2028 Claims Processing Jobs - Page 6

Role & Responsibilities Handling TPA related all process from billing to co-ordinate with TPA companies. Responsible for counseling patient's family & pre-Auth process. Maintaining & uploading patient's files on the portal. Couriering the hard copy of patient's medical file to the Insurance companies. Responsible for all co-ordination activities from patient's admission to discharge. Handling billing Department, Implants bill updating & reconciliation. Daily co-ordination with the patient and Hospital staff. Outstanding follow-up with TPA. To obtain and review referrals and authorizations for treatments. Must be aware of norms of the insurance sector. Daily follow up with Insurance companies to pass or clear the Health Insurance claims. Qualifications Bachelor's degree. Previous experience in TPA management or Banking. Good interpersonal and communication skills. Simran Sandhu 7696661783

Desired Candidate Profile 0-1 year of experience in BPO or non-voice process (claims processing preferred). Graduate degree in any specialization (B.A/B.Com). Excellent written and verbal communication skills with a focus on English language proficiency. Ability to work independently with minimal supervision while maintaining high productivity levels. Valid PAN Number - _____________________(Why PAN Required > Mandatory to Process Candidature & Find Duplicity in Internal PAN Validation Process and also to initiate a screening call Please reach out in case of any queries. Sonali Chattopadhyay I Associate People Success Orcapod Consulting Services Pvt Ltd. Email I sonali.chattopadhyay@orcapod.work www.orcapodservices.com 9548431649

Role & responsibilities Major role of the position is Process Dealer Bonus & Incentives workings related to After Sales, verifying & processing various other claims & documents apart from bonus & incentives. Raising Invoices for misc. Income / services, Training charges etc. Preparation of aftersales Debit/Credit notes. Support in Dealer reconciliation. Booking of Group companies Debit / Credit notes, manual warranty claims, overdue Interest working, TDS receivables entries, consumer case settlement entries. Payment follow-up for Royalty invoices, Monthly Warranty Provision entries, perform other tasks of accounting as & when allocated. 1. Verification and accounting of Dealer Invoices of Incentive payments on Monthly/ Quarterly/Yearly/ on requirement basis. 2. Preparation of Credit/ Debit Notes / Service Invoices for Dealers & Group Cos. 3. Resolution of dealer queries / differences in payouts. 4. Preparation of Monthly Aging Report & follow-up for payment. 5. Preparation of advice / invoices on Dealers for After Sales Incentive scheme 2. Preparation of various Invoices a. IT Service b. Renting of immovable property c. Over ridding commission/ Royalty d. Special Tools e. Training Fees f. Engine / Car/ Other Group Company settlements g. Commercial invoice for Export ( Custom purpose ) h. Other Taxable 3. Monthly calculation of overdue interest on Spare Parts outstanding on bank guarantee utilization. Accounting and follow-up for TDS certificate from Dealers/ Customer 4. MIS 1. Over ridding commission/ Royalty received 2. Misc. and Other Income details 5. Coordination, support, and provide required details to Internal Auditor, Group company auditor, System auditor and Statutory Auditor Other activities 1. Verification and accounting of Legal customer complaint cases settlement 2. Verification of CICD Documents / other claim documents, Accounting and MIS for the same 3. Warranty cost provision entry 4. Checking of Export invoices 5. Month end / year end accounting (receivables) related activities 6. Accounting & other activities basis management requirement NOTE- It's an off-role position

We are looking for a AR voice process candidate to handle claim process and join our dynamic team. As an AR you will be responsible for assisting with medical billing and RCM process. And to gain hands on Experience in US Healthcare industry.

SUMMARY Job Title: Apprentice Apprentice Machine Operator / Computer Operator (Fresher) - Jammu We are inviting fresh ITI candidates to join as Apprentices under NAPS at our CFA in Karnal. This role offers hands-on learning in machine operations, computer operations, and warehouse processes , providing a strong foundation for future career growth. Work Location: Kikri Morh, Birpur Parmandal Road, Birpur, Jammu-181133, Jammu and Kashmir Experience: Fresher Only Qualification: ITI- Fitter/Electrician/Computer (COPA) Salary (Stipend): 12,000 Working Days: 6 Days a Week (1 Day Week Off) Shift: Rotational Shift Key Responsibilities Operate and monitor basic machinery or computer systems Support in receiving, storage, and dispatch activities Maintain records, data entry, and documentation Assist in equipment handling and preventive maintenance Ensure compliance with safety and housekeeping standards Requirements Who Should Apply: Individuals with no prior work experience Physically fit and prepared for work in production or warehouse environments Keen to gain practical industry exposure through apprenticeship

