272 Health Claims Jobs - Page 8

We are hiring freshers or experienced medical officer to process the health insurance claims in TPA or Insurance companies. Educational Qualification: MBBS / BAMS / BHMS / BPT / MPT / BDS / Pharm D.

Check the medical admissibility of claim by confirming diagnosis and treatment details Verify the required documents for processing claims and raise an information request in case of an insufficiency Approve or deny claims as per T&C within TAT If candidates are interested please drop your update resume/CV on varsha.kumari@mediassist.in Thanks & Regards Varsjha Kumari Email - varsha.kumari@mediassist.in

We are currently hiring for Medical Underwriting for a global Bank India, Location Bangalore . Experience: Medical Underwriting, Life insurance, Life policies, Life insurance Underwriting. Role: Medical Underwriting Job type: Permanent What you will do: Candidate should have sound medical/technical underwriting knowledge to process Life and Health Insurance applications & proposals (Underwriting). He/she should have good decision-making ability referring to standard guidelines and principles. Productivity is the key KPI for this process and PL should engage in full time production. As a process lead, he or she should handle team queries, give expert opinion for the TM, cascade the process updates, conduct refresher training, MKT/PKT Should drive for the team accuracy and achieve KPI goals for the team (productivity, TAT, pend%, quality %) Should act as back-up for AM in performing monthly QC, query handling, reporting to client, dashboard preparation, addressing priorities in day-to-day activity. Work collaboratively with other TMs and support adjudication in complex cases. Operational task management which include (but not limited to) ISMS documentation, QMS documentation, RCA, Error analysis. Should have better communication skills, attend client calls, prepare minutes and address customer requirement. Need to create resilience within team/cross training when required. Flexible in time and shift as and when there is a need.

We will count on you for : Daily Work Management and delivery of schemes Written and Verbal communication with onshore business partners Process reporting and training Ensuring compliance of all internal and client policies Providing timely updates to AM and Onshore counterparts Driving Process improvements Assist in analyzing and evaluating Benefits data files. Review data to identify issues and discrepancies and provides resolution of errors. Maintains operation systems and tools and provides system support. Performs daily operational assignments and activities, including data analysis, system support and reporting. What you need to have? Graduate with minimum 1 year experience overall Strong health knowledge and experience in global and regional benefits Proficient with MS Word, PowerPoint, and Excel Experience in process building, best practices and/or efficiency projects Strong oral and written communication & presentation skills Good analytical skills Ability to work within a team environment Strong self-starter, fast learner, quality conscious, committed to deadlines Strong attention to detail Strong teamwork skills combined with the ability to work independently with minimal supervision. Language skills are a plus and highly desired, but not required. knowledge of H&B domain What is in it for you? Medical insurance, personal accident insurance, group term life insurance from the day you join us Holidays (As Per the location) Shared Transport (Provided the address falls in service zone) What makes you stand out? Adaptable communicator, facilitator, influencer and problem solver High attention to detail Good relationship skills, Proven ability to work on own initiative as well as in a team Adaptable communicator, facilitator and problem solver High attention to detail Ability to multi-task and prioritize time effectively

Job Summary Join our dynamic team as a PE-Ins Claims specialist where youll leverage your customer service skills and domain knowledge to enhance our claims processing efficiency. This hybrid role offers a unique opportunity to work in a rotational shift environment providing comprehensive support in the Property & Casualty Insurance sector. Your contributions will directly impact our service quality and customer satisfaction. Responsibilities Assist in processing insurance claims efficiently to ensure timely resolution and customer satisfaction. Collaborate with team members to analyze and verify claim information for accuracy and completeness. Utilize customer service skills to address inquiries and provide clear information to clients regarding their claims. Support the team in maintaining accurate records of claims and related documentation. Contribute to the development of process improvements to enhance claims processing efficiency. Participate in training sessions to stay updated on industry trends and company policies. Work closely with the Property & Casualty Insurance domain to understand specific claim requirements. Engage in rotational shifts to provide consistent support and coverage for claim processing. Communicate effectively with clients and stakeholders to ensure a smooth claims experience. Apply domain knowledge to identify potential issues and escalate them appropriately. Provide feedback to management on customer service improvements and claim processing enhancements. Ensure compliance with company policies and industry regulations in all claim handling activities. Foster a collaborative work environment to achieve team goals and improve service delivery. Qualifications Demonstrate strong customer service skills with a focus on client satisfaction. Possess basic understanding of the Property & Casualty Insurance domain. Exhibit excellent communication and interpersonal skills. Show ability to work effectively in a hybrid work model and rotational shifts. Display attention to detail and accuracy in claim processing. Have a proactive approach to problem-solving and process improvement. Certifications Required Customer Service Certification Property & Casualty Insurance Certification

