702 Claims Processing Jobs - Page 6

Role Name :North America - Finex Claims Shift Time : 6.30 pm to 3.30 am - evening shift Work mode: Hybrid Work Location: Vikhroli Experience required: 1 - 4 years Qualification: Graduation Interview Venue: WTW iTHINK Techno Campus, 7th Floor, A&B Wing, Off Pokhran Road No. 2, Close to Eastern Express Highway, Thane (West) 400 607. India (Candidate's Address should fall withing WTW's transport boundary).

Job Description: To approve claim payment file To check claim technically and provide approval To assess the claim technically and have control on Average claim Size To provide technical inputs if any to the Zone

Legal officer has to deal & coordinate with Advocates appointed by company in these maters - Investigator for IR Internal communication & processing claims with approval team Mandatory Skills: Expert in Legal related activities Desirable Skills: 1.Good communication skills. 2.Flexible & adaptable to change. 3.Well versed with MS Office. 4.Should have good analytical and problem-solving skills. 5.Should be aware of the Local language. Education/Qualification: LLB; LLM

Job Summary: We are looking for a dynamic and experienced Manager Employee Benefits to join our team in Bangalore. The ideal candidate will have strong experience in employee benefits program management, relationship management, data analytics, and coordination with insurers and TPAs. Prior experience in a brokerage firm will be an added advantage. Key Responsibilities: 1. Client Relationship & Account Management: Act as the primary point of contact for assigned corporate clients. Build and maintain strong relationships with HR and employee stakeholders. Conduct regular review meetings with clients to understand needs, resolve issues, and offer strategic advice. Support renewals and policy upgrades through proactive communication and data insights. 2. Employee Communication & Support: Address employee queries and provide resolution related to group insurance policies, claims, endorsements, and benefit structure. Conduct employee awareness sessions on policies and claims processes. Manage escalations effectively and ensure timely resolution. 3. Insurance Operations & Coordination: Liaise with insurers and TPAs for smooth issuance, endorsements, claims processing, and reconciliation. Ensure timely policy endorsements, addition/deletion of members, and coverage changes. Track claims and coordinate for claim settlements and documentation. 4. Data Management & Reporting: Prepare and manage CD (Claim Details) statements, endorsement summaries, claim trackers, and MIS reports. Create and maintain dashboards for internal and client reporting. Analyze data to identify trends and provide actionable insights. 5. Internal Coordination & Compliance: Coordinate with internal teams for data collection, report generation, and service delivery. Ensure all processes comply with IRDAI regulations and internal quality standards. Qualifications & Skills: Graduate/post-graduate in any discipline (MBA/PGDM preferred). 5-7 years of experience in employee benefits management, with at least 2-3 years in an insurance brokerage setup. Strong understanding of group health insurance, claims process, and TPA functioning. Proficiency in MS Excel, PowerPoint, and dashboard tools. Excellent communication, interpersonal, and problem-solving skills. Ability to handle data-driven discussions with HR and insurance partners.

