619 Insurance Claims Jobs - Page 11

Review and validate claims as per hospital MOU terms. Ensure accurate mapping of pricing, packages, inclusions, and exclusions. Coordinate with internal teams for issue resolutions Eligibility: BDS, BHMS, BAMS, BPT graduates. Work Type: Remote

Main Accountabilities Credit Risk Assessment & Monitoring Perform credit assessment and counterparty risk review, prepare score card for credit assessment Liaise with other departments and to seek approvals on counterparty credit risk assessments Conduct due diligence on counterparties Credit assessment and grading for all counterparties Ongoing Review of counterparties in adherence to Credit policy Database Management Updating of summary sheet and saving all the approvals for approved counterparties Annual review of active counterparties Highlight potential high credit risk counterparties Monthly Warehouse Exposure report and highlight limit breach Monthly Credit report Insurance Policy Renewals and Claims Settlements Coordinate with surveyor and transporter or plant team for survey after loss incident Register the claims and provide necessary documents for claim settlement Prepare insurance claim MIS and share fortnightly with respective stakeholders Prepare import shipments detail and share with R2R team for amortization Renewal of Insurance Policies: IAR, Standard Fire & Special Perils, Package Policy, CGL Policy, Directors and Officers Policy (D&O), Pollution Legal Liability (PLA) Renewal of Marine Policy, Domestic and Import Coordinate with valuer for insurance appraisal Sum insured enhancement time to time Knowledge and Skills Behavior Improve Bunge's outcomes by making data-driven decisions, keeping the customer at the forefront of all they do, and proactively gaining insight into the global strategy Collaborate, effectively communicate with others and take initiative to continually develop themselves Pursue opportunities to solve problems and take action while maintaining the ability to manage work, even in times of challenge or change Technical Ability to provide high quality level of customer service for Counterparty credit risk assessments & reporting Ability to work independently, efficiently and deliver high quality output under time pressure In-depth knowledge of Counterparties assessment and due diligence Good knowledge of concepts and procedures related to Counterparty credit risk assessments & reporting Experience in SAP and workflow tools Education & Experience 3 5 years of work experience in a similar role Experience in Agribusiness / Commodity trading industry preferred Experience working in Counterparty credit risk assessments & reporting Minimum Education Qualification B.Com / M.Com / MBA Finance from reputed institute Independent and meticulous with figures Strong written & oral communications skills in English. Knowledge of Asia languages added advantage Strong problem solving & organization skills Experience in managing people and processes through a sustained period of change Excellent computer skills and competency in Microsoft Office (Word, PowerPoint, Excel, Outlook) Experience in ERP / Accounting systems

Main Accountabilities Credit Risk Assessment & Monitoring Perform credit assessment and counterparty risk review, prepare score card for credit assessment Liaise with other departments and to seek approvals on counterparty credit risk assessments Conduct due diligence on counterparties Credit assessment and grading for all counterparties Ongoing Review of counterparties in adherence to Credit policy Database Management Updating of summary sheet and saving all the approvals for approved counterparties Annual review of active counterparties Highlight potential high credit risk counterparties Monthly Warehouse Exposure report and highlight limit breach Monthly Credit report Insurance Policy Renewals and Claims Settlements Coordinate with surveyor and transporter or plant team for survey after loss incident Register the claims and provide necessary documents for claim settlement Prepare insurance claim MIS and share fortnightly with respective stakeholders Prepare import shipments detail and share with R2R team for amortization Renewal of Insurance Policies: IAR, Standard Fire & Special Perils, Package Policy, CGL Policy, Directors and Officers Policy (D&O), Pollution Legal Liability (PLA) Renewal of Marine Policy, Domestic and Import Coordinate with valuer for insurance appraisal Sum insured enhancement time to time Knowledge and Skills Behavior Improve Bunge's outcomes by making data-driven decisions, keeping the customer at the forefront of all they do, and proactively gaining insight into the global strategy Collaborate, effectively communicate with others and take initiative to continually develop themselves Pursue opportunities to solve problems and take action while maintaining the ability to manage work, even in times of challenge or change Technical Ability to provide high quality level of customer service for Counterparty credit risk assessments & reporting Ability to work independently, efficiently and deliver high quality output under time pressure In-depth knowledge of Counterparties assessment and due diligence Good knowledge of concepts and procedures related to Counterparty credit risk assessments & reporting Experience in SAP and workflow tools Education & Experience 3 5 years of work experience in a similar role Experience in Agribusiness / Commodity trading industry preferred Experience working in Counterparty credit risk assessments & reporting Minimum Education Qualification B.Com / M.Com / MBA Finance from reputed institute Independent and meticulous with figures Strong written & oral communications skills in English. Knowledge of Asia languages added advantage Strong problem solving & organization skills Experience in managing people and processes through a sustained period of change Excellent computer skills and competency in Microsoft Office (Word, PowerPoint, Excel, Outlook) Experience in ERP / Accounting systems