Role & responsibilities: 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 nonavailability of tariff. Approve or deny the claims as per the terms and conditions within the TAT. • Handle escalations and responding to mails accordingly. Preferred candidate profile: BAMS, BHMS graduates ONLY. Work from Office only. Interested candidates share resume to Mail : sarika.pallap@mediassist.in Whatsapp : 8792840500

About Us At CIGNA Healthcare we are guided by a common purpose to help make financial lives better through the power of every connection. Responsible Growth is how we run our company and how we deliver for our clients, teammates, communities, and shareholders every day. One of the keys to driving Responsible Growth is being a great place to work for our teammates around the world. We are devoted to being a diverse and inclusive workplace for everyone. We hire individuals with a broad range of backgrounds and experiences and invest heavily in our teammates and their families by offering competitive benefits to support their physical, emotional, and financial well-being. CIGNA Healthcare believes both in the importance of working together and offering flexibility to our employees. We use a multi-faceted approach for flexibility, depending on the various roles in our organization. Working at CIGNA Healthcare will give you a great career with opportunities to learn, grow and make an impact, along with the power to make a difference. Join us! Process Overview International insurance claims processing for Member claims. Job Description* Delivers basic technical, administrative, or operative Claims tasks. Examines and processes paper claims and/or electronic claims. Completes data entry, maintains files, and provides support. Understands simple instructions and procedures. Performs Claims duties under direct instruction and close supervision. Work is allocated on a day-to-day or task-by-task basis with clear instructions. Entry point into professional roles. Responsibilities: - Adjudicate international pharmacy claims in accordance with policy terms and conditions to meet personal and team productivity and quality goals. Monitor and highlight high-cost claims and ensure relevant parties are aware. Monitor turnaround times to ensure your claims are settled within required time scales, highlighting to your Supervisor when this is not achievable. Respond within the time commitment given to enquiries regarding plan design, eligibility, claims status and perform necessary action as required, with first issue/call resolution where possible. Interface effectively with internal and external customers to resolve customer issues. Identify potential process improvements and make recommendations to team senior. Actively support other team members and provide resource to enable all team goals to be achieved. Work across International business in line with service needs. Carry out other ad hoc tasks as required in meeting business needs. Work cohesively in a team environment. Adhere to policies and practices, training, and certification requirements. Requirements*: Working knowledge of the insurance industry and relevant federal and state regulations. Good English language communication skills, both verbal and written. Computer literate and proficient in MS Office. Excellent critical thinking and decision-making skills. Ability to meet/exceed targets and manage multiple priorities. Must possess excellent attention to detail, with a high level of accuracy. Strong interpersonal skills. Strong customer focus with ability to identify and solve problems. Ability to work under own initiative and proactive in recommending and implementing process improvements. Ability to organise, prioritise and manage workflow to meet individual and team requirements. Experience in medical administration, claims environment or Contact Centre environment is advantageous but not essential. Education*: Graduate (Any) - Medical, Paramedical, Pharmacy or Nursing. Experience Range* : Minimum 1 year of experience in healthcare services or processing of healthcare insurance claims. Foundational Skills- Expertise in international insurance claims processing Work Timings*: 7:30 am- 16:30 pm IST Job Location*: Bengaluru (Bangalore) About The Cigna Group Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.

Responsibilities: * Prepare ILAs, survey reports & letters * Maintain claim records * Update CMS follow up with insured & teams to reduce TAT * Manage back-office claim tasks reports preparation efficiently to support smooth claims processing. Health insurance Provident fund

