understand and apply customer-provided business rules while ensuring compliance with turnaround time requirements. Work collaboratively in teams to achieve set targets. Utilize medical billing expertise to monitor and report customer KPIs. Actively participate in learning programs and compliance initiatives. Competencies & Skills: Strong interpersonal and analytical skills. Proficiency in MS Office (Word, Excel, PowerPoint). Adaptability, flexibility, and a proactive approach to tasks. Commitment to meeting productivity, quality, and attendance SLAs. Team-oriented mindset with a willingness to take initiative. Work Location : ACP Billing Services Pvt Ltd - NO.133, 2ND FLOOR, EJNS ARK, KP GARDEN STREET, MADHAVARAM HIGH ROAD, MADHAVARAM Chennai- 600 051. Land Mark : Next to ICICI Bank Madhavaram Branch. Share your CV to hr@acpbillingservices.com / WhatsApp 9841820311

Fresenius Medical Care is a global leader in providing high-quality healthcare solutions and services. We are committed to fostering an inclusive and diverse work environment where all employees are treated with respect and fairness, regardless of race, gender, caste, ethnicity, religion, disability, or any other characteristic. We believe in equal opportunities for all and celebrate diversity as a key driver of innovation and success. Our commitment to equality ensures that every individual has the opportunity to thrive. Summary of the role: 100% adherence to Insite and Prato Insta process Update all the treatments in INSTA daily with 100% accuracy. Book GRN the very same day whenever material received with 100% accuracy. Book consumption in EuCliD daily with 100% accuracy. Cost optimization: Proper utilization of Consumable per treatment, Electricity, water, proper Management of patient and staff roster, repair and maintenance cost, local purchase, petty cash and etc. Generation of Management Information reports viz. (Consumable reports, Daily revenue reports, patient data Etc...). Responsible for updating of allied government schemes and claim process. Follow up patients scheduling and maintains report with patients, managers, and employees by arranging continuing contacts. Should maintain Patient details along with addresses and contact numbers. Responsible for rising indents in consultation with Sr. Technician. Responsible for sending his & the technician s attendance on daily basis. In coordination with operation timely submit invoices and follow-up for the payment. In coordination with clinical staff s ensure proper up time of network and complete admin related EuCliD activities. Adherence - Company Policies Ensure adherence to company s time & attendance policy Ensure adherence to company s code of conduct & Compliance Maintain the team camaraderie/harmony Drive effectively the positive environment for Unit 100% accuracy in reporting Material receivable and properly organizing materials in storeroom Dispensing daily consumable to clinical staff. Close monitoring on patient wise consumption

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

Scope Of WorkPrimary Shared Across Functionally Establish procedures for meeting Health, Safety and Environment standards for project execution Implement policies, systems and procedures and ensuring compliance to standards through all phases of the Project Authorize project-specific deviations to the standard HSE Project Guidelines Prepare monthly HSE MIS for review by RCM & Project Manager Liaise with clients, consultants, and Yard construction teams relating to HSE issues Liaise with statutory bodies, certification agencies and consultants Attend important client meetings where safety is an item on the agenda Investigate all accidents and recommend appropriate corrective action/ measures Keep abreast of ILO safety guidelines and other internationally recognized HSE organizations

Role & responsibilities -Processing of Non-life and life claims. -Documentation -Client/Site/Surveyor/Insurer visits. -Joint Meeting with client/surveyors/Insurers. -Reminders & follow up with clients/surveyors/Insurer. -Resolving escalations from client. -Maintaining TATs for settlement. -Daily/Weekly/Monthly MIS Requirement - Minimum 1 and half year experience Coordinal relations with colleagues. Gentle and Soft spoken with clients. Experienced in handling EB, (Property, Marine and Liability claims will be preferred) Education - Graduation Please share cv on ankita.mohite@choiceindia.com