Greetings !!! We are hiring for top MNC Firms with attractive salary packages in the market. For more clarification about this job role, please feel free to reach out to us on the below mentioned number: Meet Your HR Contact: HR Ananya +91 88844 96986 Rivera Manpower Services *send cv on whatsapp if line is busy* Job Title: Customer Service Representative Banking (Early Morning Shift) Location: [Manyatha Techpark] Salary: 6 Lakhs Per Annum Shift Timing: Early Morning (2am to 5am First login) Employment Type: Full-Time About the Role: We are seeking a proactive and customer-focused Customer Service Representative to join our banking support team. This role is ideal for individuals with excellent communication skills, a strong service orientation, and a passion for resolving customer queries efficiently. The position involves handling inbound and outbound customer interactions, primarily via phone, email, or chat, in a fast-paced and regulated environment. Key Responsibilities: Handle customer inquiries related to banking products and services (accounts, transactions, cards, loans, etc.) via calls, emails, or chat. Provide accurate information, troubleshoot issues, and resolve complaints in a timely and professional manner. Adhere to compliance standards and maintain confidentiality of customer information. Escalate unresolved issues to appropriate departments and follow up to ensure resolution. Update customer records and maintain detailed logs of interactions. Meet or exceed service level targets such as response time, resolution rate, and customer satisfaction scores. Requirements: Bachelors degree in any discipline (Commerce/Finance preferred). 1-3 years of experience in customer service or support roles, preferably in the BFSI sector. Excellent verbal and written communication skills in English (additional regional language proficiency is a plus). Basic understanding of banking products and processes. Ability to work independently and handle high-pressure situations with professionalism. Willingness to work early morning shifts as per business requirements. What We Offer: Competitive salary package upto 6 LPA. Performance-based incentives. Extensive training and development programs. Opportunity to work with a leading name in the banking sector. Health insurance, paid leaves, and other employee benefits. Warm regards, HR Ananya +91 88844 96986 Rivera Manpower Services

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management 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 We help insurers redefine their customer experience while accelerating their innovation agenda to drive sustainable growth by transforming to an intelligent operating model. Intelligent Insurance Operations combines our advisory, technology, and operations expertise, global scale, and robust ecosystem with our insurance transformation capabilities. It is structured to address the scope and complexity of the ever-changing insurance environment and offers a flexible operating model that can meet the unique needs of each market segment.Claim processing team collects end-end data dataDevelop and deliver business solutions that support the claims process across its lifecycle, including first notice of loss, claims investigation, payment administration or adjudication, provider reimbursement (health care), subrogation and recovery. What are we looking for Claims ProcessingProperty and Casualty Insurance 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

Good Knowledge in insurance cashless process in Hospital Exp : 2-4 yrs Qualification : Any Graduate Interested candidate please share your CV on hr1.jh@mmfhospitals.in Mrunalini.S 02041096690 / 8657171616