Job description We Are Hiring for International Semi voice Process Profile -: Claim Processing associate ( Semi voice) Languages req: Excellent English communication Requirement -: Good Communication Skills Exp-: 6m- 5 yrs in claims Shifts:Rotational Location : Bangalore Immediate joiners only *** Only 2 rounds of interview Job description Document claim file by accurately capturing and updating claims data/information in compliance with best practices for low to moderate. exposure and complexity for Property and Content damage and Liability/Injury claims. Exercise judgement to determine policy verification and coverage determination by analysing applicable coverage for claims and determining whether the loss falls within the coverage. Exercise judgement to determine liability by gathering and analysing relevant facts, images; utilizing applicable coverages. Identify anomalies and patterns to identify fraudulent claims and refer to SIU team based on SOPs Work to have a timely resolution to claims with complete ownership from initiation/intake to settlement. Assess damages by calculating applicable damage or range of damages. Negotiate settlement of a claim by establishing the appropriate negotiation strategy and utilizing available resources within authority limits. Meet quality standards by following best practices Responsible for data integrity and the appropriate documentation of the claim file as well as for compliance with regulatory requirements. Accountability in customer satisfaction and execute on the strategy to provide the best claims service for host damage protection. Ensure customer service by proactively communicating information, responding to inquiries, following customer protocols and special handling instructions. Ensure legal compliance by following federal laws and regulations, and internal control requirements. Key skills required: Bachelor's degree or college Diploma. • Experience in P&C, Healthcare Claims dealing with damage, liability or injury claims. • Good knowledge of Insurance claims end-to-end value chain activities, challenges and best practices. • Good knowledge of how to evaluate injuries and damage using market tools and technology. •General knowledge of the coverages available under the damage protection, liability policy and some common exclusions. • Results driven, ability to multi-task, pay attention to detail and follow procedures. Proven leadership and time management skills in a team environment. Job Type: Full-time Qualification :Any graduates (Note: All the rounds are Held through telephonic) Email : careers@glympsehr.com NOTE: - Please call or whatsapp Manya @ 9606553811 / 9606557106 !!!Thanks & Regards HR TEAM!!!

Skill required: Claims Services - Payer Claims Processing Designation: Health Admin Services New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years About Accenture Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. Visit us at www.accenture.com 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 support the healthcare claim function, leveraging a knowledge of the processes and systems to receive, edit, price, adjudicate, and process payments for claims. What are we looking for contract conversion Roles and Responsibilities: In this role you are required to solve routine problems, largely through precedent and referral to general guidelines Your primary interaction is within your own team and your direct supervisor In this role you will be given detailed instructions on all tasks The decisions that you make impact your own work and are closely supervised You will be an individual contributor as a part of a team with a predetermined, narrow scope of work Please note that this role may require you to work in rotational shifts Qualification Any Graduation

Please Note - We are looking B. Pharma for this profile. Role & responsibilities Conduct live video streaming sessions with hospitals, patients, or insured members for claim verification. Facilitate real-time validation of treatment, hospitalization documents, and patient identity. Coordinate with claims adjudication team to ensure all required inputs are collected during the call. Identify and report suspicious or incomplete information during live interactions. Maintain call logs, notes, and outcomes in the internal claims processing system. Ensure compliance with data privacy and confidentiality norms during video interactions. Escalate technical issues or critical cases to the relevant teams promptly. Call and coordinate with external vendors (e.g., diagnostic centers, blood test labs) to verify the information shared by the patient during the live video session