A patient calling role in medical billing primarily involves handling communication with patients regarding their medical bills and payments. This includes tasks like making outbound calls to patients to discuss outstanding balances, setting up payment plans, and addressing billing inquiries. They also may need to verify insurance coverage, update patient information, and collaborate with healthcare providers on billing discrepancies. Here's a more detailed breakdown of the responsibilities: Core Responsibilities: Outbound Calling: Making calls to patients to follow up on unpaid bills or to discuss billing issues. Payment Processing: Accepting payments, setting up payment plans, and handling financial transactions. Insurance Verification: Confirming patient insurance coverage and eligibility. Billing Inquiries: Addressing patient questions and concerns regarding their bills. Data Management: Updating patient information and billing records in the system. Collaboration: Working with other departments, like medical coding and insurance claims processing, to resolve billing issues. Documentation: Maintaining accurate records of all patient interactions and transactions. Key Skills: Communication: Excellent verbal and written communication skills are essential for explaining complex billing information to patients. Customer Service: The ability to handle patient inquiries with empathy and professionalism. Problem-Solving: Identifying and resolving billing discrepancies and payment issues. Organization: Managing multiple patient accounts and tasks effectively. Computer Literacy: Proficiency in using medical billing software and navigating online portals. Medical Terminology: Basic understanding of medical terms and procedures to understand billing details.

Job Title: Insurance Desk Executive TPA Coordination / Claims Specialist Location Options: Cloudnine hospital Sarjapura branch (BLR) BBMP Khata No: 1907/Sy No: 26/1, 26, 2nd Main Rd, Kaikondrahalli, Haralur, Bengaluru, Karnataka 560035 - Sarjapur Cloudnine hospital Thanisandra branch (BLR) Address: Sy No: 86/2 and 86/3, Thanisandra Village, Thanisandra Main Rd, RK Hegde Nagar, Bengaluru, Karnataka 560077 Organization: Ayu Health Hospitals Experience Required: 02 years (Freshers are welcome to apply) Preferred Gender: Male Candidates Preferred Location: Candidates residing near hospital locations will be given preference About Ayu Health: Ayu Health is one of Indias fastest-growing healthcare networks, dedicated to making high-quality healthcare accessible and affordable for all. With a focus on technology-driven solutions, Ayu Health partners with reputed hospitals and clinics across the country to deliver standardized care, transparent pricing, and a seamless patient experience. We are on a mission to build Indias most trusted healthcare brand. Key Responsibilities: Handle insurance/TPA desk operations at the hospital premises Coordinate with TPA and insurance representatives for claim submission and follow-up Manage and organize patient insurance documentation accurately Track approvals, follow up on pending claims, and address rejections effectively Communicate professionally with patients, hospital staff, and insurance partners Support hospital administrative needs and maintain documentation records Multi-task and work collaboratively within the hospital environment Candidate Requirements: 02 years of experience in TPA coordination, insurance desk, or claims processing in hospitals (Freshers with good communication skills can apply) Strong interpersonal and communication skills Basic understanding of hospital processes is a plus Ability to manage documents and work efficiently under pressure Must be reliable, punctual, and a team player Preference will be given to candidates living nearby the hospital location Male Candidates only Immediate Joiners will be preferred

You would be responsible for managing the end-to-end claims process for clients, ensuring seamless handling from claim intimation to settlement follow-ups. You will be the key point of contact for clients and AMCs regarding claim processes. You should be strategic and detail-oriented, ensuring timely documentation, filing, and resolution of claims while also contributing to business growth through lead generation and upselling. Requirements You have a bachelors degree in administration, commerce, or a related field. 2-3 years of hands-on experience in insurance claims processing. Ability to communicate correctly and clearly with all customers. Maintain a positive attitude with a focus on customer satisfaction. Documentation and organizational skills.

