2028 Claims Processing Jobs - Page 32

Hiring for a Record Retrieval Specialist #Shift-Us Shift Timing #Location: Ahmedabad, Gujarat #Freshers can apply # Minimum 6 months of Experience Required in the Intl Voice process(for hike) #Fluent English Required Meal Facility is also available

You are invited to join our team as a Human Resource Executive specializing in US Immigration & Contracts. With over 5 years of experience, you will be based at DSL Abacus IT Park in Uppal, Hyderabad, working on-site during US shift timings from 6:30 PM to 3:30 AM IST. Your primary responsibilities will include handling Master Service Agreements (MSA) and Purchase Orders (PO), ensuring a thorough understanding of Clauses, Terms, and Conditions in Agreements. You will be responsible for managing legal documents of sub-contractors and consultants, negotiating agreements through direct client/vendor interactions, and overseeing the on-boarding process for selected consultants at client locations. In the realm of US immigration, you will be handling various visa filings such as H-1B Amendment, Extension, Transfer, along with H4 Dependents and H4 EAD filings. Your duties will also involve preparing supporting documents for PERM, I-140, and Perm Audits. Additionally, you will be responsible for providing Offer Letters, Employment Verification letters, and other relevant documentation. Furthermore, you will be tasked with maintaining Public Access Files for H1B employees, managing contractual employees and services, and ensuring compliance with I-9 Documents and Insurance Enrollment. Your role will also involve preparing and submitting immigration documents to USCIS, tracking them, and handling invoice and claims verification. If you are ready to take on this challenging and rewarding role, please send your resume to HR at ram.reddy@stiorg.com or contact us at 7386623888. We look forward to welcoming you to our team!,

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: 3-8 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 Summary We are seeking a skilled SPE-Claims HC professional with 3 to 5 years of experience in the Life and Annuity domain. The ideal candidate will possess strong technical expertise in Life and Annuity Domain Knowledge with a preference for those with experience in Life and Annuities Insurance. This role requires working from the office during night shifts with no travel required. Responsibilities Analyze and process claims efficiently to ensure timely resolution and customer satisfaction. Collaborate with team members to identify and implement process improvements in claims handling. Utilize Life and Annuity Domain Knowledge to accurately assess and manage claims. Communicate effectively with stakeholders to provide updates and gather necessary information. Ensure compliance with company policies and industry regulations in all claims activities. Maintain accurate records and documentation for all claims processed. Provide exceptional customer service by addressing inquiries and resolving issues promptly. Contribute to team meetings and discussions to share insights and best practices. Monitor claim trends and provide feedback to management for strategic planning. Assist in training and mentoring junior team members to enhance their skills. Participate in quality assurance activities to ensure high standards in claims processing. Support the development and implementation of new claims management systems. Adapt to changes in processes and technology to improve efficiency and effectiveness. Qualifications Possess strong technical expertise in Life and Annuity Domain Knowledge. Demonstrate experience in Life and Annuities Insurance is preferred. Exhibit excellent analytical and problem-solving skills. Show proficiency in claims management software and tools. Display strong communication and interpersonal skills. Maintain attention to detail and accuracy in all tasks. Demonstrate ability to work independently and as part of a team. Certifications Required Certified Life and Annuity Professional (CLAP) or equivalent certification preferred.

