3165 Claims Processing Jobs - Page 48

Greetings from Niva Bupa! Job Location- Noida Sector-59 Department- Customer Servicing 6 Days working Must be a BPT graduate. JOB SUMMARY: Answering customer who are disputing over claim rejection or claim related query, also able to provide relevant information to the customer, floor support for team for any query related medical documents, Walk-in customer for claims. KEY RESPONSIBILITIES: Handling of claim rejections/ claim related query over calls and emails Floor support Walk-in customers Interested candidate can share their CV on 7430802568 or consultant.anjalijha@nivabupa.com with a subject "CV for Claim Adjuticator"

About Client Hiring for One of the Most Prestigious Multinational Corporations! Job Description Job Title : Guidewire Policy Center Integration Developer Qualification : BE / B.Tech / Engineering Relevant Experience : 5+ Years Must Have Skills : Languages & Frameworks : Gosu, Java/J2EE, .NET (optional) Data Formats : XML, JSON Integration Tools : SOAP/REST web services, Guidewire Messaging, Event Messaging Database Knowledge : SQL Guidewire Expertise : Edge APIs, PCFs (Page Configuration Files), Rating Engine, Rules Framework Good to Have Skills : • Strong understanding of Property & Casualty insurance lifecycle • Experience working in Agile/Scrum environments • Excellent communication and p...

Job Title: TPA Manager Location: Miri Piri Institute of Medical Science & Research, Shahabad Markanda, Kurukshetra (Haryana) Hospital Strength: 420+ bedded upcoming super-specialty hospital & upcoming medical college (100 MBBS seats) Position Overview We are seeking an experienced and detail-oriented TPA Manager to lead and manage all Third-Party Administrator (TPA), insurance, CGHS, ECHS, and Ayushman cases. The role involves overseeing pre-authorization, billing, claims settlement, and ensuring smooth coordination between patients, TPAs, and hospital departments while maintaining compliance and accuracy. Key Responsibilities Handle end-to-end TPA, Insurance, Ayushman, CGHS, and ECHS cases....

Location: Ahmedabad (On-Site) Shift Timing: US Shift Working Days: 5 Days Working Salary - Freshers: 20,000K CTC/month Medical Billing / Dental Billing / RCM Process Benefits:- 1) Retention Bonus: 25,000K

Mega Walk-in Drive US Healthcare (Claims Adjudication) Date: 19th & 20th September 2025 Time: 11:30 AM 4:00 PM Venue: Sagility, KCT Tech Park, Thudiyalur Rd, Saravanampatti, Coimbatore, Tamil Nadu 641049 We Are Hiring Experienced Professionals! Join our growing team in US Healthcare Claims Adjudication Minimum Requirement 3.6+ years of experience in US Healthcare (Claims Processing & Adjudication) Additional Opportunities in Sagility : We have openings for WFM & Training functions Also for Internal Contact Center Operations (Inbound calls) Open Positions Team Leader Operations Quality Specialist Subject Matter Expert (SME) Process Trainer Quality Team Leader Assistant Manager Operations Depu...

Role & responsibilities We are looking for an accomplished Doctors with significant ICU experience and a strong ability to manage both clinical and non-clinical responsibilities. The ideal candidate will excel in patient care, clinical documentation, and possess in-depth knowledge of medical documentation essential for insurance claims processing. Key Responsibilities: Patient Documentation: Manage patient medical history and progress notes with precision. Claims Processing: Handle preauthorization and reimbursement claims, including validation and processing. Clinical Records: Maintain accurate clinical documentation in compliance with healthcare standards. Collaboration: Work closely with ...

Assistant Manager / Deputy Manager - Claims -2+ Years - Pune Are you a highly motivated claims professional looking to make an impact in the insurance industry? We are seeking an experienced Assistant Manager / Deputy Manager - Claims with over 2 years of expertise in managing and processing claims. This is your chance to work in a role where you can bring value, drive process improvements, and enhance customer satisfaction. If you are ready to embark on an exciting journey of professional growth, this is the perfect opportunity for you! Location:- Pune Your Future Employer A leading organization in the insurance domain, known for its dynamic work environment and commitment to professional e...