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

ROLE SUMMARY The Claims Business Analyst for Guidewire ClaimCenter is responsible for developing detailed business and functional requirements for claims processing and administration systems, as well as ensuring proper integration with downstream systems for reporting purposes. Their role also includes planning and conducting User Acceptance Testing to guarantee that the systems meet the necessary specifications. Additionally, the Claims Business Analyst provides analytical support for various projects and initiatives aimed at enhancing the claims management processes within the organization. ROLE RESPONSIBILITIES Lead requirements definitions for complex projects and multi-year strategic initiatives. Identify & translate business needs into clearly defined requirements. Create Documentation inclusive of business use cases, process / data flows, traceability matrices, and report mock-ups. Plan, facilitate, and conduct requirements gathering sessions, meetings, and presentations. Lead review sessions for completed business / functional requirements, with key business users focused on gaining consensus and final business approval. Cultivate strong professional relations within business units to thoroughly understand business needs. Collaborate with the development and testing teams to provide subject-matter expertise. Assist in troubleshooting and resolving issues when out-of-the-box functionality is leveraged. Ensure future solutions are efficient and effective across all business processes, while being consistent across products. Participate in the development and planning of the User Acceptance Testing activities, including test plans and scripts, based on requirements. After the planning phase, facilitate the UAT execution phase. Work with the business lead and project manager to obtain UAT signoff. TECHNICAL QUALIFICATIONS 3+ years of business analysis experience, including defining functional and reporting requirements and conducting user acceptance testing for business-critical solutions in complex environments. Possess experience with Guidewire ClaimCenter systems is required. Must have detailed claims processing knowledge and experience. Experience with iterative and agile methodologies, with working knowledge of both SDLC & PMLC processes. Proven hands-on experience with creation of business process diagrams, data rules, business requirements, and functional requirements / user stories. Possess knowledge and experience when reviewing, re-engineering, or developing IT solutions for business process / improvements automation. Candidate has experience operating and interfacing with business management during walkthrough, interview, presentation, and negotiation processes. Proven track record for creating clear, concise deliverables which reflect a deep understanding of business needs and software functionality. GENERAL QUALIFICATIONS The candidate has clear verbal and written skills. Able to understand communication channels and can escalate appropriately. Experience using standard project and business tools including, Microsoft Project, Excel, PowerPoint, Project, SharePoint, UI mock-up tools, etc. Must be proficient with process modeling tools (e.g., Visio.) Experience with visualization tools is beneficial. Possess excellent problem-solving and analytical skills. Candidate has experience supervising small teams. Possess a strong initiative with the ability to self-manage. Comfortable with ambiguity and able to work through challenges to complete the objectives correctly. The candidate is a team player who works well with technical and business resources. Able to see tasks through to completion without significant guidance. Has personal time-management skills and an ability to meet individual / team deadlines. EDUCATION REQUIREMENTS B.A. / B.S. Degree. Certified Business Analyst Professional (CBAP) is a plus but not required.

ROLE SUMMARY The Claims Business Analyst for Guidewire ClaimCenter is responsible for developing detailed business and functional requirements for claims processing and administration systems, as well as ensuring proper integration with downstream systems for reporting purposes. Their role also includes planning and conducting User Acceptance Testing to guarantee that the systems meet the necessary specifications. Additionally, the Claims Business Analyst provides analytical support for various projects and initiatives aimed at enhancing the claims management processes within the organization. ROLE RESPONSIBILITIES Lead requirements definitions for complex projects and multi-year strategic initiatives. Identify & translate business needs into clearly defined requirements. Create Documentation inclusive of business use cases, process / data flows, traceability matrices, and report mock-ups. Plan, facilitate, and conduct requirements gathering sessions, meetings, and presentations. Lead review sessions for completed business / functional requirements, with key business users focused on gaining consensus and final business approval. Cultivate strong professional relations within business units to thoroughly understand business needs. Collaborate with the development and testing teams to provide subject-matter expertise. Assist in troubleshooting and resolving issues when out-of-the-box functionality is leveraged. Ensure future solutions are efficient and effective across all business processes, while being consistent across products. Participate in the development and planning of the User Acceptance Testing activities, including test plans and scripts, based on requirements. After the planning phase, facilitate the UAT execution phase. Work with the business lead and project manager to obtain UAT signoff. TECHNICAL QUALIFICATIONS 3+ years of business analysis experience, including defining functional and reporting requirements and conducting user acceptance testing for business-critical solutions in complex environments. Possess experience with Guidewire ClaimCenter systems is required. Must have detailed claims processing knowledge and experience. Experience with iterative and agile methodologies, with working knowledge of both SDLC & PMLC processes. Proven hands-on experience with creation of business process diagrams, data rules, business requirements, and functional requirements / user stories. Possess knowledge and experience when reviewing, re-engineering, or developing IT solutions for business process / improvements automation. Candidate has experience operating and interfacing with business management during walkthrough, interview, presentation, and negotiation processes. Proven track record for creating clear, concise deliverables which reflect a deep understanding of business needs and software functionality. GENERAL QUALIFICATIONS The candidate has clear verbal and written skills. Able to understand communication channels and can escalate appropriately. Experience using standard project and business tools including, Microsoft Project, Excel, PowerPoint, Project, SharePoint, UI mock-up tools, etc. Must be proficient with process modeling tools (e.g., Visio.) Experience with visualization tools is beneficial. Possess excellent problem-solving and analytical skills. Candidate has experience supervising small teams. Possess a strong initiative with the ability to self-manage. Comfortable with ambiguity and able to work through challenges to complete the objectives correctly. The candidate is a team player who works well with technical and business resources. Able to see tasks through to completion without significant guidance. Has personal time-management skills and an ability to meet individual / team deadlines. EDUCATION REQUIREMENTS B.A. / B.S. Degree. Certified Business Analyst Professional (CBAP) is a plus but not required.