About Us. At ANZ, we're shaping a world where people and communities thrive, driven by a common goal: to improve the financial wellbeing and sustainability of our customers. Our Institutional bank helps our largest customers move trade and capital around the region, providing our people with great opportunities to build their technical expertise and their careers.. About The Role. The role has accountability of managing the deliverables and efficiency of the teams that are responsible for E2E processing of Payment Processing Operation. Managing the stakeholders, changes, transitions, escalations & complaints across various teams. Understanding risks and exposures and building effective controls to reduce the risks. Understanding values policy and regulatory requirements and support the team in adhering to them. Managing one agenda of Payment Operations Bangalore across the various teams. Developing and growing people and creating an engaged workforce. Managing domain expertise within various teams.. What will your day look like?. Improve teams Complex Productivity as per financial year target. Create FTE capacity through automation, process improvement, productivity, consolidation etc. and absorb additional work as per financial year target. Improve on cross-skill/upskill abilities from existing baseline of known processes. Improve Seat Utilisation as per financial year target. Monitor Output Per Paid Hour metric and ensure the required targets are met on a daily basis.. Ensure ATOM Rigour of the team is met on a weekly/monthly basis.. Monitor customer driven service level metrics and ensure service levels are accurately monitored and reported, including appropriate controls for the vertical.. Ensure quality and accurate reporting, in line with service levels to maximise satisfaction of the stakeholders to GM level.. Managing resiliency across hubs. Lead process and project delivery for the region in collaboration with hub and in-country teams.. Align process improvements with strategy for operations in relation to FTE management for the vertical.. Continuous improvement of processes and monitoring of operational cost reductions.. Ensure all processes are documented and fully compliant.. Ensure the process is audit and risk compliant.. What will you bring?. To grow and be successful in this role, you will ideally bring the following:. Detailed knowledge of ANZ Payments Operations systems. Detailed analytical skills, together with good written and oral communication skills. Ability to manage stakeholders with conflicting priorities. Well developed and demonstrable customer service skills. Strong commitment to working in a team orientated environment. Understanding of Payments & Cash business and Group structure. You’re not expected to have 100% of these skills. At ANZ a growth mindset is at the heart of our culture, so if you have most of these things in your toolbox, we’d love to hear from you.. So why join us?. From the moment you join ANZ, you'll be doing meaningful work that will shape a world where people and communities thrive.. But it's not just our customers who'll feel your impact. you'll feel it too. Because at ANZ, you'll have the resources, opportunities, and support you need to take the next big step in your career.. We're a diverse bunch at ANZ in different roles, different locations, doing different things. That's why we have a range of flexible working arrangements, so our people can 'make work, work for them'. We also provide a range of benefits including access to health and wellbeing services and discounts on selected products and services from ANZ and more.. At ANZ, you'll be part of an organisation where the different backgrounds, perspectives and life experiences of our people are celebrated. That's because we're committed to building a workplace that reflects the diversity of the communities we serve. We welcome applications from everyone and encourage you to talk to us about any adjustments you may require to our recruitment process or the role itself. If you are a candidate with a disability or access requirement, let us know how we can provide you with additional support.. To find out more about working at ANZ, visit https://www.anz.com.au/careers . You can apply for this role by visiting ANZ Careers and searching for reference number 91261.. Job Posting End Date. 02/04/2025 , 11.59pm, (Melbourne Australia). Show more Show less

Job Purpose / Role. The main purpose of this role is to underwrite profitable new and renewal business to meet. Negotiate, participate and pricing and terms and conditions. Have ownership of accounts and clients. To develop and maintain strong relationships with brokers and clients.. Key Responsibilities?. Underwrite new and renewal accounts to meet top and bottom line targets (local and/or regional). Negotiate participation, pricing and terms and conditions with brokers. Proactively manage capacity.. Underwrite in line with LoB governance framework e.g. Underwriting Authorities, global MSU, Underwriting Guidelines, Rules and Principles. Ensure contract certainty is achieved on all accounts at time of inception.. Ensure accurate policy documentation issued to broker (where AGCS responsibility to do so) or broker has issued documentation (where broker responsibility).. File maintenance – ensure file is established (whether electronic or paper) and maintained for each risk and transaction handled.. Proactively support acqusition of new business and retention of existing business (including client and broker negotiations where necessary).. Proactively liaise with Distribution Management team on market management initiatives.. Positively represent AGCS externally to the market.. Proactively drive involvement of functional areas in Underwriting process, including e.g. MMC, ARC, Claims, Operations.. Develop and maintain strong relationships with key brokers and clients and other relevant stakeholders (e.g. risk managers.. Key Experience / Requirements / Skills?. Proven track record in Underwriting profitable business in Property, Engineering Domain. Good understanding of LoB products and portfolio.. Demonstrable, established relationships with brokers at peer group level and established within market.. Understanding of legal and regulatory framework. Required Education/ Experience?. Engineering Degree/Graduate Degree.. Completion of professional insurance qualifcation (e.g. CII). Required General Skills?. Fluent in English. Written and verbal communication skills.. Presentation skills in a various internal and external settings. Organisational and interpersonal skills. Business knowledge and professional disposition. 75173 | Underwriting | Professional | Allianz Commercial | Full-Time | Permanent. What’s in it for you?. Let’s Care About Everything That Makes You, You. We are committed to nurturing an inclusive environment where everyone feels they belong. We offer a hybrid working model, which recognizes the value of striking a balance between in-person collaboration and remote working. Please feel free to discuss flexible working arrangements with us.. Let’s care for your financial wellbeing. We believe in rewarding performance with a great compensation and benefits package (details vary by location), including a generous bonus scheme and pension.. Let’s care for your opportunities to progress. From career development and digital learning programmes to international career mobility, we offer lifelong learning for our employees worldwide and an environment where innovation, delivery and empowerment are fostered.. Let’s care for life’s twists and turns. From our support for flexible working, health, and wellbeing (including private healthcare and generous parental leave benefits), to helping people return from career breaks with experience that nothing else can teach. We’ve got your back.. Let’s care for our society and our planet. With opportunities to be engaged in shaping a future that is safe, inclusive, and sustainable, we care for the tomorrows of our people, our industry, and our clients.. Care to join us?. Allianz Commercial is a global corporate insurance carrier and part of Allianz Group. We provide risk consultancy, Property-Casualty insurance solutions and alternative risk transfer for a wide spectrum of commercial, corporate and specialty risks across 10 dedicated lines of business.. Learn more about us by clicking?here.. Allianz is an equal opportunity employer, and therefore welcomes applications regardless of ethnicity or cultural background, age, gender, nationality, religion, disability, sexual orientation, or any other protected characteristic. Diversity of thinking is an important part of our company culture.. Show more Show less

