641 Health Claims Jobs - Page 16

Responsibilities:- Provide patients with the psychosocial support needed to cope with chronic, acute or terminal illnesses Communicate with patients suffering from various ailments post discharge to understand the status of their health and counsel them To enroll new patients into the system once they call in Skills:- Clarity in communication; Ability to articulate and talk to the patient in a clear manner without ambiguity Active Listening skills Passionate about the role and have patient care as priority Qualification:- Minimum Bachelors Degree in Clinical / Medico/ Biology background (Preferred Paramedics, Clinical Psychologists, Physiotherapist, Dietitian, Nutritionist, or such related f...

Role Summary We are seeking an experienced professional in health analytics to lead insurance benefits data analysis, trend identification, and strategy development to optimize client outcomes. This position involves tool adoption, claims analytics automation, CRM coaching, and collaboration across functions to deliver data-driven consulting. Key Responsibilities Claims Analysis & Strategy Development Analyze group health insurance claims data to identify cost drivers, trends, and anomalies. Conduct deep-dive root cause and impact analysis to support strategic cost optimization. Generate actionable insights and recommendations to improve client claim outcomes. Collaborate with internal teams...

Role & responsibilities • To be responsible for maintaining TPA Processing of cashless and all post discharge health insurance claims. • To be responsible to maintain overall TAT entry to exit. • TPA query reply and preauthorisation follow up with insurance company / tpa. • Medical scrutiny and medical opinion for health insurance claims. • Efficient in claim adjudication and claim processing. • Maintaining and ensuring Standard Operating Procedures and protocols. • To be responsible for keeping record for all correspondence done for TPA. • Post discharge reconciliation for utilization of claims. • Timely reply to internal TPA complaint portal. • TPA discharge follow up and closure. • Mmaint...

Responsibilities and Duties. Serve as a point of contact for Insurance related inquiries Create a consistent, positive work atmosphere through the communication Close interaction with respective department at hospital To interact with hospital insurance patients. Interact with Hospital Management, Doctors, Medical and non-medical staff at the hospital To create awareness about insurance claims (reimbursement and cashless claims, pre & post hospitalization claims etc.) Collecting claim support documents from the patients / hospitals & coordinate with backend team to ensure smooth transfer of data to the TPA/Insurance Company. Send the pre auth request and follow up on cashless approval form i...

Role & responsibilities : Manage end to end transactional and administration activities of insurance processes. Perform data entry and research in various systems and tracking tools. WFO/WFH - Work from Office (WFO) Work Timings 5:30 PM to 3 AM Job Description – Insurance associate, able to read, understand, apply and write basic English, MS office knowledge would be an added advantage, keyboard typing skills is mandatory. Preferred candidate profile

KEY RESPONSIBILITIES 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 ADDITIONAL SKILLS • Good communication • Familiarity with Computers and interest in learning on the job. ACADEMIC & PROFESSIONAL QUALIFICATIONS • BHMS/BAMS/BDS HR Pratiksha Shitole, Sr.Executive Talent Acquisition, MDIndia Health Insurance TPA Pvt. Ltd. S. No. 46/1, E-space, A-2 Building, 3rd floor, Pune Nagar Road, Vadgaonsheri, Pune 411014. Email Address: hr9@mdindia.com Contact No. 7058036074

Job Title: Medical Underwriter (On-site) Location: Gurgaon Duration: Contractual Salary: 60,000 - 75,000 per month Joining: Immediate Job Overview: We are hiring experienced Medical Underwriters for Gurgaon . The ideal candidates will be responsible for evaluating medical risks, reviewing applications, and making underwriting decisions based on medical history and policy guidelines. Key Responsibilities: Assess and underwrite medical insurance applications based on industry standards and company guidelines. Analyze medical reports, diagnostic tests, and case histories to determine risk exposure. Make underwriting decisions based on pre-existing diseases (PED), medical conditions, and other r...

You are a fresher who will be gaining experience in Health Claims by undergoing a few days of training. Your main responsibility will be to accurately process and adjudicate medical claims in compliance with company policies, industry regulations, and contractual agreements. In this role, you will review and analyze medical claims submitted by healthcare providers to ensure accuracy, completeness, and adherence to insurance policies and regulatory requirements. You will also verify patient eligibility, insurance coverage, and benefits to determine claim validity and appropriate reimbursement. Assigning appropriate medical codes such as ICD-10 and CPT to diagnoses, procedures, and services ac...