ROLE SUMMARY The Claims Business Analyst for Guidewire ClaimCenter is responsible for developing detailed business and functional requirements for claims processing and administration systems, as well as ensuring proper integration with downstream systems for reporting purposes. Their role also includes planning and conducting User Acceptance Testing to guarantee that the systems meet the necessary specifications. Additionally, the Claims Business Analyst provides analytical support for various projects and initiatives aimed at enhancing the claims management processes within the organization. ROLE RESPONSIBILITIES Lead requirements definitions for complex projects and multi-year strategic initiatives. Identify & translate business needs into clearly defined requirements. Create Documentation inclusive of business use cases, process / data flows, traceability matrices, and report mock-ups. Plan, facilitate, and conduct requirements gathering sessions, meetings, and presentations. Lead review sessions for completed business / functional requirements, with key business users focused on gaining consensus and final business approval. Cultivate strong professional relations within business units to thoroughly understand business needs. Collaborate with the development and testing teams to provide subject-matter expertise. Assist in troubleshooting and resolving issues when out-of-the-box functionality is leveraged. Ensure future solutions are efficient and effective across all business processes, while being consistent across products. Participate in the development and planning of the User Acceptance Testing activities, including test plans and scripts, based on requirements. After the planning phase, facilitate the UAT execution phase. Work with the business lead and project manager to obtain UAT signoff. TECHNICAL QUALIFICATIONS 3+ years of business analysis experience, including defining functional and reporting requirements and conducting user acceptance testing for business-critical solutions in complex environments. Possess experience with Guidewire ClaimCenter systems is required. Must have detailed claims processing knowledge and experience. Experience with iterative and agile methodologies, with working knowledge of both SDLC & PMLC processes. Proven hands-on experience with creation of business process diagrams, data rules, business requirements, and functional requirements / user stories. Possess knowledge and experience when reviewing, re-engineering, or developing IT solutions for business process / improvements automation. Candidate has experience operating and interfacing with business management during walkthrough, interview, presentation, and negotiation processes. Proven track record for creating clear, concise deliverables which reflect a deep understanding of business needs and software functionality. GENERAL QUALIFICATIONS The candidate has clear verbal and written skills. Able to understand communication channels and can escalate appropriately. Experience using standard project and business tools including, Microsoft Project, Excel, PowerPoint, Project, SharePoint, UI mock-up tools, etc. Must be proficient with process modeling tools (e.g., Visio.) Experience with visualization tools is beneficial. Possess excellent problem-solving and analytical skills. Candidate has experience supervising small teams. Possess a strong initiative with the ability to self-manage. Comfortable with ambiguity and able to work through challenges to complete the objectives correctly. The candidate is a team player who works well with technical and business resources. Able to see tasks through to completion without significant guidance. Has personal time-management skills and an ability to meet individual / team deadlines. EDUCATION REQUIREMENTS B.A. / B.S. Degree. Certified Business Analyst Professional (CBAP) is a plus but not required.