Job Title : P&C Claims Management Qualification : Any Graduate and Above Relevant Experience : 1 to 5 years Must Have Skills : 1.Experience in P&C Claims Management, preferably with BPO/Insurance process exposure. 2.Strong experience handling FNOL (First Notice of Loss) or FROI (First Report of Injury) cases. 3.Knowledge of claims systems like Guidewire, Duck Creek, Majesco, or similar platforms. 4.Familiarity with ISO, NCCI, and WCIRB reporting requirements. 5.Proficient in MS Office (Excel, Word) and data entry with attention to detail. 6.Strong communication and interpersonal skills with a customer-centric approach. 7.Ability to multi-task in a fast-paced and compliance-driven environment. Good Have Skills : knowledge and expertise in FNOL (First Notice of Loss) or FROI (First Report of Injury) Roles and Responsibilities : 1.Manage end-to-end claims processing for Property & Casualty lines including auto, home, general liability, and workers compensation. 2.Perform FNOL/FROI intake, assess coverage, and initiate claim setup using internal systems. 3.Verify policy information, document incidents accurately, and identify subrogation opportunities. 4.Maintain consistent communication with policyholders, claimants, vendors, and internal teams. 5.Support claims adjudication by gathering and reviewing supporting documentation, police reports, medical records, etc. 6.Ensure compliance with applicable state regulations and client-specific SLAs. 7.Coordinate with adjusters, underwriters, and legal teams where necessary. 8.Generate and maintain accurate records for audit and reporting purposes. 9.Continuously identify and escalate potential fraud or misrepresentation concerns. 10.Participate in process improvement initiatives and training sessions. Location : Mumbai CTC Range : 3.5 to 6 LPA (Lakhs Per Annum) Notice Period : Immediate Mode of Interview : Virtual Shift Timing : Night Shift Mode of Work : Work From Office Thanks & Regards, Amulya G Senior HR Analyst Black and White Business Solutions Pvt Ltd Bangalore, Karnataka, INDIA. Direct Number: 080-67432435/Whatsapp @6366979339 amulya.g@blackwhite.in | www.blackwhite.in ****************************** DO REFER YOUR FRIENDS**********************************

Medical claims processor will have to look into claims where payment was denied. Commonly due to issues of insurance coverage eligibility , the claims handler may be tasked with reviewing documentation from the patient, their physicians, or the insurance. With the medical expertise ,need to master the various products and to apply the same during claim processing. Claims processors process any claim payments when applicable and must ensure they comply with federal, state, and company regulations and policies. List of Responsibilities: To validate the authenticity and the credibility of the claims. To coordinate with various persons (Claimant, Treating Physician, Hospital insurance desk, Field Visit Drs, Investigation officers)for hassle-free claim processing . To expertise ,the process of negotiation when necessitated. The claim handler owes a duty of care to the patient, ensuring that their needs are being met and that they re receiving the treatment or medicine they need. Job Qualifications and Requirements: Required Medical Graduates. Adapt and inbuilt the process of communication and coordination across the zones and the supporting verticals accordingly.