An excellent opportunity for a seasoned operation professional to lead and manage high-performing teams in motor insurance claims. This role offers exposure to end-to-end claims operations, client interactions, and team leadership in a process excellence-driven environment. Your Future Employer - A leading global business process management company serving clients across industries like Insurance, Banking, Travel, Healthcare, and more. With a strong focus on innovation, analytics, and digital transformation, the organization enables businesses to achieve superior operational outcomes and efficiency. Responsibilities - Managing day-to-day operations and driving performance improvements across functions. Overseeing the motor bodily injury claims process with a focus on compliance and timely resolution. Leading and mentoring a team to foster engagement and accountability. Collaborating with legal and external stakeholders on complex claims. Monitoring KPIs, identifying process gaps, and driving continuous improvement initiatives. Ensuring compliance with industry regulations and internal controls. Driving automation initiatives and contributing to digital transformation efforts. Requirements - Graduate degree in Business Administration, Insurance, or a related field. Strong experience in operations management, especially in the insurance sector. Proven track record in managing motor insurance claims and leading large teams. Excellent communication, analytical, and stakeholder management skills. Familiarity with claims systems, risk assessment methodologies, and process optimization tools. What is in it for you - Opportunity to drive operational excellence and team performance. Exposure to global best practices in insurance operations. Be a key contributor to digital transformation and strategic projects. Reach us: If you think this role aligns with your career goals, please email your updated resume to vasu.joshi@crescendogroup.in for a confidential discussion. Disclaimer: Crescendo Global specializes in Senior to C-level niche recruitment. We are committed to enabling job seekers and employers with an engaging and professional recruitment experience. Crescendo Global does not discriminate on the basis of race, religion, gender, sexual orientation, age, disability, or any other protected status. Note: Due to the volume of applications we receive, we may only respond to shortlisted candidates. Thank you for your understanding. Scam Alert: Beware of fraudulent job offers in the name of Crescendo Global. We do not charge fees or request purchases. All valid opportunities are listed at www.crescendo-global.com. Profile Keywords - Deputy Manager Jobs, Operations Jobs, Insurance Claims Jobs, Motor Insurance, Claims Management, SLA Management, Team Leadership, Client Management, Operations Excellence, BPM Jobs, Insurance Operations, Claims Processing.

HIRING For Motor Claims & Body Injury Claims Location - Whitefiled 5 days working & Sat sun fixed off Graduates salary - 6.5LPA CONTACT Gopika - 7411782490

Immediate joiners or with in 15 days Salary goes up to 6LPA-6.5LPA Graduates with minimum 1.5 years into the specified domain, Sat, Sun fixed off ,2 way cab Fixed uk shift White field location Note : Experience candidates only - on same domain

Role & responsibilities Strong understanding of Banking and services. Incorporates product knowledge into internal and external customer communications Demonstrates knowledge of insurance and claims industry Understands who to go to for additional information Communicates in a timely and effective manner (verbally and written) Understands priorities and objectives to ensure all deadlines are met Claims Management Risk Management Insurance Programs Reconciliation Preferred candidate profile Graduated from finance background

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

Quality Patient Care: They play a crucial role in maintaining and improving the quality of patient care. This includes ensuring that patients receive the appropriate care, medications, and treatments based on their conditions. Nursing Protocols and Standards: Implementing and enforcing nursing protocols and best practices within the healthcare facility, making sure that nursing staff follows proper procedures and adheres to medical guidelines. Budget Management: Managing the budget for the nursing department, including resource allocation, procurement of supplies, and cost control. Patient and Family Relations: Interacting with patients and their families, addressing their concerns, and providing information about patient care and treatment plans. Training and Education: Organizing training and professional development programs for the nursing staff to keep them updated with the latest medical advances and best practices. Regulatory Compliance: Ensuring that the nursing department complies with all healthcare regulations and accreditation standards. Emergency Response: Coordinating and leading the response to nursing-related emergencies within the healthcare facility, such as medical crises or staffing shortages.