The Mortgage Foreclosure & Claims Manager role involves overseeing the end-to-end foreclosure and claims processes for defaulted mortgage loans. It is crucial to ensure compliance with investor, insurer, and regulatory guidelines while minimizing financial losses and maintaining operational efficiency. You will be responsible for supervising both judicial and non-judicial foreclosure processes across multiple states. This includes coordinating with attorneys, vendors, and internal stakeholders to ensure timely foreclosure actions. Monitoring foreclosure timelines and adhering to investor-specific requirements from entities such as FHA, VA, USDA, FNMA, FHLMC, and private investors is essential. You will also be tasked with maintaining accurate records in the servicing system and ensuring compliance with federal, state, and investor regulations. In terms of claims processing, you will be filing foreclosure advance claims for reimbursement from investors and insurers. This involves reviewing and validating claim documentation for accuracy and completeness, as well as ensuring timely submission of claims to various entities like GSE, GNMA, MI companies, and other investors. Tracking claim statuses and following up on outstanding or denied claims will also be part of your responsibilities. As a leader, you will be expected to mentor a team of foreclosure and claims specialists. Developing and implementing policies and procedures to enhance operational efficiency is crucial. Ensuring that the team meets performance metrics and service level agreements is essential. Additionally, you will participate in audits and regulatory reviews, providing documentation and responses as necessary. The ideal candidate for this position should hold a Bachelor's degree in business, finance, or a related field (preferred) and have at least 5 years of experience in mortgage servicing, foreclosure, and default claims. Strong knowledge of FHA, VA, USDA, FNMA, FHLMC, and private investors guidelines is required. Excellent analytical, organizational, and communication skills are essential, along with proficiency in MS Office and mortgage servicing platforms. Additional skills that would be beneficial include experience in managing vendor relationships and legal counsel, familiarity with credit bureau reporting and delinquency tracking, ability to lead cross-functional teams and drive process improvements, and experience with systems like Sagent, Tempo, Loansphere, and PACER. Entra Solutions, a BSI Financial Services Company, is dedicated to delivering on expectations, solving problems, and investing in the future. The core values of the company shape daily operations and decision-making, focusing on transforming the U.S. real estate economy through people, processes, and technology. Headquartered in Irving, Texas, Entra Solutions manages domestic operations. Entra Solutions is an equal employment opportunity employer, committed to providing equal opportunities to all qualified applicants without regard to race, color, religion, gender, national origin, disability status, protected veteran status, or any other characteristic protected by law.,

Position Description Job Description Skills and Competencies The team of medical practitioner part of Pre-Authorization team will use their skills and expertise in authorizing the request received and they will ensure that the customers are attended on time by following the protocol of the policy defined by the insurer and the organization. Ensuring error free processing of preauthorisation within agreed TAT (Turnaround time) by way of following the following process, o By entering accurate information into the application defined by the organization. o Review structured clinical data matching it against specified medical terms and diagnoses or procedure codes and follow established procedures defined by the insurer and the organization. o Inform providers as needed and file completed precertification requests as per procedures o Interacting with providers for discharge summery etc.. as and when required. Medical practitioner/BDS/BHMS/BAMS or equivalent qualification Ensure 100% accuracy of all the authorization approval as per the process. Any authorization not as per the limit or as per the process to be escalated to the team manager on priority. 0-3 years experience in Pre-Authorization and Claims management. Any medical opinion required from the specialist to be escalated to the specialist. Sound medical knowledge and willing to work in non clinic process. Ensuring process compliance is met as per regulatory procedures. Minimum of one year experience in handling authorization (preferred) Maintaining Daily excel maintenance for Pre auth cases received and processed. Should be willing to work in shifts as the department works on 24/7 function Solving customer queries wherever medical opinions are required and need to be address by the medical practitioner Should be willing to work from office (no WFH)Role & responsibilities Preferred candidate profile

Company Name: Anion Healthcare Services LLP Job Title: Medical Billing US Healthcare Process (Freshers) Salary: 20,500 (Take Home) Work Days: 5 Days a Week Qualification: B.Pharmacy graduates B.Sc. Computer Science graduates (Local candidates only) Eligibility: Both Male & Female candidates can apply Freshers are welcome Roles & Responsibilities: Handle US Healthcare / Medical Billing process Ensure accuracy and speed in data entry and billing tasks Communicate effectively with clients/patients (verbal & written) Maintain good typing speed and attention to detail Work collaboratively in day shifts Skills Required: Excellent communication skills (verbal & written) Good typing speed Basic knowledge of Medical Billing / US Healthcare is an added advantage Strong command over English communication Interview Timings: 11:30 AM – 2:00 PM Job Location: HMDA Maitrivanam, 8th Floor, Swarnajayanthi Complex, Adjacent to Ameerpet, Hyderabad, Telangana – 500038 Contact Person: Arun (HR) – 6303339324

To contact the insured for Underwriting referred proposals to procure the complete medical history using Audio and/or Video tools. To Follow up with customer for past medical records and/or relevant health documents Maintain end to end TAT / SLAs. Required Candidate profile Location – Bangalore Candidate must know to speak excellent English. CTC – Upto 3.5 LPA