Medical claims processor will have to look into claims where payment was denied. Commonly due to issues of insurance coverage eligibility , the claims handler may be tasked with reviewing documentation from the patient, their physicians, or the insurance. With the medical expertise ,need to master the various products and to apply the same during claim processing. Claims processors process any claim payments when applicable and must ensure they comply with federal, state, and company regulations and policies. List of Responsibilities: To validate the authenticity and the credibility of the claims. To coordinate with various persons (Claimant, Treating Physician, Hospital insurance desk, Field Visit Drs, Investigation officers)for hassle-free claim processing . To expertise ,the process of negotiation when necessitated. The claim handler owes a duty of care to the patient, ensuring that their needs are being met and that they re receiving the treatment or medicine they need. Job Qualifications and Requirements: Required BDS, BHMS, BAMS, MD, Pharm D Graduates. Adapt and inbuilt the process of communication and coordination across the zones and the supporting verticals accordingly.

Medical claims processor will have to look into claims where payment was denied. Commonly due to issues of insurance coverage eligibility , the claims handler may be tasked with reviewing documentation from the patient, their physicians, or the insurance. With the medical expertise ,need to master the various products and to apply the same during claim processing. Claims processors process any claim payments when applicable and must ensure they comply with federal, state, and company regulations and policies. List of Responsibilities: To validate the authenticity and the credibility of the claims. To coordinate with various persons (Claimant, Treating Physician, Hospital insurance desk, Field Visit Drs, Investigation officers)for hassle-free claim processing . To expertise ,the process of negotiation when necessitated. The claim handler owes a duty of care to the patient, ensuring that their needs are being met and that they re receiving the treatment or medicine they need. Job Qualifications and Requirements: Required BDS, BHMS, BAMS, Pharm D, MD Graduates. Adapt and inbuilt the process of communication and coordination across the zones and the supporting verticals accordingly.

Urgent requirement for BHMS/BAMS/BDS -Chennai(Annasalai) Freshers/candidate with clinical or TPA experience. Interested candidates can call on 9371762436 or share their updated resumes to career@mdindia.com Job Description: Scrutiny of medical documents and adjudication. Assess the eligibility of medical claims and determine financial outcomes. Identification of trigger factors of insurance related frauds and inform the concerned department. Determine accuracy of medical documents. Required Candidate profile: BAMS / BHMS / BDS graduate. Male candidate prefer. Good Medical & basic computer knowledge Should have completed internship (Permanent Registration number is mandatory) Freshers can also apply. Work from office. Venue details: MDIndia Health Insurance TPA Pvt. Ltd., Raheja towers, Unit 005, Delta wing no-177, Beside LIC building, Annasalai, Chennai-600002.

s- Responsible for the Sales enrollments/Sales in the city. Do the market race and prepare the list of prospective customers , Handle the Team Members and motivate them for better sales , Ensure the team members are in market where enrollments & usage are done regularly. Should have good networking capabilities and be willing to travel extensively throughout their specified areas Key Role: Manage an assigned geographic sales area to maximize sales target and meet corporate. Objectives Build Database of key contact persons in the assigned geography. Build and maintain relationships with key client personnel Manage Category leads from qualification to closure

Choosing Capgemini means choosing a company where you will be empowered to shape your career in the way you’d like, where you’ll be supported and inspired bya collaborative community of colleagues around the world, and where you’ll be able to reimagine what’s possible. Join us and help the world’s leading organizationsunlock the value of technology and build a more sustainable, more inclusive world. 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. Works in the area of Software Engineering, which encompasses the development, maintenance and optimization of software solutions/applications.1. Applies scientific methods to analyse and solve software engineering problems.2. He/she is responsible for the development and application of software engineering practice and knowledge, in research, design, development and maintenance.3. His/her work requires the exercise of original thought and judgement and the ability to supervise the technical and administrative work of other software engineers.4. The software engineer builds skills and expertise of his/her software engineering discipline to reach standard software engineer skills expectations for the applicable role, as defined in Professional Communities.5. The software engineer collaborates and acts as team player with other software engineers and stakeholders. Primary Skills 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. Guideware Creative Thinking (SDLC) Methodology JavaScript Policy Development Capgemini is a global business and technology transformation partner, helping organizations to accelerate their dual transition to a digital and sustainable world, while creating tangible impact for enterprises and society. It is a responsible and diverse group of 340,000 team members in more than 50 countries. With its strong over 55-year heritage, Capgemini is trusted by its clients to unlock the value of technology to address the entire breadth of their business needs. It delivers end-to-end services and solutions leveraging strengths from strategy and design to engineering, all fuelled by its market leading capabilities in AI, cloud and data, combined with its deep industry expertise and partner ecosystem. The Group reported 2023 global revenues of "22.5 billion.