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

Job Title: Assistant Manager Allocation & MIS Experience Required: 5-7 years Job Description: We are looking for a skilled and experienced professional specializing in Allocation and MIS management. The ideal candidate will be responsible for overseeing the end-to-end allocation process of health claim investigations, ensuring accurate data management, timely reporting and effective coordination to drive operational efficiency and service quality. Key Responsibilities: Managing the end-to-end allocation process for PAN India, including reconciliation, data preparation and allocation. Monitoring turnaround time (TAT), cost efficiency and hit ratio performance in vendor allocations. Ensuring timely sharing of allocation MIS reports (Costing and Projections) for management review. Reviewing and monitoring insurer-wise SLA adherence to ensure compliance and service quality. Ensure timely sharing of allocation MIS reports with Team Leads, focusing on pending status and TAT adherence. Ensure submission of MIS requirements as received from insurance companies. Maintain comprehensive tracking of all allocation data, including Assigned, Unassigned, Allocation, Withdrawal, and Auto-closure cases. Monitor and track daily allocation volumes and associated costs. In case of any spike in count or cost, a Root Cause Analysis (RCA) must be conducted and reported. Qualifications and Skills: Graduation from any stream 5-7 years of experience in health claim processing/Allocation. Ability to analyze large volumes of allocation data, identify trends, and make data-driven decisions Proficiency in MS Excel (pivot tables, VLOOKUP, formulas), data visualization tools (Power BI) Strong ability to manage multiple tasks, meet deadlines, and ensure timely delivery of reports and allocations. Strong knowledge of MIS, including report creation, costing analysis, projection modeling, and performance dashboards. In-depth knowledge of data preparation, reconciliation techniques and allocation methodologies across a large geographic area (PAN India)

Job Responsibilities: ***ONLY BHMS GRADUATES CAN APPLY.*** Having experience (at least 5 yrs) in TPA claim processing. Having a Good relationship with Hospitals under the East Zone. Financial Contribute to renewal portfolio expansion through relationship building with the insurance companies and surveyors to ensure optimum claim settlement in minimum time During processing of claim analyse the following and communicate to underwriters: adequacy of sum insured anomalies in the policy scope of additional policies other related information Control expenses Business Process Facilitate proper settlement of the claim in the shortest possible time to the satisfaction of the client by ensuring the following: Obtain complete information on the loss from the client after initial intimation Submit intimation to the insurance company for Registration of claim Allocation of a surveyor Obtain LOR (List of Requirements) from the Surveyor Match LOR with the Salasar requirement already taken from the client and take rest of the documents Once documents are received, check exclusions in fine print and prepare the draft reply from client submitted to insurance company Follow up with client for repair and reinstatement for early completion and help in documentation of estimate, contractor details, expenses etc. so that surveyor gets structured inputs for preparation of the survey report Follow up with surveyor for completion of assessment Communicate surveyors comments to client in terms of estimate and exclusion and arrange meeting between surveyor and client to resolve differences to obtain client assessment Ensure surveyors report is submitted at the earliest Follow up with insurance company for early settlement of claim Obtain settlement voucher from insurance company and forward to client Get discharge of client (signoff) and submit to insurance company for disbursement Update each step in SAIBA on real time basis and ensure due IRDA compliance Ensure resolution of all complex technical issues in claims and timely escalation of the same for quick disposal of the claim Customer Support the marketing department in obtaining new business and ensuring best possible coverage for client, talk to technical dept of client to understand which risks need to be covered, type of production (continuous/ batch) Reopen claims in case of new businesses and follow up to obtain claims after reopening of file by insurance company if repudiation is not time-barred Participate in fortnightly meetings to give updates to the business development and client servicing teams on the status of claims in order that they are updated about the same before meeting client for renewals Interface with clients to reinforce relationship with existing clients Prepare and submit daily / monthly reports on status of claims People Growth Acquire product knowledge and always keep self updated with latest variations in product offerings Attend training sessions (external/ internal) and working on on-job assignments to implement new learning Conduct training sessions for marketing team as well underwriting and claims teams to build product knowledge across functions Set objectives, review and evaluate performance periodically and give feedback Review pending work and initiate action Perform all such duties which are required to be performed by this position in an insurance broking house in general course and to perform all such duties and carry out all such responsibilities so delegated or asked to be performed by the Designated Authority from time to time External Interface: Internal interface: Existing clients Prospective clients Insurance companies Employees Preferred Competencies of Incumbent a) Functional Competencies Demonstrates domain knowledge in own area of operation Understands product offerings Understands service standards as per the Organization's ethos Learns continuously and keeps self-updated b ) Leadership Competencies : Relationship Building Networks effectively with both external and internal customers Focuses on building long-term, sustainable relationships Delivers on commitment every time Creative & Analytical Problem Solving Understands the strategic objectives of the Organization, unit, and function Collates data and analyses them objectively Takes objective decisions based on data to achieve the strategic objective of the Organization Goes the extra mile to achieve creative solutions Customer Focus Designs solutions that meet the requirements of the customer (external/ internal) Demonstrates a sense of urgency to resolve all external and internal customer concerns and responds to queries and requests within defined timelines and processes Educates customers (external/ internal) about changes in processes, policies and offerings Creates long term relationships with customers (external/ internal) through continuous interface Obtains customer (external/ internal) feedback to improve processes Promotes loyalty and converts customers to brand ambassadors Achieves customer delight concerning both internal and external customers Is sensitive to the code of conduct in the office and customer establishments Perseverance Makes every possible effort to understand the viewpoints of external and internal customers Takes all possible steps to resolve issues Understands the importance of deadlines, proactively removes roadblocks, and delivers as per requirement Tries alternatives to achieve the target Does not give up in the face of adversity Explains own point of view assertively to get necessary support and approval Is patient and persistent towards follow-up on all leads and prospects generated during the past, towards new client acquisition Achievement Orientation Understands the strategic objectives of the Organisation, unit, and function Aligns individual and team targets with strategic goals Plan and deploy appropriate resources to meet targets in the short and long term Goes the extra mile to achieve targets as per committed timelines and enables the team to do so Achieves and motivates excellence irrespective of circumstances Shares best practices across businesses Benchmarks with the best and continuously raise the bar Upgrades competencies of self and team to achieve excellence Interested candidate can share their CVs at susweta@salasarserviecs.com