Ready to shape the future of work? At Genpact, we don't just adapt to change we drive it. AI and digital innovation are redefining industries and were leading the charge. Genpacts AI Gigafactory, our industry-first accelerator, is an example of how were scaling advanced technology solutions to help global enterprises work smarter, grow faster, and transform at scale. From large-scale models to agentic AI, our breakthrough solutions tackle companies most complex challenges. If you thrive in a fast-moving, tech-driven environment, love solving real-world problems, and want to be part of a team thats shaping the future, this is your moment Genpact (NYSE: G) is an advanced technology services and solutions company that delivers lasting value for leading enterprises globally. Through our deep business knowledge, operational excellence, and cutting-edge solutions we help companies across industries get ahead and stay ahead. Powered by curiosity, courage, and innovation , our teams implement data, technology, and AI to create tomorrow, today. Get to know us at genpact.com and on LinkedIn , X , YouTube , and Facebook. We are inviting applications for the role of Process associate Claims_Lucknow **Only freshers are eligible (We are considering only B.sc graduates for these roles) Shifts: US (night) Work location: Lucknow (work from office) To assess claims products to ensure that benefit spend is in accordance with the policies and rules relevant to our members policies and contracted agreements with providers of Healthcare. Responsibilities Data Entry of Information related to personal details, provider details, invoice information, procedure & impairment codes Validation of information entered by indexer and data Entry Operator Check & Select correct Pre-authorization Identify duplicate Claims and take appropriate action Reading & taking appropriate action on Alerts related to Members & providers. Referring case to calling team for further information Dealing with Policy & Non Policy messages Interpreting, analyzing & further investigating the Policy messages on various tools like support point, info site etc. Interpretation of hospital contracts & taking appropriate action basis that Referring cases to various department like HCS, TMT, Triage after adjudication as and when required Identify any over charge, ineligible chargers, contract compliance, Provider or Member Fraud Qualifications we seek in you Minimum qualifications Graduate (B,sc graduate) Preferred qualifications B.Sc. Life Science Good knowledge of healthcare & medical terminologies Eye for detail & investigative skills Good interpretation & comprehension skills Why join Genpact? Be a transformation leader Work at the cutting edge of AI, automation, and digital innovation Make an impact Drive change for global enterprises and solve business challenges that matter Accelerate your career Get hands-on experience, mentorship, and continuous learning opportunities Work with the best Join 140,000+ bold thinkers and problem-solvers who push boundaries every day Thrive in a values-driven culture Our courage, curiosity, and incisiveness - built on a foundation of integrity and inclusion - allow your ideas to fuel progress Come join the tech shapers and growth makers at Genpact and take your career in the only direction that matters: Up. Lets build tomorrow together. Genpact is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, religion or belief, sex, age, national origin, citizenship status, marital status, military/veteran status, genetic information, sexual orientation, gender identity, physical or mental disability or any other characteristic protected by applicable laws. Genpact is committed to creating a dynamic work environment that values respect and integrity, customer focus, and innovation. Furthermore, please do note that Genpact does not charge fees to process job applications and applicants are not required to pay to participate in our hiring process in any other way. Examples of such scams include purchasing a 'starter kit,' paying to apply, or purchasing equipment or training.