Works in the area of Software Engineering, which encompasses the development, maintenance and optimization of software solutions/applications.1. Applies scientific methods to analyse and solve software engineering problems.2. He/she is responsible for the development and application of software engineering practice and knowledge, in research, design, development and maintenance.3. His/her work requires the exercise of original thought and judgement and the ability to supervise the technical and administrative work of other software engineers.4. The software engineer builds skills and expertise of his/her software engineering discipline to reach standard software engineer skills expectations for the applicable role, as defined in Professional Communities.5. The software engineer collaborates and acts as team player with other software engineers and stakeholders. - Grade Specific Experience – 3 to 15 years Skills – 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.

Role & responsibilities - Due Diligence - Document Indexing & Management - Sanction Screening - Compliance checks - Premium Bordereaux Processing - Knowledge of insurance systems like Acturis, Applied Epic/Eclipse will be added advantage - Experience in the insurance sector, preferably with brokers or MGAs, will be an added advantage - Familiarity with Lloyds systems integration (XIS, XCS, ICOS/IPOS) is a plus - Updating the process documents - Providing supporting documents during various internal/external audits - Advance excel knowledge Preferred candidate profile Need Fresher or who have experience into claims and settlement Must be fluent with communication

Role & responsibilities Location: Any where in India 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. Preferred candidate profile Perks and benefits

We're Hiring: Guidewire Developers - Claim Center, Policy Center, Billing center (6- 10 + Years Experience) | Contract Roles | Work From Office (WFO) Are you an experienced Guidewire Developers - Claim Center, Policy Center, Billing center looking for your next challenge? Join our dynamic team and contribute to exciting projects across various domains. We are hiring for multiple contractual positions with Work From Office (WFO) mode. Requirements: Minimum 6+ years of relevant experience in the relevant Guidewire Development. Strong domain knowledge and hands-on implementation experience. Excellent communication and problem-solving skills. Availability for Work From Office. Mode of hire: Contractual Location: Hyderabad, Bangalore,Delhi Start Date: Immediate - 15 Days Joiners Available Roles : 1. Guidewire Claim Center Developer Primary Skill: Guidewire ClaimCenter, GOSU, Integration & Configuration Secondary Skill: Java, SQL, Jenkins, Git, Agile Methodology Develop and configure ClaimCenter components using GOSU Implement business rules, workflows, and UI enhancements Integrate ClaimCenter with external systems using web services (SOAP/REST) Perform unit testing, debugging, and performance tuning Collaborate with QA and business teams for requirement validation Maintain documentation for configurations and customizations Follow Guidewire best practices and coding standards 2. Guidewire Billing Center Developer Primary Skill: Guidewire BillingCenter, GOSU, Integration & Configuration Secondary Skill: Java, Web Services, Jenkins, Git, Oracle/SQL Server Design and implement BillingCenter solutions including invoicing, payments, and collections Customize billing rules and workflows using GOSU Develop integrations with financial systems and third-party services Conduct unit testing and resolve defects in a timely manner Collaborate with cross-functional teams for end-to-end delivery Document technical designs and configurations 3. Guidewire Policy Center Developer Primary Skill: Guidewire PolicyCenter, GOSU, Product Model, Configuration Secondary Skill: Java, XML, Jenkins, Git, Agile/Scrum Customize PolicyCenter screens, workflows, and business rules Work on product model configuration and policy transactions Integrate PolicyCenter with external systems using APIs Perform code reviews and ensure adherence to best practices Support testing and deployment activities Maintain documentation for all development work 4. Guidewire Digital Portal Developer (React / Jutro) Primary Skill: Guidewire Digital Portal, React.js, Jutro Framework Secondary Skill: JavaScript, HTML/CSS, Node.js, Git, CI/CD tools Develop responsive UI components using React and Jutro for Guidewire Digital Portals Customize and extend Guidewire Digital applications for Policy, Billing, and Claims Integrate digital portals with backend Guidewire systems via REST APIs Optimize performance and ensure cross-browser compatibility Collaborate with UX designers and backend developers Maintain reusable components and follow UI/UX best practices