Collaborate with cross-functional teams to achieve strategic outcomes Apply subject expertise to support operations, planning, and decision-making Utilize tools, analytics, or platforms relevant to the job domain Ensure compliance with policies while improving efficiency and outcomes

*Process* Bagic (Insurance Sales Process) Need - *Fresher or Experience with Good Eng comms* Qualification - *Min HSC* Experience - *Fresher / min 6months experience in motor Insurance* Salary - 16k inhand Week off - *Rotational off* Timing - *10am - 7pm* Job location - *Ghansoli Mahape*

Role & responsibilities To give Claims & Cashless/preauthorization, and scrutiny Medical Reimbursement Claims, and to Process Claims Third Party Administration (Health) services (TPA) Claims and Preauthorization Processing HealthCare Assistance Services High Ratio Claims Management in coordination with Networking and Empanelment Department Monitoring the overall operations of Claims and Preauthorization. Responsible for ensuring efficient response at the level of Preauthorization to maintain TAT. Ensure adherence to processes and controls. Creating the process for claim processing (Cashless and Reimbursement). Co-ordination between Network Hospitals/Preauthorization/Claims. Ensuring a high-quality patient care at customized/optimized cost. Creating the process for claim processing (Cashless and Reimbursement). Preferred candidate profile • Good Excellent oral and written communication, negotiation, and decision-making skills. • Good customer service/relationship skills and ability to work effectively in a fast-paced environment with shifting priorities . Must be willing to work in non - clinic TPA EXPERIENCE mandatory. Clinical Exp.

Role & responsibilities To give Claims & Cashless/preauthorization, and scrutiny Medical Reimbursement Claims, and to Process Claims Third Party Administration (Health) services (TPA) Claims and Preauthorization Processing HealthCare Assistance Services High Ratio Claims Management in coordination with Networking and Empanelment Department Monitoring the overall operations of Claims and Preauthorization. Responsible for ensuring efficient response at the level of Preauthorization to maintain TAT. Ensure adherence to processes and controls. Creating the process for claim processing (Cashless and Reimbursement). Co-ordination between Network Hospitals/Preauthorization/Claims. Ensuring a high-quality patient care at customized/optimized cost. Creating the process for claim processing (Cashless and Reimbursement). Preferred candidate profile • Good Excellent oral and written communication, negotiation, and decision-making skills. • Good customer service/relationship skills and ability to work effectively in a fast-paced environment with shifting priorities . Must be willing to work in non - clinic TPA EXPERIENCE mandatory.Clinical Exp.

Experience: 1 - 4 Years Location: Pune, Mumbai, Kolhapur, Akola, Jalgaon, Latur, Nagpur, Satara, Solapur Notice Period: Immediate to 30 Days About HDFC ERGO HDFC ERGO General Insurance is one of Indias leading private general insurance companies. As a joint venture between HDFC Ltd. (Indias premier financial services conglomerate) and ERGO International AG (the primary insurance arm of Munich Re Group, Germany), HDFC ERGO combines financial strength with deep insurance expertise to serve millions of customers across India. We are committed to delivering innovative insurance solutions and exceptional customer service. About the Role We are looking for a passionate and result-oriented Assistant Agency Manager - Health to join our growing Health Agency team at HDFC ERGO. In this role, you will play a crucial role in driving our health insurance agency business across multiple locations. You will work closely with agents, guiding them through onboarding, coaching, and engagement processes, while contributing to significant business growth. Key Responsibilities Drive Agency Success Build and grow the health insurance agency business across assigned locations. Recruit, onboard, and train insurance agents for successful activation. Coach agents to enhance productivity, customer engagement, and overall performance. Implement agency best practices across all Digital Office (DO) locations. Deliver Business Results Achieve revenue, premium, and profitability targets for your region. Drive renewal business to meet defined goals. Provide strategic insights based on local market dynamics to inform business plans. Design and implement location-specific business development strategies. Build Strong Relationships Work closely with cross-functional teams including sales, operations, and support functions. Create an engaging and motivating environment for agents. Monitor agent performance and provide ongoing coaching through regular reviews. Minimum Qualifications Bachelors degree in any field. Proficiency in computer applications and digital tools. Strong communication, interpersonal, and team management skills. Preferred Qualifications 3-4 years of experience in insurance, sales, or agency management. Proven track record of consistently achieving business targets. Ability to work effectively with cross-functional teams. Highly motivated, self-starter with a proactive approach. Why Join HDFC ERGO? Competitive salary aligned with industry standards. Comprehensive health insurance coverage for you and your family. Attractive performance-based incentives and recognition programs. Learning and development opportunities for continuous career growth. Work-life balance initiatives and employee well-being programs. Opportunity to be part of one of Indias most trusted and fast-growing general insurance companies.