About the Team The Process Excellence team at Navi is focused on maintaining and elevating the quality of customer interactions. As the quality audit function, the team conducts regular audits of agent communications across calls, chats, and other channels to ensure accuracy, consistency, and compliance. The team also ensures compliance across different verticals and runs multiple initiatives in coordination with business team stakeholders to drive key business metrics. Insights from these audits are used to drive continuous improvement through targeted training, helping agents close knowledge or process gaps and deliver a consistently excellent customer experience. About the Role We are seeking an experienced doctor with medical knowledge for the process excellence vertical to join our dynamic team. As a vital member of our Process Excellence team, a quality auditor dedicated exclusively to auditing claims processed by medical officers to ensure accuracy, compliance, and continual improvement. A quality auditor conducts detailed reviews of claims, identifying areas for improvement.. What We Expect From You The role involves identifying discrepancies, fraud, or errors in claims to ensure compliance with health insurance policies and regulatory requirements Review health claims for accuracy, completeness, and compliance with insurance policies and applicable regulations. Identify any inconsistencies, overbilling, or discrepancies between the services provided and the claims submitted Detect potential fraudulent claims by analyzing patterns and identifying suspicious activities or behaviors Suggest process improvements to enhance the efficiency and accuracy of the claims audit process. Stay updated with industry trends, regulations, and changes in healthcare policies that may impact claims auditing. Must Haves Medical Graduate in any stream (MBBS/BHMS/BAMS/BUMS/BDS) Experience in handling an audit Background in claims processing with clinical experience in a hospital setting Data analytics experience would be an added advantage Knowledge of different languages would be an added advantage. Proficiency in Hindi and English is mandatory. Knowledge of health insurance policies and regulations, IRDAI circulars is a must Strong analytical and problem-solving skills. Excellent attention to detail and ability to spot discrepancies Ability to anticipate potential problems and take appropriate corrective action Effective communication skills for working with different stakeholders Time management skills to meet deadlines. Should have a broad understanding of Claims Practice Sharp business acumen to understand health insurance claim servicing needs Excellent communication skills, including writing reports and presentations 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 Youll 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 Process Excellence team at Navi is focused on maintaining and elevating the quality of customer interactions. As the quality audit function, the team conducts regular audits of agent communications across calls, chats, and other channels to ensure accuracy, consistency, and compliance. The team also ensures compliance across different verticals and runs multiple initiatives in coordination with business team stakeholders to drive key business metrics. Insights from these audits are used to drive continuous improvement through targeted training, helping agents close knowledge or process gaps and deliver a consistently excellent customer experience. About the Role We are seeking an experienced Doctor with medical knowledge for the Process Excellence vertical to join our dynamic team. As a vital member of our Process Excellence team, a quality auditor dedicated exclusively to auditing claims processed by medical officers to ensure accuracy, compliance, and continual improvement. A quality auditor conducts detailed reviews of claims, identifying areas for improvement.. What We Expect From You Review submitted health claims for accuracy, completeness, and compliance with insurance policies and applicable regulations. Reviewing and evaluating medical claims to determine their eligibility for payment, and investigating medical claims to identify fraud. Making decisions about medical claims, such as whether to approve or deny a claim Liaison with internal stakeholders to ensure the deadlines of TAT s and SLA s Work towards designated tasks. Claim Analytics- Periodical claim analysis to identify frauds, monitor claim performance metrics. Informing the customer about the rejection of their claim through a call. Must Haves The role involves identifying discrepancies, fraud, or errors in claims to ensure compliance with health insurance policies and regulatory requirements. Ability to handle independent assignments having the acumen to draw logical conclusions. He/she should have a broad understanding of Claims Practice. Sharp business acumen to understand health insurance claim servicing needs.. Excellent communication skills, including writing reports and presentations. Ability to anticipate potential problems and take appropriate corrective action. Knowledge of health regulations, IRDA circulars is a must. Knowledge of different languages would be an added advantage. Proficiency in Hindi and English is mandatory. Medical Graduate in any stream (MBBS/BHMS/BAMS/BUMS/BDS) Experience in handling an audit. Background in claims processing with clinical experience in a hospital setting. Candidates having data analytics experience would be an added advantage. 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 Youll 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.

Responsibilities include verifying patient eligibility, processing claims, maintaining accurate records, coordinating with hospitals, and providing support throughout the treatment process. Required Candidate profile Looking for a dedicated PMJAY Operator to assist patients in availing benefits under the Pradhan Mantri Jan Arogya Yojana.Strong communication skills and familiarity with PMJAY processes are essential

Salary: Up to 23,000 CTC + Incentives (5,000 – 7,000) Qualification: Minimum 12th Pass with Experience / Graduate fresher Shift Timing: 5:30 PM – 2:30 AM (Fixed Shift) Working Days: 5 Days/Week (Saturday & Sunday Fixed Off) Facilities: Cab + meal

