629 Health Claims Jobs - Page 5

Hiring for Medical Underwriters- Health Insurance Only M.B.B.S - BPT, BDS, BMS, MPT Job Role- To assess the risk associated with insuring individuals or groups, evaluate medical history, and determine policy terms, coverage limits, and premiums, all while adhering to company policies and industry regulations. Experience Required - Minimum 2+Years of Experience Locations - Gurgaon Chennai (Tamil) Kochi (Malayalam) Interested candidates can directly share their resumes on simranbagga@policybazaar.com or 9311501270

Hiring for Medical Underwriters- Health Insurance Only M.B.B.S - BPT, BDS, BMS, MPT Job Role- To assess the risk associated with insuring individuals or groups, evaluate medical history, and determine policy terms, coverage limits, and premiums, all while adhering to company policies and industry regulations. Experience Required - Minimum 2+Years of Experience Locations - Gurgaon Chennai (Tamil) Kochi (Malayalam) Interested candidates can directly share their resumes on simranbagga@policybazaar.com or 9311501270

Hiring for Medical Underwriters- Health Insurance Only M.B.B.S - BPT, BDS, BMS, MPT Job Role- To assess the risk associated with insuring individuals or groups, evaluate medical history, and determine policy terms, coverage limits, and premiums, all while adhering to company policies and industry regulations. Experience Required - Minimum 2+Years of Experience Locations - Gurgaon , Kochi, Bangalore & MumbaiRole & responsibilities Preferred candidate profile

Role & responsibilities Verify the accuracy and completeness of claim documents, including medical records and billing information Handle customer inquiries related to claims status and provide resolution. Maintain and update claim records in the system. Identify discrepancies, fraudulent claims, and escalate cases as necessary.

Job Description: Ayushman TPA Head (5 Years Experience) Position: Ayushman TPA Head Department: Billing / Claims / Ayushman Bharat Experience Required: Minimum 5 years in TPA or Ayushman Bharat claim management Key Responsibilities: Oversee all Ayushman Bharat scheme operations, including patient registration, pre-authorization, and claim submission. Coordinate with TPA officials, insurance companies, and empaneled hospitals for smooth claim processing. Verify treatment packages, patient eligibility, and documentation as per NHPM guidelines. Ensure timely claim submission, query resolution, and settlement tracking. Maintain records and prepare daily, weekly, and monthly MIS reports. Train bi...

Pre-Authorization - Health Insurance (Hong Kong) Processor Role Job Responsibilities and Expectations Review and validate pre-authorization requests for medical services and procedures. Ensure completeness of documentation submitted by policyholders and healthcare providers. Verify eligibility and coverage based on policy terms and conditions. Coordinate with internal claims and underwriting teams for complex cases. Input and update pre-authorization decisions in the claims management system. Communicate authorization outcomes to providers and insured members. Ensure compliance with Hong Kongs Insurance Authority (IA) regulations and internal SOPs. Identify and escalate potential fraud or ab...

We have vacancy for the post of TPA manager. Qualification - BAMS/BHMS Experience - 2 to 10 yrs. as TPA Manager Job description - Act as the primary liaison between the hospital and various TPAs, insurance companies, and corporate clients. Handle empanelment and renewal of contracts with TPAs and insurance companies. Ensure smooth coordination for pre-authorization, approval, and discharge processes. Resolve disputes or issues related to pending approvals, denials, or short payments. Supervise TPA executives/coordinators in the billing or insurance desk. Train staff on TPA procedures, documentation standards, and claim follow-up. Conduct regular performance reviews and ensure efficient team ...

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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. Genpact's 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 that's shaping the future, this is your moment Genpact (NYSE: G) is an advanced technology services ...

You would be responsible for managing the end-to-end claims process for clients, ensuring seamless handling from claim intimation to settlement follow-ups. You will be the key point of contact for clients and AMCs regarding claim processes. You should be strategic and detail-oriented, ensuring timely documentation, filing, and resolution of claims while also contributing to business growth through lead generation and upselling. Job Duties and Deliverables include, but are not limited to Constantly upgrading yourself on industry trends and claim procedures. Managing claim intimations and ensuring accurate registration of claims. Coordinating with AMCs for smooth claim processes and timely res...

