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3.0 - 7.0 years
0 Lacs
hyderabad, telangana
On-site
As a leading financial services and healthcare technology company based on revenue, SS&C is headquartered in Windsor, Connecticut, and has 27,000+ employees in 35 countries. Some 20,000 financial services and healthcare organizations, from the world's largest companies to small and mid-market firms, rely on SS&C for expertise, scale, and technology. The Transaction Processing team at SS&C is responsible for managing six participant-level transactions, including contributions, enrollments, distributions, transfers, exchanges, participants" account maintenance, and plan account maintenance. This team operates with a focus on efficiency and accuracy, utilizing flexible workforces across multiple locations, automated workforce management tools, and a centralized processing management structure to maximize resource utilization and minimize costs. The team at SS&C follows a quality methodology that emphasizes standard processes and technological automation to ensure high-quality processing outcomes. By leveraging these tools and methodologies, the team can focus directly on critical-to-quality processing components, ensuring that transactions are completed accurately and efficiently. Please note that unless explicitly requested or approached by SS&C Technologies, Inc. or any of its affiliated companies, the company will not accept unsolicited resumes from headhunters, recruitment agencies, or fee-based recruitment services.,
Posted 2 weeks ago
6.0 - 10.0 years
6 - 10 Lacs
Coimbatore, Tamil Nadu, India
On-site
Looking for experienced folks from Member or group enrollment process . Job Title: Assistant manager Enrollment & Claims Adjudication (US Healthcare) Experience: 6-10 years Qualification: Bachelors degree Shift: Night shift Transportation: Pick up and drop would be provided Job Summary: The Assistant manager - Enrollment and Claims Adjudication will oversee a team of healthcare professionals responsible for processing member enrollments and adjudicating claims in compliance with US healthcare regulations, client-specific guidelines, and quality standards. The role ensures efficient workflow, team performance, process improvement, and client satisfaction. Key Responsibilities: Team Management & Leadership: Lead, mentor, and manage a team handling enrollment and claims adjudication processes. Monitor team productivity, quality, and adherence to service level agreements (SLAs). Provide training, coaching, and development opportunities to team members. Conduct regular team meetings, performance reviews, and provide constructive feedback. Resolve escalations and complex issues promptly and professionally. Enrollment Management: Oversee new member enrollment, renewals, terminations, and updates in healthcare plans. Ensure data accuracy for member eligibility, coverage, and benefits. Collaborate with clients and internal teams to resolve enrollment discrepancies or queries. Claims Adjudication Oversight: Supervise the processing of healthcare claims ensuring accuracy and compliance with policies, provider contracts, and regulatory guidelines (HIPAA, CMS, etc.). Ensure proper review of claims for eligibility, benefits coverage, coding, and payments. Monitor claim denials and implement corrective action plans to reduce errors and rework. Process & Compliance: Ensure compliance with US healthcare regulations, privacy laws (HIPAA), and client-specific guidelines. Identify process improvement opportunities and work with quality teams to implement best practices. Prepare and analyze reports related to team performance, quality audits, and operational metrics. Liaise with clients and stakeholders for updates, process changes, or reporting needs. Required Skills and Qualifications: Bachelors degree or equivalent work experience in healthcare operations. Minimum 6-10 years of experience in US healthcare processes, with 1-2 years in a team leader in Enrollment and claims Strong knowledge of US healthcare insurance, including enrollment, eligibility, claims processing, and adjudication rules. Familiarity with CMS, Medicaid, Medicare, ACA, and HIPAA regulations. Proficient in claims platforms Excellent analytical, problem-solving, and decision-making skills. Strong communication and interpersonal skills. Ability to multitask and work under pressure. Interested folks can share your updated cv to : [HIDDEN TEXT] or Whats app your cv to : 9949217482 Role: Assistant Manager Industry Type: BPM / BPO Department: Customer Success , Service & Operations Employment Type: Full Time, Permanent Role Category: Operations Education UG: Any Graduate
Posted 1 month ago
5.0 - 9.0 years
0 Lacs
karnataka
On-site
As an Academic Administrator, you will be responsible for overseeing the administration of school activities and managing the staff effectively. Your role will involve enhancing the relationship with parents and working towards increasing enrollments year on year. You will also focus on enhancing English language skills within the school campus. The ideal candidate for this position should hold a postgraduate degree in Science, Arts, or Maths, along with a B.Ed. or M.Ed. qualification. Your educational background will be essential in fulfilling the responsibilities of this role effectively.,
Posted 1 month ago
5.0 - 9.0 years
0 Lacs
andhra pradesh
On-site