Role & responsibilities Contribute to renewal portfolio expansion through relationship building with the insurance companies and surveyors to ensure optimum claim settlement in the minimum time. During the processing of the claim analyze the following and communicate to underwriters: adequacy of coverage wrt. location specifications e.g.. Earthquake /flood etc. adequacy of the sum insured anomalies in the policy scope of additional policies other related information Control expenses Business Process Facilitate proper settlement of the claim in the shortest possible time to the satisfaction of the client by ensuring the following: Obtain complete information of loss from the client after initial intimation Submit intimation to the insurance company for Registration of claim, Allocation of surveyor. Follow up for deputation of surveyor In case of big losses, ensure Salasar representative accompanies the surveyor to understand the nature and extent of loss and give the client an indication of documents required. Intimate documents requirement for the client. Obtain LOR (List of requirements) from Surveyor Match LOR with Salasar's requirement already taken from the client and take the rest of the documents. Once documents are received, check exclusions in fine print and prepare the draft reply from the client submitted to the insurance company Follow up with a client for repair and reinstatement for early completion and help in documentation of estimate, contractor details, expenses, etc. so that the surveyor gets structured inputs for preparation of the survey report Follow up with surveyor for completion of assessment Communicate surveyor comments to the client in terms of estimate and exclusion and arrange a meeting between the surveyor and client to resolve differences to obtain client assessment Ensure surveyors report is submitted at the earliest Follow up with insurance company for early settlement of claim Obtain settlement voucher from insurance company and forward to client Get discharge of client (signoff) and submit to the insurance company for disbursement Update each step in SAIBA on real time basis and ensure due IRDA compliance Ensure resolution of all complex technical issues in claims and timely escalation of the same for quick disposal of the claim Customer Support the marketing department in obtaining new business and ensuring the best possible coverage for clients, talk to the technical dept of the client to understand which risks need to be covered, type of production (continuous/ batch) Reopen claims in case of new businesses and follow up to obtain claims after reopening of the file by the insurance company if the repudiation is not time-barred. Participate in fortnightly meetings to give updates to the business development and client servicing teams on the status of claims in order that they are updated about the same before meeting clients for renewals Interface with clients to reinforce relationships with existing clients Prepare and submit daily/monthly reports on the status of claims. People Growth Acquire product knowledge and always keep yourself updated with the latest variations in product offerings Attend training sessions (external/ internal) and work on on-job assignments to implement new learning Conduct training sessions for the marketing team as well as underwriting and claims teams to build product knowledge across functions Set objectives, review and evaluate performance periodically, and give feedback Review pending work and initiate action Perform all such duties which are required to be performed by this position in an insurance broking house in general course and to perform all such duties and carry out all such responsibilities so delegated or asked to be performed by the Designated Authority from time to time External Interface: Internal interface: Existing clients Prospective clients Insurance companies Surveyors Employees Preferred candidate profile a) Functional Competencies Demonstrates domain knowledge in own area of operation Understands product offerings Understands service standards as per Organisation ethos Learns continuously and keeps self-updated b ) Leadership Competencies: Relationship Building Networks effectively with both external and internal customers Focuses on building long-term sustainable relationships Delivers on commitment every time Creative & Analytical Problem Solving Understands the strategic objectives of the Organisation, unit, function Collates data and analyses them objectively Takes objective decisions based on data to achieve the strategic objective of the Organisation Goes the extra mile to achieve creative solutions Customer Focus Designs solutions that meet the requirements of the customer (external/ internal) Demonstrates a sense of urgency to resolve all external and internal customer concerns and responds to queries and requests within defined timelines and processes Educates customers (external/ internal) about changes in processes, policies, and offerings Creates long-term relationships with customers (external/ internal) through continuous interface Obtains customer (external/ internal) feedback to improve processes Promotes loyalty and converts customers to brand ambassadors Achieves customer delight with respect to both internal and external customers Is sensitive to code of conduct in office and customer establishments Perseverance Makes all possible efforts to understand the viewpoints of external and internal customers Takes all possible steps to resolve issues Understands the importance of deadlines, proactively removes roadblocks, and delivers as per requirement Tries alternatives to achieve the target Does not give up in the face of adversity Explains own point of view assertively to get necessary support and approval Is patient and persistent towards following up on all leads and prospects generated during the past towards new client acquisition Achievement Orientation Understands the strategic objectives of the Organisation, unit, function Aligns individual and team targets with strategic goals Plans and deploy appropriate resources to meet targets in the short and long term Goes the extra mile to achieve targets as per committed timelines and enable the team to do so Achieves and motivates excellence irrespective of circumstances Shares best practices across businesses Benchmarks with the best and continuously raises the bar Upgrades competencies of self and team to achieve excellence. Share your resume at susweta@salasarservices.com