Role & responsibilities Job Description: Processing Membership / Claims transactions or a health care project in Chennai CDC5 location. User to be ready for work from office 5 days a week and should be based out of Chennai location. Should not have any arrears in academic semester. Should have WIFI connection in home. User should have good english written, understanding and communication skills. Should be strong in email drafting. Work Timings: 5 PM to 2:30 AM IST WFO/WFH: Work from office Qualification Any Graduation (BCom, BSC, BA, BBA Etc) except Computer science graduates.

Roles and Responsibilities Provide health coaching services to patients, focusing on patient care and counseling. Assist doctors in managing patient relationships and ensuring effective communication between patients, families, and medical professionals. Support healthcare operations by coordinating with various departments to ensure seamless delivery of healthcare services. Collaborate with health management teams to develop strategies for improving patient outcomes through data-driven decision making To schedule your interview Call or send your CV through WhatsApp (number mentioned below) HR Ashwini : 9923656681

Job Responsibilities : Building and maintaining strong relationships with key customers and serving as a point of contact for client inquiries and escalations. Applying medical knowledge to resolve the queries and providing guidance. Grievance redressal, handling escalations and identifying the fraudulent claims Responding to customer inquiries via phone calls and emails and resolving customer complaints and concerns. Assisting clients in understanding and navigating the claims process. Collecting and verifying claim documents and coordinating with internal teams and external partners (e.g., TPAs) for claim processing. Tracking claim status and ensuring timely resolution. Maintaining accurate and up-to-date records of client interactions and claim information. Using CRM systems to manage client relationships and track claims Required: We are seeking for applicants who are either BAMS or BHMS with experience in handling health claims grievances only.

Crucial role in managing the entire claims process — right from documentation and coordination to ensuring smooth and timely settlements.