Job Summary Join our dynamic team as a PE-Ins Claims specialist where you will leverage your expertise in the Life and Annuity domain to process and manage insurance claims efficiently. With a focus on accuracy and customer satisfaction you will play a crucial role in ensuring smooth operations and contributing to the companys success. This position requires working from the office during night shifts providing an opportunity to collaborate closely with team members and enhance your skills in a supporti Responsibilities Process insurance claims with precision and ensure compliance with company policies and regulations. Analyze claim documents and assess the validity of claims based on Life a...

Job Summary Join our dynamic team as a PE-Ins Claims specialist where you will leverage your expertise in the Life and Annuity domain to enhance our claims processing efficiency. With 1 to 3 years of experience you will work from our office during night shifts contributing to the seamless operation of our insurance services. Your role will be pivotal in ensuring accurate and timely claims management directly impacting customer satisfaction and company success. Responsibilities Analyze and process insurance claims within the Life and Annuity domain to ensure accuracy and compliance with company policies. Collaborate with team members to identify and resolve discrepancies in claims documentati...

Dear Applicant, Hiring for US Healthcare - Operations Manager(OM) Role: Operations Manager I DESIGNATION: Operations Manager I LOCATION: Pune Qualification : Any Graduate PACAKAGE : 13LPA YEARS OF EXPERIENCE: 10-12 years Key Role and Responsibilities: Managing a team of 150 associates with the help of aligned 5 to 7 TLs Meet and exceed SLA targets Understand operational metrics & have governance to ensure no misses Drive performance and exceed the expectations Attend weekly and monthly reviews with Internal Stakeholders and Client Actively involved in client calls & manage client needs Monitor production, efficiency, and schedule adherence tool to ensure high levels of efficiency Establish c...

Urgent opening for TPA Medical Officer/customer service manager profile in Raipur, Rajkot, Kanpur, Baramati, Trivandrum locations. Graduate Medical background, MR (B pharma), BHMS, BAMS/ MBA in Hospital Administration. 2+ Years working experience in health insurance/health insurance TPA at Hospital handling/audit Candidate must have excellent knowledge of health insurance / Health TPA domain. Candidate must have excellent bill/medical negotiation skills & customer handling skills.Good communication skills in Hindi/English and regional language of the state/region .Ready to relocate himself/herself at location within India as may be required according to the job requirement. Candidate must ow...

Urgent opening for TPA Medical Officer/customer service manager profile in Raipur, Rajkot, Kanpur, Baramati, Trivandrum locations. Graduate Medical background, MR (B pharma), BHMS, BAMS/ MBA in Hospital Administration. 2+ Years working experience in health insurance/health insurance TPA at Hospital handling/audit Candidate must have excellent knowledge of health insurance / Health TPA domain. Candidate must have excellent bill/medical negotiation skills & customer handling skills.Good communication skills in Hindi/English and regional language of the state/region .Ready to relocate himself/herself at location within India as may be required according to the job requirement. Candidate must ow...

Vidal is hiring for claim Processor Designation: Executive-Claims Location: Gurgaon, Key Responsibilities: Review and validate claim documents submitted by hospitals or insured members Scrutinize medical records and bills for completeness and accuracy Apply policy terms, conditions, and exclusions to adjudicate claims Perform ICD and procedure coding as per ailment and treatment Coordinate with medical officers for clinical opinion when required Maintain claim logs and update CRM systems with claim status Ensure adherence to defined SLAs and minimize processing errors Flag suspicious or potentially fraudulent claims for investigation Communicate with stakeholders for clarifications or missin...

To lead and manage the claims operations by ensuring timely, fair, and compliant claim settlements, optimizing processes for efficiency, and supporting strategic goals through data-driven decision-making and cross-functional collaboration Ensure timely and accurate settlement of claims within defined turnaround times (TATs) Maintain adherence to IRDAI regulations and internal claims policies Identify and mitigate fraudulent claims through effective investigation and controls Enhance claimant experience through transparent communication and service excellence Lead, mentor, and upskill the claims team to improve performance and accountability Optimize claim payouts and reduce leakage through d...