Job Summary Join our dynamic team as a PE-Ins Claims specialist where you will leverage your expertise in the Life and Annuity domain to enhance our claims processing efficiency. With 1 to 3 years of experience you will play a crucial role in ensuring accurate and timely claims management. This is an office-based role with night shifts offering an opportunity to make a significant impact in the insurance industry. Responsibilities Analyze and process insurance claims in the Life and Annuity domain to ensure accuracy and compliance with company policies. Collaborate with cross-functional teams to streamline claims processing and improve overall efficiency. Utilize domain knowledge to identify discrepancies and resolve issues in claims documentation. Maintain detailed records of claims activities and ensure all data is accurately entered into the system. Provide exceptional customer service by addressing inquiries and resolving claims-related concerns promptly. Assist in the development and implementation of claims processing procedures to enhance workflow. Monitor claims trends and provide insights to management for strategic decision-making. Ensure adherence to regulatory requirements and company standards in all claims processing activities. Participate in training sessions to stay updated on industry trends and best practices. Support team members in achieving departmental goals and objectives through effective collaboration. Contribute to continuous improvement initiatives by providing feedback and suggestions for process enhancements. Prepare reports and presentations on claims performance metrics for management review. Engage in professional development opportunities to enhance skills and knowledge in the Life and Annuity domain. Qualifications Possess strong analytical skills with a keen attention to detail in claims processing. Demonstrate proficiency in Life and Annuity domain knowledge with a focus on claims management. Exhibit excellent communication and interpersonal skills for effective collaboration. Show adaptability to work night shifts and manage time efficiently in a fast-paced environment. Display a proactive approach to problem-solving and decision-making in claims handling. Have a customer-centric mindset with a commitment to delivering high-quality service. Be familiar with insurance regulations and compliance standards relevant to the Life and Annuity domain. Certifications Required Certification in Life and Annuity Claims Management or equivalent is preferred.

Job Summary Join our dynamic team as a PE-Ins Claims specialist where you will leverage your expertise in the Life and Annuity domain to process and manage insurance claims efficiently. With a focus on accuracy and customer satisfaction you will play a crucial role in ensuring smooth operations and contributing to the companys success. This position requires working from the office during night shifts providing an opportunity to collaborate closely with team members and enhance your skills in a supporti Responsibilities Process insurance claims with precision and ensure compliance with company policies and regulations. Analyze claim documents and assess the validity of claims based on Life and Annuity domain knowledge. Collaborate with cross-functional teams to resolve complex claim issues and provide timely resolutions. Maintain accurate records of all claims processed and update the system with relevant information. Communicate effectively with clients to gather necessary information and provide updates on claim status. Identify potential areas of improvement in claim processing and suggest actionable solutions. Ensure high levels of customer satisfaction by addressing inquiries and resolving issues promptly. Monitor claim trends and provide insights to management for strategic decision-making. Adhere to company guidelines and industry standards while handling sensitive client information. Participate in training sessions to stay updated on industry changes and enhance domain expertise. Support team members by sharing knowledge and best practices in claim management. Contribute to the development of efficient workflows and processes to optimize claim handling. Utilize technical skills to streamline claim processing and improve overall efficiency. Qualifications Possess strong Life and Annuity domain knowledge with a focus on insurance claims. Demonstrate excellent analytical skills to evaluate and process claims accurately. Exhibit effective communication skills to interact with clients and team members. Show proficiency in using claim management software and related tools. Have a keen eye for detail to ensure accuracy in claim documentation. Display a proactive approach to identifying and solving claim-related issues. Certifications Required Certified Insurance Claims Professional (CICP) or equivalent certification preferred.