As a Test Lead in our team, you will be responsible for leading testing activities within the Healthcare Industry. With 8-10 years of experience in Manual and Automation Testing, your role will involve working extensively on Agile Methodology. Your expertise in SQL, functions, views, and procedures will be crucial, along with a deep understanding of FACETS or QNXT modules such as Claims and Enrollments. You will play a key role in Healthcare, focusing on EDI files processing, managing a small team, and resolving issues efficiently. Exceptional problem-solving and troubleshooting skills are essential for this position. Your responsibilities will include managing Testing Scope, SLAs, communication, risks, and issues. Reviewing and analyzing project requirements, creating test schedules, and designing test strategies will be part of your daily tasks. You will identify the testing scope for each release based on the requirements document and collaborate with developers to address defects and application issues. Understanding End to End Business Scenarios and Software Test Life Cycle processes is crucial. Your role will involve holding meetings within the test team, generating test reports, and interacting with stakeholders. You will coordinate with the Automation team to identify test cases suitable for automation. Leading, guiding, and monitoring the analysis, design, and execution of test cases and procedures will be part of your responsibilities. Throughout the project, you will schedule tests for execution, monitor progress, control test results, and adapt the test plan as needed. Communication skills, including speaking, writing, and presentation abilities, are vital for interacting with customers, SMEs, and stakeholders. Qualifications: - BE - Minimum 5 years to maximum 8 years of experience in relevant field,
Posted 1 month ago
1.0 - 6.0 years
3 - 6 Lacs
Mumbai, Maharashtra, India
On-site
Job description Assist the prospective leads in understanding the course in detail and convert them to take up the course. Conduct Career Counseling to prospective leads and help them choose the right course to build their career Required Candidate profile Experience: Inside Sales - 1+ year(s) (Required)
Posted 1 month ago
8.0 - 15.0 years
0 Lacs
chennai, tamil nadu
On-site
You will be working as an Assistant Manager in the Retirement Services team at RRD GO Creative, a company specializing in business communications, marketing solutions, and digital productivity. With over three decades of experience, our company focuses on transforming customer experiences through Global Brand Solutions, Smart Work Solutions, and Technology & Innovation Services. Your primary responsibility will be to oversee the Retirement Process, specifically focusing on 401K, Defined Contributions, and Defined Pensions. You will be expected to manage workflows efficiently, meet defined Turnaround Times (TATs), and act as a Subject Matter Expert (SME) for the assigned processes. Collaboration with Line of Business partners and maintaining high levels of engagement and communication will be essential aspects of your role. To excel in this position, you should possess 8-15 years of experience in retirement services, particularly in ADP/ACP testing, Top Heavy and Coverage testing, and 5500 form processing. A background in Commerce, Finance, or an MBA along with a strong understanding of 401K, Defined Contributions, Pension claims, US Pension Retirement accounts, and Insurance Claims will be beneficial. Proficiency in MS Office Suite, hands-on experience in retirement claims management and reconciliation, excellent communication skills, and the ability to work flexible shifts are qualities that will be advantageous in this role. Your capability to work both independently and collaboratively with cross-functional teams will be crucial in ensuring accurate management reporting and successful delivery of key metrics and performance indicators.,
Posted 1 month ago
1.0 - 5.0 years
0 Lacs
karnataka
On-site
As an Inside Sales professional at Skillfyme, a rapidly growing platform dedicated to empowering individuals to upskill in high-demand tech fields, you will have the opportunity to play a key role in shaping the future of tech education and directly impacting the career success of our learners. Your primary responsibility will be to drive enrollments for our tech programs through consultative sales, guiding prospective students from inquiry to enrollment while providing valuable insights on how our courses can help them achieve their career goals. Your key responsibilities will include responding to inquiries, following up with potential students, and converting leads into enrollments using effective consultative selling techniques. You will need to understand the needs of prospective students and offer tailored guidance on how Skillfyme's tech programs can support their career advancement. Efficient pipeline management using CRM tools, meeting or exceeding monthly and quarterly sales targets, and collaborating closely with the marketing team to maximize lead quality are also crucial aspects of this role. To succeed in this position, you must have prior experience in sales or customer service, along with strong communication, interpersonal, and persuasive skills. The ability to work independently, set goals, and manage time effectively in a dynamic work environment is essential. By joining our team, you will be part of a rapidly growing startup that is reshaping tech education, with the opportunity to make a significant impact on learners" careers. You can expect a collaborative, dynamic work environment with plenty of opportunities for growth and development. If you are passionate about sales and excited about making a difference in education and technology, we encourage you to apply now and be a part of our team at Skillfyme.,
Posted 2 months ago
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