JD Coordinate with teams & hospitals on reconciliations Prepare monthly MIS reports Reconcile payments Manage reconciliation process from start to finish Must know about Government panels like ,Government railways and Ayushman Bharat Provident fund Annual bonus

Basic Purpose: Provide timely and accurate responses to both internal and external customer inquiries. Collaborate closely with underwriters to establish target dates and communicate coverage recommendations. Manage tasks including account set-up, quoting, proposals, policy issuance, policy administration requests, and general account servicing. Review received documentation for completeness and follow up for missing information. Maintain and document unit processes and procedures, and disseminate updates to relevant teams. Perform additional responsibilities as needed. Job Responsibilities: Screen transactions to determine authority level and either process or escalate per established guidelines. Gather and verify rating elements from various sources such as applications, underwriter instructions, WC rating bureaus, NCCI, Reference Connect, and company guidelines. Accurately input information into policy rating systems. Review rating system output to confirm accuracy and adherence to applied elements. Maintain rating documentation within a paperless policy environment per company standards. Provide endorsement quotes on demand. Build effective working relationships within and across departments to ensure timely task completion and meet customer expectations. Collaborate with underwriters to initiate and manage the renewal process; maintain professional communication with producers. Address and resolve customer service issues. Ensure accurate initiation and completion of incoming policy-related requests such as issuance, quotes, endorsements, and policy updates. Identify process improvement opportunities and make recommendations for enhancements in procedures or systems. Qualifications, Skillset, and Experience: Experience Required: Associate: Minimum 6+ months in P&C insurance underwriting support (Issuance, Endorsements). Sr. Associate: Minimum 24+ months in the same field. Key Skills: Strong organizational and interpersonal skills to manage priorities and time effectively. Excellent verbal and written communication skills; fluent in English. Customer-first attitude with problem-solving capabilities. Proficient in using the internet, computer applications, and web-based tools. Ability to multi-task in a high-paced environment. Typing speed of 30+ WPM. High attention to detail. • Educational Requirements: Minimum of 2 years of college education. Graduate Location: Pune, Maharashtra Shift Timings: US Night Shift Mode: Work From Office