Job Summary We are seeking a skilled professional with 3 to 5 years of experience in the Life and Annuity domain for the role of SPE-Ins Claims. The ideal candidate will work from our office during night shifts contributing to the efficiency and effectiveness of our claims processing. This role does not require travel allowing you to focus on delivering exceptional service and expertise in the Life and Annuities Insurance sector. Responsibilities Analyze and process insurance claims related to life and annuities ensuring accuracy and compliance with company policies and regulations. Collaborate with team members to improve claims processing workflows and enhance operational efficiency. Utilize domain knowledge to assess claims and provide recommendations for resolution ensuring customer satisfaction. Maintain detailed records of claims and communicate effectively with stakeholders to provide updates and resolve inquiries. Conduct thorough investigations of claims to identify potential discrepancies and ensure fair outcomes. Provide insights and feedback to management on trends and patterns observed in claims data to support strategic decision-making. Assist in the development and implementation of training programs for new team members to ensure consistent knowledge sharing. Monitor industry developments and regulatory changes to ensure compliance and adapt processes as necessary. Support the continuous improvement of claims processing systems by identifying areas for enhancement and suggesting solutions. Engage with policyholders and beneficiaries to address concerns and provide clear explanations of claim decisions. Collaborate with cross-functional teams to ensure seamless integration of claims processes with other business operations. Prepare detailed reports and presentations on claims performance and outcomes for management review. Ensure adherence to night shift schedules and maintain a high level of productivity and focus during working hours. Qualifications Demonstrate strong expertise in Life and Annuity domain knowledge essential for effective claims processing. Possess excellent analytical skills to evaluate and resolve complex claims efficiently. Exhibit strong communication skills to interact with stakeholders and provide clear concise information. Have a keen eye for detail to ensure accuracy and compliance in all claims-related activities. Show proficiency in using claims management software and tools to streamline processes. Display a proactive approach to problem-solving and continuous improvement in claims operations. Demonstrate the ability to work independently and collaboratively within a team environment. Certifications Required Certified Life and Annuity Claims Specialist (CLACS) or equivalent certification.

Job Summary Join our dynamic team as a PE-Ins Claims specialist where you will leverage your expertise in the Life and Annuity domain to enhance our claims processing efficiency. With 1 to 3 years of experience you will work from our office during night shifts contributing to the seamless operation of our insurance services. Your role will be pivotal in ensuring accurate and timely claims management directly impacting customer satisfaction and company success. Responsibilities Analyze and process insurance claims within the Life and Annuity domain to ensure accuracy and compliance with company policies. Collaborate with team members to identify and resolve discrepancies in claims documentation enhancing overall process efficiency. Utilize domain knowledge to assess claims and determine appropriate resolutions minimizing risk and maximizing customer satisfaction. Maintain detailed records of claims activities ensuring transparency and accountability in all transactions. Communicate effectively with internal and external stakeholders to facilitate smooth claims processing and address any inquiries. Implement best practices in claims management to streamline operations and reduce processing times. Provide insights and recommendations for process improvements based on data analysis and industry trends. Ensure adherence to regulatory requirements and company standards in all claims-related activities. Support the development and implementation of new claims processing tools and technologies. Participate in training sessions and workshops to stay updated on industry developments and enhance professional skills. Contribute to team meetings and discussions sharing knowledge and experiences to foster a collaborative work environment. Monitor and report on claims processing metrics identifying areas for improvement and implementing corrective actions. Assist in the preparation of reports and presentations for management review highlighting key performance indicators and achievements. Qualifications Demonstrate strong analytical skills with a focus on accuracy and attention to detail. Exhibit excellent communication and interpersonal skills to effectively interact with stakeholders. Possess a solid understanding of Life and Annuity insurance products and processes. Show proficiency in claims management software and related technologies. Display the ability to work independently and as part of a team in a fast-paced environment. Have a proactive approach to problem-solving and decision-making. Demonstrate a commitment to continuous learning and professional development. Certifications Required Certified Insurance Claims Specialist (CICS) or equivalent certification in Life and Annuity domain.