Job Title: Associate - Claims Operations Care.fi is a new age Health fintech startup in Gurgaon, offering smart financing and claim management solutions to hospitals. With a focus on driving efficiencies through technology, Care.fi provides seamless financing and revenue cycle management solution for healthcare providers. The company has strong institutional investor backing and founders with over 20 years of experience in the industry. About the Role Department: Claims Processing / Operations Reports to: Team Lead / Operations Manager Location: Gurugram, Haryana Work Schedule: 6 Days Working We are seeking a diligent File Dispatch Associate with strong medical billing know-how and hospital experience. This role is crucial for our claims processing workflow, involving close collaboration with our AI-powered document review system. The primary responsibility is to assess claims and dockets filed daily, meticulously identifying missing documents and discrepancies to ensure each file is 100% complete and accurate before final dispatch. This position requires a keen eye for detail and specific knowledge of Indian government health schemes. What You'll Do The associate will be responsible for the final human audit of medical files processed by our AI system, focusing on completeness and correctness. Responsibility Area 1. Daily File Assessment Assess claims dockets daily to identify and flag any missing documents or discrepancies across the provided paperwork. Verify the AI's initial classification of Billing Type, Admission Nature, and Anesthesia Type. 2. Document Completeness Audit Core Documents: Ensure the presence and correctness of the Discharge Summary, Patient Feedback Forms, complete Indoor Case Papers (ICP), and both Final and Detailed Bills. Conditional Documents: Based on the case type, validate the presence of mandatory reports and notes, such as Investigation Reports, OT Notes, and Anesthesia Records. 3. Financial & Evidence Verification Billing Audit: Cross-reference the itemized bill with investigation reports to ensure all billed tests have supporting documents High-Value Items: For applicable cases, verify that required evidence for implants (invoices, stickers) and high-cost/chemotherapy medicines (invoices, wrappers) is present in the file. 4. Process Compliance Ensure every file strictly adheres to the medical review checklist before being dispatched Provide clear feedback on any errors or omissions found, contributing to system and process improvement. Maintain accurate logs of file status and reviews. What We're Looking For Required Qualifications Experience Hospital Experience: Prior experience working in a hospital setting (e.g., billing department, TPA desk, medical records) is mandatory Claims Processing: Experience in assessing medical or insurance claims is highly preferred. Knowledge Medical Billing Know-How: Strong, practical understanding of hospital billing processes, including package vs. itemized billing Insurance Knowledge: Must have working knowledge of major government health schemes, specifically Ayushman Bharat, CGHS, and ECHS . Skills Attention to Detail: Exceptional ability to spot errors, omissions, and discrepancies in dense medical documents. Computer Knowledge: Proficient in using computers, including Microsoft Office and other software for viewing and managing digital files. Communication Skills: Decent verbal and written communication skills for reporting and team collaboration. Personal Attributes Methodical & Organized: Ability to follow a checklist-driven process with high accuracy and consistency. Reliable & Accountable: A strong sense of responsibility for the quality and completeness of each file reviewed. Why Carefi Work on real problems that matter healthcare, payments, and patient journeys Small team = high ownership and fast learning Be part of a mission-driven, product-first culture Competitive compensation and flexible work setup (hybrid from Gurgaon)

We are Hiring at Knack RCM! Join our growing team of passionate professionals! Knack RCM is currently hiring for the role of Insurance Verification DME Billing. Minimum Experience Required: 6 months Location: Mohali Punjab Industry: US Healthcare / Revenue Cycle Management (RCM) If you have prior experience in DME (Durable Medical Equipment) billing and a keen eye for detail, wed love to hear from you! Key Responsibilities: Verify patients' insurance eligibility and benefits using online portals or by calling payers. Ensure accurate and complete documentation of insurance details in the system. Obtain prior authorizations and pre-certifications when required. Communicate with patients, insurance companies, and internal teams as needed. Handle insurance-related queries efficiently and in a timely manner. Follow-up with insurance companies for updates on pending verification or authorizations. Maintain confidentiality of patient information at all times. Interested candidates can share their resumes at meenu.5728@knackglobal.com Lets build something great together at #KnackRCM !

Roles and Responsibilities Provide health coaching services to patients, focusing on patient care and counseling. Assist doctors in managing patient relationships and ensuring effective communication between patients, families, and medical professionals. Support healthcare operations by coordinating with various departments to ensure seamless delivery of healthcare services. Collaborate with health management teams to develop strategies for improving patient outcomes through data-driven decision making.

Skill Required -PROFICIENCY IN EXCEL IS A MUST JOB RESPONSIBILITIES Building and maintaining strong relationships with key customers and serving as a point of contact for client inquiries and escalations. Responding to customer inquiries via phone calls and emails and resolving customer complaints and concerns. Providing proactive support and guidance on claim processes to improve the client experience. Assisting clients in understanding and navigating the claims process. Collecting and verifying claim documents and coordinating with internal teams and external partners (e.g., TPAs) for claim processing. Tracking claim status and ensuring timely resolution. Providing accurate and timely information on policy coverage and claims procedures. Maintaining accurate and up-to-date records of client interactions and claim information. Using CRM systems to manage client relationships and track claims Please Note : Timings for this profile will be fixed. No rotational shift. Only candidates with relevant experience in CRM/grievance will be eligible for the interview.

