2030 Claims Processing Jobs - Page 37

Dear Candidate, Greetings from AGS Health! Job Title: Process Associate/Sr Process Associate Job Role: Responsible for calling US Insurance companies on behalf of doctors/physicians and following up on outstanding Accounts Receivable. Should have basic knowledge of the entire RCM (Revenue Cycle Management) Perform analysis of accounts receivable data and understand the reasons for pending claims in AR and the top denial reasons Process : International Voice process - AR Calling Qualification: Any Graduate Interview Process: Rounds off interviews: 1. HR screening 2. Online Assessment Test 3. Operational/Technical Round Shift Timing: 5.00 PM to 2.00 AM or 07:00 PM to 4:00 AM Night Shift (US Shift) - Should be flexible for both shifts. Transport: Two-way transport is available based on boundary limits. Location: Western Pearl, Kothaguda, Kondapur, Hyderabad Job Type: Full-time, Regular / Permanent Benefits: 5 days work Work from the Office PF ESI Health insurance Performance bonus Required Skills: Minimum 1 year of experience in AR calling Calling experience on Denial Management - Physician Billing Should be comfortable working with Night shifts Good Communication skills Looking for an aspirant who can join us immediately. Note: Immediate joiners preferred. Address - 9th Floor, Western Pearl Building, Survey No. 13, Kondapur, Kothaguda, Hyderabad, Telangana 500084 Regards Bhaviri

Review the claim allocated and check status by calling the payer or through IVRWeb Portal Ask a series of relevant questions depending on the issue with the claim and record the responses Prepare call notes, initiate or execute the corrective measures by sending necessary documents to Payers Record the actions and post the notes on the clients revenue cycle platform Us e appropriate client specific call note standards for documentation Adhere to Companys information, HIPAA and security guidelines Be in the center of ethical behavior and never on the sidelines Job Profile: Should have worked as an AR Caller for at least 2 years to 4 years with medical billing service providers Good knowledge of Revenue Cycle and Denial Management concept Positive attitude to solve problems Ability to absorb clients business rules Strong communication skills with a neutral accent Graduate degree in any field Note- Immediate Joiners preferred. Schedule: Night shift Experience: AR Caller: 1 year (Preferred)

We are hiring for a Senior Process Associate in Insurance Claims with 37 years of relevant experience. This is an excellent opportunity to join a reputed financial services firm and play a key role in managing claims, ensuring operational accuracy, and supporting risk management initiatives. Your Future Employer - A globally respected organization in the financial services space, known for its strong commitment to process excellence, innovation, and employee growth. Responsibilities - Manage end-to-end claims processes within the insurance domain Demonstrate strong understanding of banking and insurance services Communicate clearly and effectively with internal and external stakeholders Perform risk management activities and support insurance programs Execute reconciliation tasks and ensure accurate documentation Prioritize tasks and meet deadlines in a fast-paced environment Collaborate with product and process experts to stay updated on workflows Requirements - 3-7 years of relevant experience in insurance claims Any graduate (Finance qualification preferred) Excellent written and verbal communication skills Proficiency in Microsoft Excel Comfortable working in a 6 PM - 3 AM shift (Hybrid work model, Pune) What is in it for you - A hybrid work environment providing flexibility and structure Opportunity to be a part of a high-performing, growth-focused team Exposure to end-to-end insurance operations with a global client base Continuous learning and career advancement in a leading firm Reach us: If you think this role aligns with your career aspirations, kindly send your updated CV to vasu.joshi@crescendogroup.in for a confidential discussion on the opportunity. Disclaimer: Crescendo Global specializes in Senior to C-level niche recruitment. We are passionate about empowering job seekers and employers with an engaging, memorable job search and leadership hiring experience. Crescendo Global does not discriminate based on race, religion, color, origin, gender, sexual orientation, age, marital status, veteran status, or disability status. Note: Due to the high volume of applications, if you do not hear back within 1 week, please assume your profile was not shortlisted. Your patience is appreciated. Scam Alert: Crescendo Global never asks for money, purchases, or system upgrades. Verify all opportunities at www.crescendo-global.com and report any fraud immediately. Stay alert! Profile Keywords - Claims Management Jobs, Insurance Jobs, Finance Operations, Reconciliation, Claims Analyst, Risk Management, Hybrid Jobs Pune, Excel Insurance Jobs, SPA Jobs Pune, Insurance Claims Processing, Banking and Insurance Careers.