Key Roles : Ensure accurate documentation and timely claim settlement Follow up with TPA and Govt. bodies for approvals/payments Strong knowledge of Govt. healthcare panels (ECHS, CGHS, ESIC, etc.) Experience in hospital billing & claim processing Annual bonus Provident fund Health insurance

Managing CGHS, ECHS, CAPF and Ayushman Bharat Government Portals: Claim Processing Audit Uploading Query Management Reconciliation and Recovery Management. Annual bonus Provident fund Health insurance

Greetingd from Niva Bupa! Key Roles & Responsibilities: Answer incoming customer calls in a professional and timely manner. Assist customers with inquiries including medical claims and rejections. Provide accurate and detailed information about claim procedures, documentation requirements, and coverage. Investigate and resolve customer concerns, ensuring high levels of customer satisfaction. Collaborate with internal departments, such as claims processing to address and resolve complex issues. Maintain thorough and up-to-date knowledge of products, medical billing codes, and claim processes. Document customer interactions and update customer records accurately in the system. Identify and esc...

# Location- Ahmedabad # Shift Timing: US Shift (Night Shift) # Facilities - Cab Facility # Working- 5 days # Week - Fixed off # Fluent English # Saturday, Sunday fixed off # Freshers & Experienced both can apply

Scrutiny of medical documents and adjudication Assess the eligibility of medical claims and determine financial outcomes. Ideinform the concerned department. Determine accuracy of medical documents Required Candidate profile Job Profile : Medical Officer Qualification : BHMS, BAMS, BDS Industry : Health Care Experience: 0 to 2 year Exp

Walkin : Mon to Sat between 11am to 3pm - Siruseri Unit Job Title: Insurance Co-ordinator Role & responsibilities: List out the total Number Of credit patients (All Insurance). To send the Pre- Authorization form to the concern insurance company. Explain the Admission & Discharge procedure to the patient & attenders also. All data's and activities should be computerized. Watch the approval status and query reply to be update shortly. To Proper communication about the patient Admission, Approval, Enhancement procedure, Discharge, Payment, and cancellation process. The most common job duties for a health unit coordinator are clerical tasks like answering phones and processing paperwork, includ...

Hiring Clinical Doctors for Medical coding role in Mohali !! Job Location - Mohali Role : Auditor I (IPDRG) Eligibility Criteria: Education BHMS,BAMS,MBBS,BPT Candidates with prior US Healthcare or Clinical experience will be preferred. Fresher Physicians can also apply with good clinical knowledge. Noncertified Physicians can apply however should be ready to complete the same within specified timeline. (CIC) Good communication skills. Candidates with corporate experience will be preferred. Immediate joiners preferred. Should be ready to work from office. Should be ready to work in night shift. Interested candidates can share resume - abdul.rahuman@cotiviti.com Regards, Abdul Rahuman 9080276...

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

We are seeking a dynamic and detail-oriented Insurance Professional for the Legal Department to manage end-to-end insurance policy administration, claims processing, and risk management across multiple sites. The ideal candidate will have experience in insurance handling, preferably in the solar sector, and the ability to manage and coordinate across teams and insurance partners. COMPENSATION & BENEFITS: Medical Insurance Performance Incentives Cool Work Environment Travel Reimbursement (as per company policy) Exposure to challenging legal and insurance portfolios Supportive team and professional development ABOUT SADBHAV FUTURETECH LIMITED: Company Size - ~100 employees Headquarters - Gurga...

We are looking for a highly skilled and experienced AR Associate to join our team at Omega Healthcare Management Services Pvt. Ltd., Location - Omega Healthcare - F2 Airport Bengaluru, Karnataka Rustam Bagh Layout, Bengaluru, Karnataka 560017 https://lnkd.in/gKk48dh5 Date - 28-Jun-2025 ( 2 PM ) - Saturday Roles and Responsibility Manage and process accounts receivable transactions with high accuracy and attention to detail. Develop and implement effective strategies to improve cash flow and reduce outstanding balances. Collaborate with cross-functional teams to resolve billing discrepancies and ensure timely payments. Analyze and report on key performance indicators, such as delinquency rate...