Designation : AR caller RCM, US healthcare Department : Operations Location : Hyderabad Report to : Team Leader, Operations. Work Set-up: Work from Office WORK BRIEF: To perform the job successfully, an individual must be able to perform each essential duty satisfactorily. The goal of the Sr. Revenue Cycle Billing Specialist is to successfully collect on aging medical insurance claims. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. CORE RESPONSIBILITIES File claims using all appropriate forms and attachments. Research account denials and file written appeals, when necessary. Evaluate the information received from the client to determine which insurance to bill and attain necessary attachments or supporting documentation to send with each claim. Research account information to determine the necessary attachments or supporting documentation to send with each claim. Document in detail all efforts in CUBS system and any other computer system necessary. Verify patient information and benefits. Essential Knowledge: Basic knowledge of using MS office basic applications like Word, PowerPoint, Excel, Notes, etc. Essential Skills: Min 2 Years of experience in accounts receivable follow-up / denial management for US healthcare customers Fluent verbal communication abilities Knowledge on Denials management and A/R fundamentals will be preferred Willingness to work in night shifts from office Prior experience of working in a medical billing company and use of medical billing software will be considered an advantage Knowledge of Healthcare terminology and ICD/CPT codes will be considered a plus MINIMUM QUALIFICATION: Graduate with minimum 2 Years of AR calling experience in US Healthcare market Pursuing Candidates – NOT Accepted for this role Note : Kindly mention HR- Nawaz khan on top of CV at the time of Walk-in. Disclaimer: Firstsource follows a fair, transparent, and merit-based hiring process. We never ask for money at any stage. Beware of fraudulent offers and always verify through our official channels or priyanka.narayanamoorthy@firstsource.com

Record Retrieval Executive/International Voice Process Shift - Night(Fixed) Salary - 32k CTC After 3months Increament After 1 year completed provide 25k bonus 5days working Excellent English communication

Hiring for a Record Retrieval Specialist #Shift-Us Shift Timing #Location: Ahmedabad, Gujarat #Freshers can apply # Minimum 6 months of Experience Required in the Intl Voice process(for hike) #Fluent English Required Meal Facility is also available

Hiring for a Record Retrieval Specialist #Shift-Us Shift Timing #Location: Ahmedabad, Gujarat #Freshers can apply # Minimum 6 months of Experience Required in the Intl Voice process(for hike) #Fluent English Required Meal Facility is also available

Dear Applicant, Hiring for US Healthcare - Operations Manager(OM) Role: Operations Manager I DESIGNATION: Operations Manager I LOCATION: Pune Qualification : Any Graduate PACAKAGE : 13LPA YEARS OF EXPERIENCE: 10-12 years Key Role and Responsibilities: Managing a team of 150 associates with the help of aligned 5 to 7 TLs Meet and exceed SLA targets Understand operational metrics & have governance to ensure no misses Drive performance and exceed the expectations Attend weekly and monthly reviews with Internal Stakeholders and Client Actively involved in client calls & manage client needs Monitor production, efficiency, and schedule adherence tool to ensure high levels of efficiency Establish cross skilling plan for the agents Develop the team members by providing necessary support and guidance and nominate them for different OD trainings Work closely with the team to ensure timely feedback is provided Create good engagement levels with team members and reduce attrition numbers Handle escalations (team and client) Ensure complete participation and contribution in organization/process level initiatives (e.g., Absenteeism, Attrition control) that may be implemented from time to time to improve efficiency Achieve stretch targets and make decisions as well as manage complex/ difficult employee situations Work as a Single point of contact for all non-operations departments and identify, evaluate & coordinate operational, Admin, IT and HR issues Make appropriate recommendations and adjustments to leverage resources, skill changes, post Overtime, or escalate as required Attrition Management & Employee engagement Ensure leaves for the team are planned so that productivity is not affected Coaching and feedback to mid and bottom quartile agents Mentoring top quartile performers Data collection and analysis of team performance parameters Contribute to process improvements and innovation Key skills and knowledge: Good communication and Analytical skills Planning and prioritization of schedule adherence Proficient with MS Office (Word, Power point and Excel) Flexible to work in Shifts (Morning and Night shifts and on Saturday/ Sunday weekly off) Ability to motivate under-performers to improve and excel US Healthcare expertise - preferred Interested candidates contact HR Hema@9136535233/ hemavathi@careerguideline.com

Prepare ILAs, Final Survey Reports, and requirement letters Maintain updated records of claim intimation, surveyor visits, document status, and report submissions Follow up with insured parties to minimize TAT Enter claims info in CMS software Health insurance Provident fund