As an Insurance Portfolio Manager, your primary responsibility will be to oversee all types of insurance policies within the company. Your key tasks will involve ensuring adequate risk coverage at optimal costs, efficient claims management, and timely renewal of insurance policies. It will be crucial for you to procure various insurance policies with sufficient coverage at the best possible cost, meeting internal customer expectations for deliverables in terms of time, cost, and service quality aligned with business objectives. You should possess a high level of proficiency in managing insurance claims, particularly PDBI claims, and demonstrate a strong technical knowledge of insurance products, coverage features, and claims processes. Your role will also involve coordinating with cross-functional teams, both internally and externally, including the Company, Subsidiaries, insurers, and surveyors. Implementing best practices in accordance with the company's guidelines will be essential, as well as ensuring compliance with various processes through internal and external audits. Additionally, you will be responsible for obtaining and compiling relevant information from different departments on insurance requirements, understanding various risks, suggesting appropriate clauses or wordings in insurance policies to mitigate risks, and securing the desired insurance coverage. Monitoring and reviewing the performance of insurers and TPAs to ensure prompt settlement of insurance claims within specified time frames will be part of your duties. Promptly addressing queries and concerns related to insurance matters and conducting knowledge-sharing sessions with colleagues from other departments on important insurance policies and the claims process will also be expected from you. To be eligible for this role, you should hold a degree as a Graduate with Associate or Fellow from the Insurance Institute of India, or an MBA/PGDBA with insurance specialization, or a BE with additional qualifications specialized in insurance.,

Batch date - Immediate joining Requirement - HSC with mandatory 6 month experience on paper/ grad fresher Nature Of Job - Voice Salary up to 17-18k in hand 24*7 Shifts in training and (2 rotational week offs) One time home drop facility Required Candidate profile • Transport Boundaries Kalyan - Sion GTB - Seawoods Bandra - Borivali • Interview Rounds: HR, Amcat, Typing and Ops

Job Title: Guidewire ClaimCenter / ContactManager Developer Locations: Hyderabad | Chennai | Bangalore | Pune | Jaipur | Gurugram | Bhopal Company: Xebia Work Mode: Hybrid (3 days/week from office) Relocation: Willingness to relocate to Sweden after 6 months (Client On-site) Join: Immediate joiners or candidates with 15 days' notice Job Description Xebia is hiring skilled Guidewire CC/CM Developers to join our growing delivery teams working on enterprise-scale insurance solutions. Youll contribute to the design, development, and seamless integration of ClaimCenter and ContactManager while preparing for on-site client engagement in Sweden after 6 months. Key Responsibilities Work within a large, collaborative Guidewire ClaimCenter / ContactManager team. Design and implement scalable, maintainable, and robust insurance claims features . Develop and integrate with REST/SOAP messaging , ensuring platform stability. Participate in CI/CD practices and promote DevOps excellence . Collaborate within agile teams to ensure quality delivery across the SDLC. Your Profile 3+ years of experience in Guidewire ClaimCenter (CC) . Familiarity with ContactManager (CM) and its CC integration. 2+ years of hands-on GOSU development . Strong experience in messaging and integration (REST/SOAP) . Proficiency with version control systems and agile methodologies . Practical experience with DevOps and CI/CD for Guidewire platforms. Agile team player with strong communication skills (English B2C1 level). Willingness to relocate to Sweden after 6 months. Nice to Have Knowledge of Guidewire PolicyCenter . Familiarity with ACE or configuration best practices. Experience in data migration and archival . Background in Java development . How to Apply Immediate Joiners (or 15 Days' Notice) Only Please share your resume with the following details to vijay.s@xebia.com : Full Name: Total Experience: Current CTC: Expected CTC: Current Location: Preferred Xebia Location (Hyd/Chennai/Blr/Pune/Jaipur/Gurugram/Bhopal): Notice Period / Last Working Day (if serving): Primary Skills: LinkedIn Profile: Join Xebia to work on transformative Guidewire implementations, and take your career global with a potential Sweden relocation opportunity . Hybrid Work | Global Project Experience | Agile Teams | Career Mobility #XebiaHiring #GuidewireJobs #ClaimCenter #ContactManager #GuidewireDeveloper #SwedenOpportunity #HybridJobs #ImmediateJoiners