Job Title : P&C Claims Management Qualification : Any Graduate and Above Relevant Experience : 1 to 5 years Must Have Skills : 1.Experience in P&C Claims Management, preferably with BPO/Insurance process exposure. 2.Strong experience handling FNOL (First Notice of Loss) or FROI (First Report of Injury) cases. 3.Knowledge of claims systems like Guidewire, Duck Creek, Majesco, or similar platforms. 4.Familiarity with ISO, NCCI, and WCIRB reporting requirements. 5.Proficient in MS Office (Excel, Word) and data entry with attention to detail. 6.Strong communication and interpersonal skills with a customer-centric approach. 7.Ability to multi-task in a fast-paced and compliance-driven environment. Good Have Skills : knowledge and expertise in FNOL (First Notice of Loss) or FROI (First Report of Injury) Roles and Responsibilities : 1.Manage end-to-end claims processing for Property & Casualty lines including auto, home, general liability, and workers compensation. 2.Perform FNOL/FROI intake, assess coverage, and initiate claim setup using internal systems. 3.Verify policy information, document incidents accurately, and identify subrogation opportunities. 4.Maintain consistent communication with policyholders, claimants, vendors, and internal teams. 5.Support claims adjudication by gathering and reviewing supporting documentation, police reports, medical records, etc. 6.Ensure compliance with applicable state regulations and client-specific SLAs. 7.Coordinate with adjusters, underwriters, and legal teams where necessary. 8.Generate and maintain accurate records for audit and reporting purposes. 9.Continuously identify and escalate potential fraud or misrepresentation concerns. 10.Participate in process improvement initiatives and training sessions. Location : Mumbai CTC Range : 3.5 to 6 LPA (Lakhs Per Annum) Notice Period : Immediate Mode of Interview : Virtual Shift Timing : Night Shift Mode of Work : Work From Office Thanks & Regards, Aneesha HR Analyst Black and White Business Solutions Pvt Ltd Direct Number : 08067432440| Whats app : 9035128021|aneesha.g@blackwhite.in

UK Health Care Process Nature of Work : Claim Processing/ Backend Candidates should have their own system and internet connection Configuration required Windows 10 Processor - i3/i5 RAM - 4 GB Speed - 10mbps rotational shifts, 5 days working Required Candidate profile Rounds of Interviews - HR - Medical Test - Email Test - Amcat - Ops

1) Receiving of claims courier sent by employees 2) Segregation of claims according to department, 3) Validation of employee claims as per the Travel policy, GST requirements and Eligibility by following internal processes and SOPs in CRM 4) Communication of status of claim process and related queries and updates by e-mail and CRM 5) Coordinate by calling the employees on disputed balance confirmations and clarifying the doubts and get the confirmations 6) Preparing of weekly exception and pending claims report and GST sheets 7) Follow up mails in case of no revert 8) Accounting of Claims into weekly batch, 9) Writing file numbers on the accounted claims and filing of the hard copies of the claim in order of file numbers 10) Capture of GST details and Invoice segregation and scanning of invoices to handover to tax team

Greetings from Alldigi Tech!!! Job Description: HealthCare (non-Voice) Shift: Day Shift (9am to 6pm) Experience: 1 to 3 years Notice Period: Immediate Joiners Connecting with our client's business partners in the US, typically insurance companies to follow up and coordinate on the following activities: Coordinates medical specialty referrals and procedures for patients in a timely, efficient, and equitable manner Utilizes EMR system(s) to track and research urgent requests and keep patient information current and accurate Communicates information, including updates of referral requests, appointment details, and communication preferences vis EMR, email, chat, and patient portal Review patient charts and records to understand what authorizations and documentations need to be pursued Ensures that all barriers to care (such as language, transportation restrictions, or financial needs) are addressed Provides clear, thorough, and accurate documentation of all referral processing steps, in the patient's electronic health records Processes necessary prior authorizations and insurance referrals as needed to complete the referral process Follows organizational guidelines regarding the use of the Electronic Medical Record (EMR) in compliance with HIPAA and patient confidentiality standards Maintains access to the Health Information Exchange (HIN) and other related systems Uses HIN and other related systems to gather information needed to coordinate care and keep patients' electronic health records up to date with the status of care that is being coordinated Maintains surveillance ticklers and/or work with Health Information Technology to proactively identify the need for patient care Navigates patient to care, as assigned. Interested candidates can come for the Direct Walk-In Interview to the office.