About the Team The Motor Claims team is a critical function within our Insurance Business team, dedicated to providing efficient and customer-centric claims services for all motor insurance policyholders. About the Role As Claims Manager, you will play a critical role in building and managing our motor garage and surveyor network. Must Haves Experience: At least 5 years of experience in Motor Insurance Claims Technical Skills: Strong understanding of vehicle mechanics, automobile parts, repair processes, vehicle damage assessment, and repair cost estimation. Proven experience in negotiating with and managing vendors, workshops, and surveyors. Communication Excellence: Good command of written and spoken English and Hindi. Multilingual ability is an added advantage. Soft Skills: Strong interpersonal, strategic thinking, and negotiation abilities. Flexible and adaptable to a changing and digital-first work environment. What We Expect From You Own the end-to-end partner ecosystemidentify, vet, and empanel top-quality garages and surveyors. Lead commercial negotiations, define competitive rate cards and SLAs, and build strong, long-term partner relationships. Oversee the coordination between customers, surveyors, and garages, ensuring the team delivers a seamless and rapid claims process. Monitor key metrics (TAT, quality, cost) and drive service excellence Guide teams in negotiating repair costs with garages to minimize loss while upholding quality standards and partner relationships. Inside Navi We are shaping the future of financial services for a billion Indians through products that are simple, accessible, and affordable. From Personal & Home Loans to UPI, Insurance, Mutual Funds, and Gold we’re building tech-first solutions that work at scale, with a strong customer-first approach. Founded by Sachin Bansal & Ankit Agarwal in 2018, we are one of India’s fastest-growing financial services organisations. But we’re just getting started! Our Culture The Navi DNA Ambition. Perseverance. Self-awareness. Ownership. Integrity. We’re looking for people who dream big when it comes to innovation. At Navi, you’ll be empowered with the right mechanisms to work in a dynamic team that builds and improves innovative solutions. If you’re driven to deliver real value to customers, no matter the challenge, this is the place for you. We chase excellence by uplifting each other—and that starts with every one of us. Why You'll Thrive at Navi At Navi, it’s about how you think, build, and grow. You’ll thrive here if: You’re impact-driven You take ownership, build boldly, and care about making a real difference. You strive for excellence Good isn’t good enough. You bring focus, precision, and a passion for quality. You embrace change You adapt quickly, move fast, and always put the customer first.

About the Team The Motor Claims team is a critical function within our Insurance Business team, dedicated to providing efficient and customer-centric claims services for all motor insurance policyholders. About the Role As a Senior Executive, you will play a critical role in ensuring a smooth, fast, and fair claims experience for our customers. You will be responsible for the end-to-end management of motor own-damage (OD) claims, serving as the primary point of contact for customers and service partners. Must Haves Experience: At least 3 years of hands-on experience in Motor Own-Damage (OD) claims survey/assessment. Technical Skills: Strong understanding of vehicle mechanics, automobile parts, repair processes, vehicle damage assessment, and repair cost estimation. Communication Excellence: Good command of written and spoken English and Hindi. Multilingual ability is an added advantage. Soft Skills: Excellent analytical and problem-solving abilities. Flexible and adaptable to a changing and digital-first work environment. Strong interpersonal and negotiation skills. What We Expect From You Own end-to-end motor claim decisionsdecide claims based on policy, technical evaluation, and evidence. Review surveyor reports, validate estimates, and ensure cost-effective repair vs. replacement. Leverage digital tools for assessment and settlement, and communicate outcomes clearly and empathetically to customers. Ensure smooth coordination between customers, surveyors, and garages. Negotiate repair costs to control losses while maintaining quality. Handle stakeholder communication, ensuring timely updates and resolution within TAT. Support network expansion by identifying and vetting quality garages and surveyors. Assist in site visits, documentation, and feedback for empanelment decisions. Inside Navi We are shaping the future of financial services for a billion Indians through products that are simple, accessible, and affordable. From Personal & Home Loans to UPI, Insurance, Mutual Funds, and Gold were building tech-first solutions that work at scale, with a strong customer-first approach. Founded by Sachin Bansal & Ankit Agarwal in 2018, we are one of Indias fastest-growing financial services organisations. But we’re just getting started! Our Culture The Navi DNA Ambition. Perseverance. Self-awareness. Ownership. Integrity. We’re looking for people who dream big when it comes to innovation. At Navi, you’ll be empowered with the right mechanisms to work in a dynamic team that builds and improves innovative solutions. If you’re driven to deliver real value to customers, no matter the challenge, this is the place for you. We chase excellence by uplifting each other—and that starts with every one of us. Why You'll Thrive at Navi At Navi, it’s about how you think, build, and grow. You’ll thrive here if: You’re impact-driven You take ownership, build boldly, and care about making a real difference. You strive for excellence Good isn’t good enough. You bring focus, precision, and a passion for quality. You embrace change You adapt quickly, move fast, and always put the customer first.