Bpo Hiring For Health Care Domain Voice Process 6.5 LPA Location Gurugram Only Graduates. No B.E./Btech/UG''s Minimum 1 Year of Voice Experience With International BpO MUST Pls Cal Dipankar @ 9650094552 Email CV @ jobsatsmartsource@gmail.com

Greetings from The Job Factory !! Job Summary: We are seeking highly motivated and enthusiastic undergraduate or graduate freshers/ experience to join our team as International Process Associates. The successful candidates will work on international processes, providing exceptional service to our global clients. **Only immediate joiners with Graduates and Undergraduates can apply** **Only candidates who have excellent communication can apply** For More Details Call : HR smitha @ 9880964847 (Call or Whatsapp) Email id : smitha@thejobfactory.co.in Role & Responsibilities: 1. Handle customer inquiries and resolve issues via phone, email, or chat 2. Provide product information and support to cus...

We are hiring Part-time / Freelance Field Executives – Insurance Investigation for Bihar Locations: Begusarai, Bhagalpur, Bihar Sharif, Darbhanga, Gaya, Madhubani, Muzaffarpur, Nawada, Purnia Required Candidate profile Visit places to check insurance claims. Collect and write down information clearly. Talk to patients, hospital staff, and others. Make sure the claim details are true and correct.

About Client Hiring for One of the Most Prestigious Multinational Corporations! Job Description Job Title : Guidewire Policy Center Integration Developer Qualification : BE / B.Tech / Engineering Relevant Experience : 5+ Years Must Have Skills : Languages & Frameworks : Gosu, Java/J2EE, .NET (optional) Data Formats : XML, JSON Integration Tools : SOAP/REST web services, Guidewire Messaging, Event Messaging Database Knowledge : SQL Guidewire Expertise : Edge APIs, PCFs (Page Configuration Files), Rating Engine, Rules Framework Good to Have Skills : • Strong understanding of Property & Casualty insurance lifecycle • Experience working in Agile/Scrum environments • Excellent communication and p...

Positions General Duties and Tasks: Process Insurance Claims timely and qualitatively Meet & Exceed Production, Productivity and Quality goals Review medical documents, policy documents, policy history, Claims history, system notes and apply the trained client level business rules to make appropriate Claims decisions, call out claims trends and flag fraud activities Analyze customer queries to provide timely response that are detailed and ordered in logical sequencing Cognitive Skills include language, basic math skills, reasoning ability with excellent written and verbal communication skills Stay up to date on new policies, processes, and procedures impacting the outcome of Claims processin...

Positions General Duties and Tasks: Process Insurance Claims timely and qualitativelyMeet & Exceed Production, Productivity and Quality goals Review medical documents, policy documents, policy history, Claims history, system notes and apply the trained client level business rules to make appropriate Claims decisions, call out claims trends and flag fraud activities Stay up to date on new policies, processes, and procedures impacting the outcome of Claims processing Be a team player and work seamlessly with other team members on meeting customer goals Requirements for this role include: Both Under Graduates and Post Graduates can apply. Excellent communication (verbal and written) and custome...

Checks for completeness and appropriateness of source data. Involved in fact finding, information search and data gathering. Verifies and compiles data. Identifies and resolves routine and recurring problems. Skills Required Ability to analyze and process transactions based on rules. Able to integrate knowledge as a skilled specialist. Possess strong domain knowledge in Healthcare and Insurance domain.

Roles and Responsibilities: 2-3 years of experience in processing claims adjudication and adjustment process Experience in professional (HCFA) and institutional (UB) claims Knowledge in handling authorization, COB, duplicate and pricing 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 Audit claims as outlined by Policies and Procedures. Utilize appropriate system-generated reports applicable for specialty claims. Document, track findings per organizational guidelines for reporting purpose. Based upon trends, determine ongoing Claims E...

Role - Reinsurance Exp - 2 to 4 years Salary - upto 6LPA Location - Bangalore Experience in Reinsurance is mandatory(Only International experience) Medium to High back office transactions, Complex transactions and MIS operations Gopinath 9150989283

We are hiring Part-time / Freelance Field Executives (Verifiers) for – Bihar Locations: Begusarai, Bhagalpur, Bihar Sharif, Darbhanga, Gaya, Madhubani, Muzaffarpur, Nawada, Purnia Flexible hours | Attractive payout per visit Must have 2-wheeler phone Required Candidate profile Interested candidates send your resume at hr1@gravityintegrates.in with subject line “Application for Field Executive – [City Name]”

TATA AIG General Insurance Company Limited is looking for Deputy Manager - Health Claims to join our dynamic team and embark on a rewarding career journey Assist the Manager in the day-to-day operations of the business, including setting goals, developing strategies, and overseeing the work of team members Take on leadership responsibilities as needed, including managing team members and making decisions in the absence of the Manager Identify and address problems or challenges within the business, and develop and implement solutions Collaborate with other departments and teams to ensure smooth and efficient operations Maintain accurate records and documentation Contribute to the development ...