• Check the medical admissibility of a claim by confirming the diagnosis and treatment details. • Scrutinize the claims, as per the terms and conditions of the insurance policy • Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiation of open billing and package etc. • Understand the process difference between PA and an RI claim and verify the necessary details accordingly. • Verify the required documents for processing claims and raise an IR in case of an insufficiency. • Coordinate with the LCM team in case of higher billing and with the provider team in case of non- availability of tariff. • Approve or deny the claims as per the terms and conditions within the TAT. Interested candidate can share your resume to varsha.kumari@mediassist.in

Roles and Responsibilities Handle claims from receipt to settlement, ensuring timely and accurate processing. Verify claim documents, including medical records, bills, and reports. Coordinate with hospitals, doctors, and other stakeholders for necessary documentation. Conduct thorough investigations into complex cases to resolve disputes efficiently. Ensure compliance with regulatory requirements and company policies.

1. Conducting surveys in field and assessment of loss. 2. Coordinating with insured for claim documents & processing. 3. Monitor the process flow of allotted claims from registration to settlement. 4. Coordinating with repairer on settlement and payment reconciliation. 5. Building relationship with internal and external customer Education - Diploma, BE -Mechanical/Automobile

TPA - Claim Processing

Experience in BPO Industry- International Voice only Team Leader - Healthcare process voice (MUST) Medical billing AR Excellent Comms

About The Role Vault functionEnsure timely opening of vault and availability of cash to cash van officers.To ensure Proper cash dispensing branch wise with no errors. Adjudication of Notes as per RBI norms & Rules-Updation of bin register and card on time and ensuring proper signatures.-Managing cash inflows and out flows from chest vault and periodical balancing during the day. -Ensuring constant supply of ATM Counter issuable cash. Ensure enough fresh cash availability in all denominations.-To keep the vault clean of any un wanted stuff.Must have knowledge to pass notes as per RBI refund rules and to get full value during RBI inspections. -Proper scrutiny and upkeep of key registers and keys.Identify potential with other CC banks for offloading excess cash through diversion orders , maintain relationship with other banks & regulatorsSecurity and house keeping-To ensure 24 hours vigil in chest area by attentive guards.-Ensure proper checks and frisking by guard during movement in chest area.-To conduct surprise checks specially on holidays and nights to see guards on duty. -To ensure duty of one person to keep vigil in chest area all the time.Proper functioning of all security equipment and their regular checking and servicing. Maintaining CCTV Backups and recordings -To ensure proper upkeep and cleaning of all the areas in the chest.Audit-To ensure absolutely clean audit report with no adverse comments in any area.-Constant review of process and controls to ensure complete controls.-Timely submission of all demanded records to audit for scrutiny.-To keep good relation with them and timely resolution to the queries. -RBI audit has to be exceptionally good with no adverse remarks.Should have knowledge of RBI guidelines , procedure & controls for better cash management in the unit, and achieve good audit rating-To regularly check all areas especially critical ones from process as well as audit point of view.Floor Manager-To observe the sorting and counting activities.To observe the cash movements from the vault and vice versa.Stationery control-To keep optimum level of stationary required in chest.-To stop leakage in stationary use and device ways to reduce cost.