GOOD KNOWLEDGE IN INSURANCE ,CASHLESS PROCESS INTO HOSPITAL

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 Stay up to date on new policies, processes, and procedures impacting the outcome of Claims processing Be a team player and work seamlessly with other team members on meeting customer goals Preferences for this role include: 1.5+ years of experience processing insurance claims in the health, life, or disability disciplines that required knowledge of CPT, HCPCS, ICD9/10, CDT. 2+ year(s) of experience in role that required understanding and interpreting complex documents such as medical records and legal contracts. Requirements for this role include: Candidate should be flexible & support team during crisis period Should be confident, highly committed and result oriented Experience on working in an office environment set up utilizing Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools Experience in a professional/office related role that required you to communicate (oral/written) effectively with internal team members and external customers Experience in a role that required a focus on quality including attention to detail, accuracy, and accountability for your work product Candidate should be flexible to work from home and office environment. Broadband connection is must while working from home. Both Under Graduates and Postgraduates can apply. Excellent communication (verbal and written) and customer service skills. Able to work independently; strong analytic skills. Detail-oriented; ability to organize and multi-task. Ability to make decisions. Required computer skills: must have experience with data entry and word processing, possess a working knowledge of MS Office applications, and understand how to navigate through web-based applications. Demonstrate strong reading comprehension and writing skills. Cognitive Skills include language, basic math skills, reasoning ability and verbal communication skills. Ability to work in a team environment. Handling different Reports - IGO/NIGO and Production/Quality. To be in a position to handle training for new hires Work together with the team to come up with process improvements Strictly monitor the performance of all team members and ensure to report in case of any defaulters. Encourage the team to exceed their assigned targets. **Required schedule availability for this position is Monday-Friday 6PM/4AM IST . The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekends basis business requirement.

Greetings from Access Healthcare Minimum 1year of experience required Should have Knowledge in payer or provider experience Candidate should have good communication skills Basic knowledge on Revenue cycle management Salary as per company norms Ready to work in night shift Location : Chennai Interested candidates can drop your resume through WhatsApp - 9944497268/9043315031

Greetings !!! We are hiring for top MNC Firms with attractive salary packages in the market. For more clarification about this job role, please feel free to reach out to us on the below mentioned number: Shiva: +917996772782 Muskaan: 8884496984 Job Title: Customer Service Representative Banking (Early Morning Shift) Location: [Manyatha Techpark] Salary: 6 Lakhs Per Annum Shift Timing: Early Morning Employment Type: Full-Time About the Role: We are seeking a proactive and customer-focused Customer Service Representative to join our banking support team. This role is ideal for individuals with excellent communication skills, a strong service orientation, and a passion for resolving customer queries efficiently. The position involves handling inbound and outbound customer interactions, primarily via phone, email, or chat, in a fast-paced and regulated environment. Key Responsibilities: Handle customer inquiries related to banking products and services (accounts, transactions, cards, loans, etc.) via calls, emails, or chat. Provide accurate information, troubleshoot issues, and resolve complaints in a timely and professional manner. Adhere to compliance standards and maintain confidentiality of customer information. Escalate unresolved issues to appropriate departments and follow up to ensure resolution. Update customer records and maintain detailed logs of interactions. Meet or exceed service level targets such as response time, resolution rate, and customer satisfaction scores. Requirements: Bachelors degree in any discipline (Commerce/Finance preferred). 1-3 years of experience in customer service or support roles, preferably in the BFSI sector. Excellent verbal and written communication skills in English (additional regional language proficiency is a plus). Basic understanding of banking products and processes. Ability to work independently and handle high-pressure situations with professionalism. Willingness to work early morning shifts as per business requirements. What We Offer: Competitive salary package upto 6 LPA. Performance-based incentives. Extensive training and development programs. Opportunity to work with a leading name in the banking sector. Health insurance, paid leaves, and other employee benefits. Thanks and regards, Shiva

Roles and Responsibilities Manage a team of insurance claims handlers to achieve targets and improve process efficiency. Ensure compliance with regulatory requirements, company policies, and procedures. Develop and implement effective training programs for new joiners and existing staff to enhance their skills. Monitor performance metrics such as quality scores, first-call resolution rates, and customer satisfaction ratings. Identify areas of improvement and implement changes to optimize processes. Desired Candidate Profile 7-10 years of experience in handling insurance claims or related roles. Strong knowledge of UK insurance industry regulations and practices. Excellent communication skills (written & verbal) with ability to handle complex customer queries. Ability to work effectively under pressure while maintaining high levels of accuracy.