We are looking for a highly skilled and experienced PDI Associate to join our team at Ekya Schools. The ideal candidate will have 2-5 years of experience in the field. Roles and Responsibility Collaborate with cross-functional teams to design and implement effective learning solutions. Develop and maintain high-quality educational content and materials. Provide training and support to teachers and staff on new technologies and methodologies. Evaluate student progress and provide feedback to improve outcomes. Participate in professional development opportunities to stay current with best practices. Foster positive relationships with students, parents, and community members. Job Requirements Strong understanding of IT Services & Consulting industry trends and technologies. Excellent communication and interpersonal skills. Ability to work effectively in a fast-paced environment and prioritize tasks. Strong problem-solving and analytical skills. Experience with project management tools and techniques. Familiarity with educational software and technology platforms. A graduate degree is required for this position. About Company Ekya Schools is a leading provider of innovative education solutions, committed to delivering high-quality education experiences to students. We focus on creating engaging and interactive learning environments that promote student growth and development.

Company: Marsh Description: Ensures timely and accurate production/processing of complex documents/information (includes report preparation) Maintains a basic understanding of the core aspects of relevant Insurance and related legislation (customer awareness) and strengthen established relationships Adheres to Company policies and performance standards Contributes to the achievement of Operations team Service Level Agreements (SLA) , Key Performance Indicators (KPI) and business objectives Marsh, a business of Marsh McLennan (NYSE: MMC), is the world s top insurance broker and risk advisor. Marsh McLennan is a global leader in risk, strategy and people, advising clients in 130 countries across four businesses: Marsh, Guy Carpenter, Mercer and Oliver Wyman. With annual revenue of $24 billion and more than 90,000 colleagues, Marsh McLennan helps build the confidence to thrive through the power of perspective. For more information, visit marsh.com, or follow on LinkedIn and X.

Desired Candidate profile Good communication skills Fresh Nursing Graduates Analyze and process US medical claims and billing records Basic computer literacy Flexible with shift timings Benefits

We are looking for a skilled Payment Posting and Charge Entry - Rcm Executive to join our team at Prodat IT Solutions, with 1-6 years of experience in the field. Roles and Responsibility Manage payment posting and charge entry processes for accurate and timely payments. Coordinate with clients and internal teams to resolve payment-related issues. Develop and implement process improvements to increase efficiency and reduce errors. Analyze data to identify trends and areas for improvement in payment posting and charge entry. Collaborate with cross-functional teams to achieve business objectives. Ensure compliance with company policies and procedures. Job Requirements Strong knowledge of payment posting and charge entry processes. Experience working with RCM systems is required. Excellent analytical and problem-solving skills. Ability to work effectively in a team environment. Strong communication and interpersonal skills. Familiarity with industry standards and regulations.