About The Role Vault functionEnsure timely opening of vault and availability of cash to cash van officers.To ensure Proper cash dispensing branch wise with no errors. Adjudication of Notes as per RBI norms & Rules-Updation of bin register and card on time and ensuring proper signatures. -Managing cash inflows and out flows from chest vault and periodical balancing during the day. -Ensuring constant supply of ATM Counter issuable cash. Ensure enough fresh cash availability in all denominations.-To keep the vault clean of any un wanted stuff.Must have knowledge to pass notes as per RBI refund rules and to get full value during RBI inspections. -Proper scrutiny and upkeep of key registers and keys.Identify potential with other CC banks for offloading excess cash through diversion orders , maintain relationship with other banks & regulatorsSecurity and house keeping-To ensure 24 hours vigil in chest area by attentive guards.-Ensure proper checks and frisking by guard during movement in chest area. -To conduct surprise checks specially on holidays and nights to see guards on duty.-To ensure duty of one person to keep vigil in chest area all the time.Proper functioning of all security equipment and their regular checking and servicing. Maintaining CCTV Backups and recordings -To ensure proper upkeep and cleaning of all the areas in the chest.Audit-To ensure absolutely clean audit report with no adverse comments in any area.-Constant review of process and controls to ensure complete controls.-Timely submission of all demanded records to audit for scrutiny. -To keep good relation with them and timely resolution to the queries.-RBI audit has to be exceptionally good with no adverse remarks.Should have knowledge of RBI guidelines , procedure & controls for better cash management in the unit, and achieve good audit rating -To regularly check all areas especially critical ones from process as well as audit point of view.Floor Manager-To observe the sorting and counting activities.To observe the cash movements from the vault and vice versa.Stationery control-To keep optimum level of stationary required in chest.-To stop leakage in stationary use and device ways to reduce cost.

Capgemini Capgemini location No constraintsBudget: OpenExperience 3 to 15 yearsSkills Guidewire Developer experience with any of the detailed skill like (Policy / Billing / Claims / Integration / Configuration / Insurance Now / Portal / Rating) Insurance domain knowledge with Property & Casualty background Hands on experience in at least one of the Guidewire products (Claim/Policy/Billing) Should have knowledge on Admin data loading. Good knowledge in Web services, XML, GxModel, Messaging, Batch implementation, Integrating with 3rd Party Systems and Document composition tools like Xpressions, Thunderhead Experience on any database Oracle / SQL Server and well versed in SQL Designed & modified existing workflows (required for Billing Integration) Experience in SCRUM Agile, prefer Certified Scrum Master (CSM) Good written and oral communication Excellent analytical skills.

Overview Roles & Responsibilities: 1) Candidates Should have worked in hospital Insurance desk 2) Provide Medical opinion for health Insurance claims 3) Processing of cashless requests & Health Insurance claims document 4) Proficient with medical terms & system 5) Understanding of policy terms & system. 6) Understanding of Claims adjudication/ Claims Processing Tagged as: insurance Before applying for this position you need to submit your online resume . Click the button below to continue. Related Jobs RELATIONSHIP OFFICER IN BANK Bank Jorhat Full Time 2024-01-19

Wipro hiring for Insurance US insurance profile in Kolkata location. We are hiring Any Under Graduate/Graduate fresher OR Experienced. Candidate must be comfortable with WORK FROM OFFICE. *Must BE* The candidate must have good verbal communication skills. The candidate must be staying or ready to relocate to Kolkata. As it is WORK FROM OFFICE. Roles and Responsibilities Candidate will take care of Insurance claims of International customers. Desired Candidate Profile Any Grad fresher- 3 Lakhs Experienced- 3 Lakh + Inc.+ Cabs Other Details- Fixed Shift time- US shifts Complete Inbound Voice Profile Cabs in odd hours only If you are meeting the above requirements. Then please please call our recruiter. Click on Apply NOW Tab Contact: Ravinder Singh Rawat

Summary: We at @Prudent Insurance Brokers, are seeking an experienced Employee Benefit-Claims Service Support professional for our International Business (IB) vertical. Employee Benefits Practice at Prudent is a strategic business unit dedicated to strengthening Prudents global brand in the international market. The individual will be responsible to Serve as primary point of contact for all employee claim queries etc. We are committed to delivering bespoke Benefit & Total Reward Solutions with high standards of service excellence, world-class advisory and consultancy support for MNC clients who have their operations in India. Our team forms a bridge of trust between the expectations of senior stakeholders globally and the seamless delivery of these best practices in India. Roles & Responsibilities: • 1) Exceptional Employee Experience Support system by Prudent Serve as primary point of contact for all employee claim queries and own the process of developing strong employee relationships & engagement 2) Facilitating the cashless and reimbursement process: Ensuring employees understand the steps involved in both cashless and reimbursement claims. Offering exceptional support and guidance to employees/HR throughout the entire process to ensure a smooth experience. 3) E-cards/network hospitals: To provide employees e-cards and information about network hospitals. 4) Providing claim-related queries: Addressing questions about claim status, claim deductions, and explanations of queries. 5) TPA Co-ordination: Co-ordinating with TPA daily to ensure the smooth functioning of employee-related queries 6) Employee Engagement & Support SPOC: Daily tracking of claims on status/rejections/deductions and providing the report to MCS Desired profile/who should join: Good listening & communication skills Should have good technical knowledge about Employee health Insurance/ General Insurance products. (Cashless/Reimbursements) Experience in General Insurance/ Insurance Brokers Years of experience: 2 to 5 years Education qualification: Bachelor's Degree, Master's Degree Good knowledge of the TPA/Insurance processes Well-versed in health insurance policy conditions Well-versed with current medical practices & advancements Should know about IRDAI health regulation