Please mention Kanchan Maurya/Aastha on the front of your CV. (WhatsApp only-9211499587) Point of Contact: Kanchan Maurya (kmaurya378@r1rcm.com), Aastha (aaryika@r1rcm.com) Dear Candidates, We are pleased to invite you to the R1 RCMs Walk-In Drive for our 6-month paid apprenticeship program under the National Apprenticeship Training Scheme (NATS), followed by Full-Time Employment, subject to performance . This is an excellent opportunity for fresh graduates to gain hands-on experience in the U.S. healthcare revenue cycle domain with one of the industry's most respected employers. We are conducting a Walk-In Drive as per the details below: Time: 12:00 PM to 5:00 PM Mode of Interview : Face-to-Face Venue: R1 RCM, Tower 9, 7th Floor , Candor TechSpace, Sector 135, Noida 201304 About the Apprenticeship Program: Role: Apprentice AR Follow-Up (U.S. Healthcare Process) Duration: 6 months (Paid Apprenticeship) followed by Full Time Employment, subject to performance. Program Type: Registered under the NATS program Future Scope: Conversion to full-time employee based on performance This program is designed to provide structured training in insurance claim follow-up, denial handling, U.S. healthcare communication, and process understanding, all under the guidance of experienced mentors. Benefits: Paid a monthly stipend during the apprenticeship Paid leaves and National Holidays Free pick-up/drop-off facility for night shifts R1-sponsored medical and accidental insurance Access to R1 wellness and teleconsultation programs Government Certificate of Completion (NATS) Attractive salary package on successful conversion to full-time role Fast-track career growth opportunities Complimentary Meals Who Can Apply: Eligible Qualification : Fresh Graduates (Non-Engineering Streams only) Not Eligible Qualifications : B.Pharm, B.Tech/BE, LLB, B.Sc. Biotech. Strong spoken English and interpersonal skills. Analytical mindset with willingness to work in high-volume calling environments. Comfortable with rotational night shifts. What Youll Learn: U.S.healthcare insurance lifecycle and terminology End-to-end claim handling processes Communication with U.S.-based clients Structured corporate communication skills Process orientation and quality focus About R1 RCM: R1 RCM is a leading provider of technology-driven solutions that help hospitals and health systems manage their revenue cycle more efficiently and improve overall patient experience. With a presence in major Indian cities including Noida, Hyderabad, Bangalore, and Chennai, we support 300,000+ providers, 1000+ hospitals, and physician groups globally. We have been consistently recognized among: Top 25 Best Workplaces in Healthcare Top 50 Workplaces for Women Top 75 for Diversity & Inclusion Top 10 for Health and Wellness Top 50 Workplaces for Millennials At R1, we believe in a purpose-driven, inclusive work culture that empowers employees to grow. With over 30,000 employees globally, R1 is a dynamic, future-forward company offering robust employee benefits and a fast-paced learning environment. Mandatory to Carry: Two copies of your updated resume. A valid Government-issued photo ID proof (Aadhar, PAN, Voter ID, etc.) Start your career with a globally trusted healthcare brand that prioritizes your learning, development, and future growth. We look forward to seeing you at the drive.

About this role: Wells Fargo is seeking an Associate Fraud & Claims Operations Representative. In this role, you will: Support and capture all pertinent information from customers about their claims Conduct research and provide updates on status of new and existing claims Identify opportunities to improve customer experience after thorough research of complex account activity, and take appropriate actions to handle the claim Perform routine customer support tasks by maintaining balance between exceptional customer service and solid investigative research while answering incoming calls in a call center environment Receive direction from team lead and escalate questions and issues to more experienced roles Interact with colleagues on basic day-to-day issues, and network with supporting functional areas to create a seamless experience for the customers Required Qualifications: 6+ months of customer service experience, or equivalent demonstrated through one or a combination of the following: work experience, training, military experience, education.

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 assistance to underwriting teams as needed, along with people management, performance appraisals, and client interaction. Skills and Competencies: Effective communication skills Strong people management skills Sound knowledge of property and casualty underwriting Commercial awareness and understanding of the insurance market Problem-solving and decision-making abilities Basic knowledge of regulatory and legal compliance issues Excellent numeric, analytical, and written skills Effective prioritization and organizational skills Proficiency in Microsoft Word, Excel, and Outlook Primary Responsibilities: Monitoring the performance of a team of Claims adjusters and providing timely feedback Conducting employee performance reviews Assisting with the professional development of the team Setting objectives and managing the team's progression Coordinating with internal customers and maintaining the flow of work Ensuring SLA adherence Preparation and review of reporting packs for senior management and stakeholders Additional Responsibilities: Ensuring appropriate performance metrics are in place and accurately reported Identifying issues and implementing remedial action, including staff training Identifying and implementing opportunities for streamlining claims activity Ensuring Standard Operating Procedures and User Guides reflect current procedures Facilitating and monitoring new activities transitioned to the service provider Assisting with the investigation and resolution of data quality issues Assisting with the testing and roll out of new IT initiatives

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