TATA AIG General Insurance Company Limited is looking for Senior Manager - Health Claims to join our dynamic team and embark on a rewarding career journey Analysis for the current business practice. Find out the different operational strategies. Work on developing the current operational strategy applied to the company with the most recent technology. Coordinate with the operations manager to take the required steps after brainstorming and research. Optimize the operations in the company. Put the suitable operational strategy to fit with the companys culture. Implement the operational strategy in the different departments of the company. Supervise the strategy, and make sure that all the emp...

Retail Claims - Automation ProjectsKey Responsibilities1. Automate Claims Processes- Design anddevelop automated workflows and business rules to streamline claims processing. 2. Integrate with Existing Systems- Integrateautomated claims processing solutions with existing systems and technologies. 3. Testing and UAT - Test and validateautomated claims processing solutions to ensure accuracy and efficiency. 4. Daily production issue - Troubleshootissues and resolve problems related any day-to-day production issues across allclaim systems for death and health claims5. Collaborate with IT stakeholders, claim team and other requiredstakeholders to understand requirements and implement solutions6....

Managing Deduction claims and Invoice claims processing in SAP TPM Assist with promotional event enrolments / claim approvals. Ensure all customer contract legends are current to provide Trade Promotion Analyst guidance. Maintain a strong control environment with accurate trade accruals, contract approvals and verification. Manage exception through verbal and written interactions with Sales and Sales Finance. Responsibilities Managing Deduction claims and Invoice claims processing in SAP TPM Assist with promotional event enrolments / claim approvals. Ensure all customer contract legends are current to provide Trade Promotion Analyst guidance. Maintain a strong control environment with accura...

SUMMARY Job Title: P&C Insurance Team Lead Location: Noida Experience: 7+ years in claim processing Requirements Requirements: Graduate or Post graduate with 7+ years of experience Experience in dealing with international clients (Preferred) Must have Property and Casualty (P&C) Insurance experience Should have claims adjudication and adjusting experience Experience in end-to-end claims processing Minimum 2 years of experience in a team handling role Preferably CPCU or equivalent insurance designation Position Summary: The job holder will be responsible for managing a team and overseeing all relevant technical/operational processing activities. This role also involves providing direct assist...

Role Objective: Follow up is the most essential part in the RCM cycle. It is usually the last step in the cycle after cash posting. After Denial management (AR Follow up), again the cycle starts till the payment is made by the insurance company. Essential Duties and Responsibilities: Establishes and assures compliance with departmental policies and procedures in conformance with corporate policies and procedures.Manages people and drives retention. Analysis data to identify process gaps, prepare reports.Performance managementFirst level of escalationWork in all shifts on a rotational basisNeed to be cost efficient with regards to processes, resource utilization and overall constant cost mana...

Medcare Hospitals Medical Centres is looking for Senior Executive.Revenue Cycle Management to join our dynamic team and embark on a rewarding career journey Leading the full audit cycle by checking tax compliance, verifying financial records, and inspecting accounts. Analyzing the results of the audit and presenting possible solutions for ineffective financial practices to management. Evaluating company accounting procedures, payroll, inventory, and tax statements to guide financial policymaking. Conducting risk assessments to recommend aversion measures and cost savings. Following up with management to ensure remediations are implemented into the company's financial practices. Supervising j...

Medcare Hospitals Medical Centres is looking for Associate to join our dynamic team and embark on a rewarding career journey 1 Customer service: Associates in Insurance serve as the primary point of contact for customers, providing them with information about policies, handling claims and addressing any concerns or issues they may have 2 Risk assessment and analysis: They help assess risks associated with insuring different clients, analyze data and make recommendations to senior-level professionals 3 Claims processing: Associates in Insurance handle claims processing, by gathering information, reviewing policies, assessing damage and negotiating settlements 4 Compliance: They help ensure th...