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

Responsibilities: * Lead claims settlements and operations on-site * Ensure compliance with HIPAA & insurance ops standards * Manage health claims of our patients from start to finish * Collaborate with stakeholders on claim resolution

Candidate must have experience in service delivery, transitions, process excellence, transformational leadership, and solutioning Required Experience - Healthcare Operations + Transitions Candidate must be green/black certified, good with transformation concepts Shift - US Location - Kochi Essential Functions The role will manage a single or multi-client portfolio in healthcare domain with span of control of ~400 - 500 employees The role will be responsible for ensuring noiseless delivery across the accounts, working closely with the onshore teams to support sales opportunities, and moving each of the delivery accounts towards Intelligent (a combination of leveraging AI, robotics, and analytics effectively) The responsibility would be to manage multiple teams who would work from different offshore locations for US Helathcare payer business Preferably experience with Claims, Appeals, Utilization management, Back office enrollment, prior Auth Engage with various existing support teams (Process Excellence/ Digital / Analytics) that will help us achieve the results Manage relationships with customers at the senior management level and ensure customer satisfaction Establish and maintain robust tracking mechanism for key indicators of the operations to support decision-making Responsible for tracking and driving all process parameters critical to quality for process delivery Assist management with career development activities for team members, team leaders and managers, including performance management, feedback and training Ensure adequate guidance & training of team members to ensure process objectives & Customer requirements are met Profession Skills Requirement Operational Skills Prior work experience in managing US Healthcare payer client/s independently in a third-party organization. Need to have management skills to manage large teams and take both top line & bottom line responsibilities Candidate should have ability to respond rapidly and creatively address problems and opportunities, to devise solutions that address the business needs. Proven track record of managing and growing businesses Ability to work in a matrix organization and be sensitive to cross cultural/geographical sensitivities Ability to create a strategy, implement it and be operational at the same time. Soft skills An effective communicator with excellent relationship building, Negotiation & interpersonal skills Versatility, High level of professionalism and confidence Strong leadership skills and the ability to effectively and efficiently manage others Highly flexible, adaptable and creative Strong analytical, problem solving abilities & complexity management Respond to business problems or challenges with new perspectives and explore a variety of relevant possible solutions. Take prompt and effective action to rectify problems and bring structure and clarity when managing within unstructured, ambiguous environments. Self-motivated, able to work independently and under pressure, resourceful, self-driven with a strong sense of commitment and multitask management are pre-requisites

Medusind Solutions Openings for AR Callers/ WFO Location : Ahmedabad ( 7th & 8th Floor, Corporate Rd, Makarba, Ahmedabad, Gujarat 380015 ) HR : Rohan 878007771 Role & responsibilities Outbound calls to insurances for claim status and eligibility verification Denial documentation and further action Calling the insurance carriers based on the appointment received by the clients. Working on the outstanding claims reports/account receivable reports received from the client or generated from the specific client software. Calling insurance companies to get the status of the unpaid claims. Willing to work in any process pertaining to voice based on the requirement (Insurance Follow UP, Patient calling, Provider outreach program etc. Maintain the individual daily logs. Performs assigned tasks/ completes targets with speed and accuracy as per client SLAs Work cohesively in a team setting. Assist team members to achieve shared goals. Compliance with Medusind' s Information Security Policy, client/project guidelines, business rules and training provided, company's quality system and policies Communication / Issue escalation to seniors if there is any in a timely manner Punctuality is expected all the time Perks and benefits Any Undergraduate 0.6-2 Years Relevant experience into medical billing Basic knowledge of MS Office Preparing spreadsheets and documents Good Communication skills must be able to fluently converse in English. Must have a neutral accent No stammering Working Day - 5 days working (Sat & sun fixed off ) Shift timing - 5.30 PM to 2.30 AM Drop Available with 25kM office radius Interested candidate can call on 878007771 or Can share their profiles rohan.shaikh@medusind.com