As a Claims Processing & Adjudication professional, you will be responsible for evaluating and processing medical/health insurance claims in accordance with policy terms, SOPs, and quality benchmarks. Your role will involve validating coverage, exclusions, sub-limits, and waiting periods against policy documents to ensure accurate claim processing. Ensuring documentation accuracy and compliance is crucial in this role. You will be required to maintain complete and compliant claim files that adhere to IRDAI guidelines and internal policies. Participation in quality control reviews and corrective actions will be necessary to uphold production and quality standards. Additionally, preparing detailed claim notes, summaries, and system entries with zero data discrepancies will be part of your routine tasks. Effective customer communication is key in this position. Handling inbound/outbound calls and emails to explain policy terms and conditions, claim decisions, and necessary documents to customers is essential. Providing timely status updates and resolving customer queries in a professional manner will be a significant aspect of your daily responsibilities. You will also be responsible for fraud detection and investigation. Identifying suspicious patterns, inconsistencies, or potential fraud and escalating for further investigation when necessary will be part of your duties. Conducting basic fact-finding activities such as doctor/hospital verification and requesting additional documents to support validity checks will also be required. In the realm of issue resolution and coordination, you will play a vital role in liaising with hospitals, TPAs, and internal teams to resolve mismatches, billing errors, and document gaps efficiently. Adaptability and continuous improvement are essential in this role. You will need to be able to work across multiple product lines and processes, supporting your peers during peak workloads. Additionally, suggesting process improvements to enhance turnaround time, accuracy, and customer experience will be encouraged. Participation in refresher trainings and staying updated on regulatory changes will also be expected. Keeping track of daily productivity, pending queues, and exceptions, and reporting them to the team lead/manager will be part of your responsibilities. Maintaining secure records and ensuring the confidentiality of customer data at all times is of utmost importance. If you are looking to embark on a full-time career in the field of Claims Processing & Adjudication and are eager to contribute to a dynamic team, we encourage you to apply now at btwgroup.co/careers. Job Types: Full-time, Fresher Work Location: In person For further inquiries, please contact the employer at +91 9503776369.,

Vidal is hiring for claim Processor Designation: Executive-Claims Location: Gurgaon, Key Responsibilities: Review and validate claim documents submitted by hospitals or insured members Scrutinize medical records and bills for completeness and accuracy Apply policy terms, conditions, and exclusions to adjudicate claims Perform ICD and procedure coding as per ailment and treatment Coordinate with medical officers for clinical opinion when required Maintain claim logs and update CRM systems with claim status Ensure adherence to defined SLAs and minimize processing errors Flag suspicious or potentially fraudulent claims for investigation Communicate with stakeholders for clarifications or missing documents Support audit and compliance teams with documentation and reports Shortfalls & Queries Required Skills & Competencies: Strong understanding of health insurance policies and TPA workflows Familiarity with medical terminology and coding (ICD, CPT) Attention to detail and analytical thinking Proficiency in claims processing software and MS Office tools Good written and verbal communication skills Ability to manage high volumes under pressure Commitment to confidentiality and data protection norms Qualifications & Experience: Graduate in any discipline (preferably life sciences or healthcare) 1-3 years of experience in claims processing within a TPA or insurer

Candidate should have experience working as a Process Trainer in Claims adjudication process for US Healthcare Shift - US rotational shifts Work Location - Hyderabad Required Candidate profile Immediate Joiners OR Max 1 month notice period candidates can apply Call HR Swapna @ 7411718707 for more details.