4+ Years of Experience in US Healthcare Claims Adjudication Open Positions : Team Leader Operations Quality Specialist Subject Matter Expert (SME) Process Trainer Hari - 7618776218 Shiny -7022976218

HURRY UP !!! Urgent Hiring for US Healthcare Claims Adjudications. OPEN REQURIMENTS Team Leader Operations. Quality Specialist. Subject Matter Expert (SME). Process Trainer. International voice exp with 4+yrs Contact HR Maya 9880516218

Management Profile: Provider Management/Healthcare Purchasing Roles & Responsibilities: Tariff Negotiations and cost management Conducting surprise audits and checks of the claims and case to case negotiations Manage workload of both field and office effectively Experience in dealing with providers (Hospitals/Diagnostics & OPD Clinics) Understanding of Health Claims and claim related processes Good understanding of Health Insurance and related products Managing relationship with the providers Flexible to travel across locations based on the organizational requirements Managing internal (Claims Team, Sales and Central Teams and external stakeholders (Brokers, Channel partners & Corporates) Ma...

We are looking for Duty Medical Officer who has experince in Insurance Sector. Experience : Minimum of 1 year in Insurance Qualification : MBBS Interested kindly contact 7358189600

Role & responsibilities This role will need to partner with others inter-departmental teams in order to realize some of the outcomes About you: • The successful candidate should have excellent computer (PowerPoint, Excel and Word) skills, strong financial and analytic research skills, problem solving, and organizational skills as well as a commitment to quality, customer satisfaction and meeting of deadlines. • Previous experience in claims processing preferably in the Consumer Directed Health market with knowledge of HSA, FSA, HRA, DCA, and other Transit products. • Ability to work independently and collaboratively in a fast-paced environment. EDUCATION/EXPERIENCE • Bachelors/ master’s degr...

Role & responsibilities - Acts as an interface between the TPA, Insurance Company and the hospital. - Responsible for investigation of suspicious claims on calls & Emails. - Effective usage of Fraud control measures. - Act as a backend support to the TPA. - Responsible for data mining and analytics related to Fraud and Investigation (IFD) Preferred candidate profile Qualification - B Pharmacy / M Pharmacy Experience - 6 Months to 2 Years.

Role & 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 escalate critical o...

Role & responsibilities Coordinate with patients, TPAs, and insurance companies for pre-authorization, approval, and final claim settlements. Prepare and submit claim documents and bills to TPAs/insurance companies in the prescribed format. Follow up regularly with TPAs for claim status, pending queries, and settlement updates. Verify patient insurance details, coverage, and eligibility before admission and discharge. Maintain accurate and up-to-date records of all claims submitted and settled. Handle rejections, discrepancies, and short settlements by coordinating with relevant departments and TPAs. Ensure compliance with hospital policies and TPA/insurance requirements. Generate periodic r...

Role & responsibilities Asst. Billing Manager works under supervision of Head of Accounts & Finance Guide and mentor team Maintains billing controls by preparing and recommending policies and procedures. Maintains financial security by following internal controls. Prepares refunds by verifying documentation, and requesting refunds. Maintains customer confidence and protects operations by keeping financial information confidential. Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies. Accomplishes the result by performing the duty. Supervise, guide, train,...

Hiring Medical Officers - Doctors for non clinical profile. Must have experience in claims processing.

Role Summary: Responsible for end-to-end management of Group Personal Accident (GPA) claims within the health claims vertically. This is a non-medico role focused on operational excellence, stakeholder coordination. Please share resume at aparna@aceconsultants.in

About The Role Skill required: Claims Services - Payer Claims Processing Designation: Health Admin Services New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years What would you do? Embedding digital transformation in healthcare operations end-to-end, driving superior outcomes and value realization today, and enabling streamlined operations to serve the emerging health care market of tomorrowYou will be a part of the Healthcare Claims team which is responsible for the administration of health claims. This team is involved in core claim processing such as registering claims, editing & verification, claims evaluation, and examination & litigation.Business solutions that...

Management Profile: Provider Management/Healthcare Purchasing Roles & Responsibilities: Tariff Negotiations and cost management Conducting surprise audits and checks of the claims and case to case negotiations Manage workload of both field and office effectively Experience in dealing with providers (Hospitals/Diagnostics & OPD Clinics) Understanding of Health Claims and claim related processes Good understanding of Health Insurance and related products Managing relationship with the providers Flexible to travel across locations based on the organizational requirements Managing internal (Claims Team, Sales and Central Teams and external stakeholders (Brokers, Channel partners & Corporates) Ma...

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. Genpact's 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 that's shaping the future, this is your moment Genpact (NYSE: G) is an advanced technology services ...

Will be responsible for leading & managing the overall operations & business development activities. This role requires strong leadership, operational excellence & client relationship skills to ensure smooth service delivery & business growth. Required Candidate profile Candidate MUST have experience in TPA *Operations Management *Business Development *Team Leadership *Compliance & Reporting *Client Relationship Management *Networking & Negotiation Skills