Company: Sutherland Global Services Job Title: Senior Claims/Insurance Executive Position Level: L2 Employment Type: Full-Time Work Model: Brick & Mortar (On-site) Process Type: Blended Process Package: 4.0 4.5 LPA (Based on Experience & Skills) Experience Required: Minimum 2 years of relevant experience in Insurance or Claims Processing Preference will be given to candidates with Motor Claims experience Key Responsibilities: Handle end-to-end claims processing and insurance operations within a blended process model Ensure accurate and timely resolution of insurance claims in line with company policies and procedures Liaise with internal teams, clients, and insurers to gather and verify required documentation Maintain a high level of accuracy and attention to detail in claim evaluation and documentation Provide prompt responses and resolutions to queries and escalations Ensure strict compliance with industry regulations and internal standards Mandatory Requirements: Excellent communication skills in English – both written and verbal Strong understanding of insurance terms, processes, and documentation Ability to work independently and collaboratively in a fast-paced environment Proficiency in MS Office tools and digital claim processing systems Interview Process: HR Round Assessment Managerial Round Preferred Candidate Profile: Detail-oriented and organized Strong analytical and problem-solving skills Customer-focused with a professional approach Prior experience in a corporate insurance/claims environment Job Location: Unit No. 202, 2nd Floor, Campus D, Centennial Business Park, Kundalahalli Main Road, EPIP Area, Bangalore, Karnataka, India – 560066 Walkin now to be a part of a dynamic and growing team!

1 To investigate and verify insurance health claims 2 Required to work on computers and make calls to our clients 3 discuss cases with patients and doctors. We provide full training

Job description We Are Hiring for International Semi voice Process Profile -: Claim Processing associate ( Semi voice) Languages req: Excellent English communication Requirement -: Good Communication Skills Exp-: 6m- 5 yrs in claims Shifts:Rotational Location : Bangalore Immediate joiners only *** Only 2 rounds of interview Job description Document claim file by accurately capturing and updating claims data/information in compliance with best practices for low to moderate. exposure and complexity for Property and Content damage and Liability/Injury claims. Exercise judgement to determine policy verification and coverage determination by analysing applicable coverage for claims and determining whether the loss falls within the coverage. Exercise judgement to determine liability by gathering and analysing relevant facts, images; utilizing applicable coverages. Identify anomalies and patterns to identify fraudulent claims and refer to SIU team based on SOPs Work to have a timely resolution to claims with complete ownership from initiation/intake to settlement. Assess damages by calculating applicable damage or range of damages. Negotiate settlement of a claim by establishing the appropriate negotiation strategy and utilizing available resources within authority limits. Meet quality standards by following best practices Responsible for data integrity and the appropriate documentation of the claim file as well as for compliance with regulatory requirements. Accountability in customer satisfaction and execute on the strategy to provide the best claims service for host damage protection. Ensure customer service by proactively communicating information, responding to inquiries, following customer protocols and special handling instructions. Ensure legal compliance by following federal laws and regulations, and internal control requirements. Key skills required: Bachelor's degree or college Diploma. • Experience in P&C, Healthcare Claims dealing with damage, liability or injury claims. • Good knowledge of Insurance claims end-to-end value chain activities, challenges and best practices. • Good knowledge of how to evaluate injuries and damage using market tools and technology. •General knowledge of the coverages available under the damage protection, liability policy and some common exclusions. • Results driven, ability to multi-task, pay attention to detail and follow procedures. Proven leadership and time management skills in a team environment. Job Type: Full-time Qualification :Any graduates (Note: All the rounds are Held through telephonic) Email : careers@glympsehr.com NOTE: - Please call or whatsapp Manya @ 9606557106 / 9606553811 !!!Thanks & Regards HR TEAM!!!

Role & responsibilities HEAPS is a health tech platform and Software as a Service (SAAS) provider which leverages advanced data analytics, artificial intelligence and machine learning to revolutionize healthcare delivery and payments model by building a Healthcare Network and a Value Based Care” model. 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 Role & responsibilities Preferred candidate profile