We are hiring for Medical Billing/AR Caller/payment posting/authorisation for one of the client! Location: Iskcon Cross Road, Ahmedabad Shift timings: 5 days, 6.30 PM to 3.30 AM If interested share your resume to HR LARA: 7283 825 024!

Claims Executive Responsibilities: Receiving and answering emails, telephone calls related to claims Advice policyholders on claim procedure Ensure fair settlement of a claim with TAT Manage all administration aspects of the claim Adhere to legal requirements, industry regulations and customer quality standards set by the company. Handle any complaints associated with a claim Claims Executive Requirements: A bachelor's degree in any discipline. At least 2-4 years' experience as a claims handler or a similar role. Excellent time management skills and organizational abilities. Top-notch client interaction skills. Ability to work in a high-pressure environment. A general understanding of insurance terminology and abbreviations. Attention to detail and process-orientated thinking. The ability to work independently and multitask. Proficient in basic computer handling.

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

Greetings From starworth ! Urgent Opening for AR Caller/SR AR Caller -Medical Billing-Voice Process Job Loc: Chennai, Trichy, Bangalore, Pune, Hyderabad Exp:1yr-5yrs Salary:40k Max Skills: Any Billing ,Denials NP: Immediate Joiner IF INTERESTED CALL: 7010527243 REGARDS; HR Priya

We are looking for an experienced CGHS Billing Executive with a minimum of 2 years of experience in hospital billing, specifically handling CGHS (Central Government Health Scheme) processes.

Job Title: Sr Manager Health Insurance Claims Location: Bangalore (Hybrid) Company: Pazcare Type: Full-time About Pazcare Pazcare is transforming employee healthcare and wellness for 2000+ companies including Mamaearth, Chaayos, Mindtickle, and more. We simplify health insurance and wellness benefits, giving HR teams superpowers through real-time claim tracking, analytics, and stellar employee experiences. Role Overview As a Claims Manager, you will be the frontline owner of ensuring claims are settled within the agreed turnaround time (TAT) across TPAs. You will play a critical role in driving TPA performance, resolving escalations, and advocating on behalf of our clients to ensure no valid claim is wrongly repudiated. Key Responsibilities Ensure all reimbursement and cashless claims are processed within the committed TAT across clients. Track, analyze, and manage TAT performance of multiple TPAs; escalate and hold them accountable for delays or service gaps. Reopen wrongly repudiated claims with TPAs/insurers and fight for fair resolution on behalf of clients. Collaborate closely with the customer success and insurance teams to address claim escalations proactively. Drive continuous process improvement in claims handling and communication workflows. Maintain internal dashboards and reports to track SLAs and spot trends. Requirements 3+ years of experience in health insurance claims (TPA/insurance broker/insurer preferred). Strong understanding of reimbursement, cashless claim processes, and IRDAI guidelines. Assertive communicator with negotiation skills to handle TPAs and insurers. Analytical mindset with ability to identify patterns in delays or rejections. Empathy for the end user the employee or HR dealing with a health issue. Why Join Pazcare? Work with a mission-driven, fast-growing team redefining how India experiences employee health benefits. Ownership of high-impact outcomes and the opportunity to shape the future of claims at scale. Be part of a culture that values transparency, speed, and customer-first thinking.

Hiring for AR Caller #Graduate fresher #Fluent in English #Both side cab facility #Voice process #Us shift #5 Days working #Location: Prahlad Nagar

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.