" Healthcare,Agile,Business Analysis,Requirement Gathering ","description":" Engage with stakeholders to understand, document, and clarify business requirements and user needs. Analyze and prioritize business problems based on customer input and impact. Conduct requirements analysis and management , driving clarity and completeness across the project lifecycle. Prepare detailed User Stories with clear Acceptance Criteria aligned with Agile methodology. Propose and evaluate solutions, identifying pros and cons to aid in decision-making. Serve as the primary liaison between business users and technical teams , including developers and QA. Maintain and manage JIRA for tracking and updating requirements. Provide ongoing clarification and support to development and QA teams throughout the SDLC. Assist QA teams in User Acceptance Testing (UAT) by providing business context and reviewing test cases. Identify and document functional and non-functional requirements . Conduct walkthroughs and presentations to internal\/external stakeholders. Track and manage requirement changes and ensure alignment with project goals. Create and maintain Business Process Documentation . Required Skills and Qualifications: Bachelordegree in any discipline; Masterdegree in a related field is a plus. 9+ years of experience as a Business Analyst with strong emphasis on Healthcare domain projects. 10+ years of total industry experience in IT or Business Consulting. Strong knowledge of Healthcare processes , regulations, claims processing, and standards (e.g., HIPAA, EDI). Hands-on experience with tools like JIRA, Confluence , and other Agile lifecycle tools. Excellent written and verbal communication skills and interpersonal skills. Proven expertise in eliciting and documenting requirements , conducting gap analysis, and managing stakeholders. Ability to drive collaboration across business and IT teams . Prior experience working in Agile\/Scrum environments . Preferred Skills: Familiarity with HealthEdge platform and ability to map features to business needs. Experience in payer systems , including claims processing, eligibility, provider management, etc. Exposure to cloud-based healthcare solutions is a plus. ","

Looking for a skilled professional with 5-8 years of experience to lead our delivery team in Chennai. The ideal candidate will have a strong background in healthcare management services and excellent leadership skills. Roles and Responsibility Lead the delivery team to ensure successful project execution and client satisfaction. Develop and implement effective project plans, resource allocation, and risk management strategies. Collaborate with cross-functional teams to identify and prioritize project requirements. Provide guidance and mentorship to team members to enhance their skills and performance. Monitor and report on project progress, identifying areas for improvement and implementing corrective actions. Ensure compliance with company policies, procedures, and industry standards. Job Minimum 5 years of experience in healthcare management services or a related field. Strong knowledge of healthcare operations, including medical billing, claims processing, and patient care coordination. Excellent leadership, communication, and problem-solving skills. Ability to work in a fast-paced environment and adapt to changing priorities. Strong analytical and decision-making skills, with attention to detail and accuracy. Experience with CRM/IT enabled services/BPO is an added advantage.

Looking to onboard a highly motivated and detail-oriented AR Associate with 0-1 years of experience to join our team in Bengaluru. The ideal candidate will have excellent communication skills and the ability to work effectively in a fast-paced environment. Roles and Responsibility Manage accounts receivable, including processing payments and resolving billing issues. Coordinate with clients to ensure timely payment and resolve any discrepancies. Maintain accurate records of all transactions and reports. Collaborate with internal teams to resolve account-related issues. Develop and implement effective strategies to improve cash flow. Analyze data to identify trends and areas for improvement. Job Strong understanding of accounting principles and practices. Excellent communication and interpersonal skills. Ability to work effectively in a team environment. Proficient in using computer software applications. Strong analytical and problem-solving skills. Ability to meet deadlines and work under pressure. Experience working in a CRM/IT Enabled Services/BPO industry is preferred. Omega Healthcare Management Services Private Limited is a leading healthcare management services company committed to providing high-quality patient care and services to its clients. We are a dynamic and growing company with a strong presence in the healthcare industry.

Cashless Executive, TPA Executive, Insurance Executive Responsibilities: Patient Eligibility Verification: Claim Processing: Pre-authorization and Approvals: Coordination: Status Tracking and Follow-up: Cashless Admission Facilitation:

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