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 Stay up to date on new policies, processes, and procedures impacting the outcome of Claims processing Be a team player and work seamlessly with other team members on meeting customer goals Requirements for this role include: Both Under Graduates and Post Graduates can apply. Excellent communication (verbal and written) and customer service skills. Able to work independently; strong analytic skills. Detail-oriented; ability to organize and multi-task. Ability to make decisions. Required computer skills: must have experience with data entry and word processing, possess a working knowledge of MS Office applications, and understand how to navigate through web-based applications. Demonstrate strong reading comprehension and writing skills. Cognitive Skills include language, basic math skills, reasoning ability and verbal communication skills. Ability to work in a team environment. Handling different Reports - IGO/NIGO and Production/Quality. To be in a position to handle training for new hires Work together with the team to come up with process improvements Strictly monitor the performance of all team members and ensure to report in case of any defaulters. Encourage the team to exceed their assigned targets. **Required schedule availability for this position is Monday-Friday 6PM/4AM IST. The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekend s basis business requirement. Requirements for this role include: Candidate should be flexible & support team during crisis period Should be confident, highly committed and result oriented Experience on working in an office environment set up utilizing Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools Experience in a professional/office related role that required you to communicate (oral/written) effectively with internal team members and external customers

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 processing Continuous learning to ramp up on the knowledge curve to be the SME and to be compliant with any certification as required to perform the job Be a team player and work seamlessly with other team members on meeting customer goals Developing and maintaining a solid working knowledge of the insurance industry and of all products, services and processes performed by Claims function Handle reporting duties as identified by the team manager Handle claims processing across multiple products/accounts as per the needs of the business Requirements for this role include: Both Under Graduates and Post Graduates can apply. Excellent communication (verbal and written) and customer service skills. Able to work independently; strong analytic skills. Detail-oriented; ability to organize and multi-task. Ability to make decisions. Required computer skills: must have experience with data entry and word processing, possess a working knowledge of MS Office applications, and understand how to navigate through web-based applications. Demonstrate strong reading comprehension and writing skills. Cognitive Skills include language, basic math skills, reasoning ability and verbal communication skills. Ability to work in a team environment. Handling different Reports - IGO/NIGO and Production/Quality. To be in a position to handle training for new hires Work together with the team to come up with process improvements Strictly monitor the performance of all team members and ensure to report in case of any defaulters. Encourage the team to exceed their assigned targets. Candidate should be flexible & support team during crisis period Should be confident, highly committed and result oriented Experience on working in an office environment set up utilizing Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools Experience in a professional/office related role that required you to communicate (oral/written) effectively with internal team members and external customers Experience in a role that required a focus on quality including attention to detail, accuracy, and accountability for your work product Candidate should be flexible to work from home and office environment. Broadband connection is must while working from home. Preferences for this role include: 5+ years of experience processing insurance claims in the health, life, or disability disciplines that required knowledge of CPT, HCPCS, ICD9/10, CDT. 2+ year(s) of experience in role that required understanding and interpreting complex documents such as medical records and legal contracts. ***Required schedule availability for this position is Monday-Friday 6PM/4AM IST. The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekend s basis business requirement.

Positions General Duties and Tasks In these roles you will be responsible for: Performing outbound calls to insurance companies (in the US) to collect outstanding Accounts Receivables. Responding to customer requests by phone and/or in writing to ensure customer satisfaction and to assure that service standards are met Analyzing medical insurance claims for quality assurance Resolving moderately routine questions following pre-established guidelines Performing routine research on customer inquiries. Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team Requirements for this role include: Ability to work regularly scheduled shifts from Monday-Friday 8:30PM to 5:30AM or 10:30PM to 7:30AM. High school diploma 1+ year(s) of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools. 0-6 months of experience in a service-oriented role where you had to correspond in writing or over the phone with customers who spoke English. 0-6 months of experience in a service-oriented role where you had to apply business rules to varying fact situations and make appropriate decisions *** The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekend s basis business requirement. *** All new hires will be required to successfully complete our Orientation/Process training classes and demonstrate proficiency of the material.

Scope Of Work* 1.Ensure adherence to established contracts management procedures 2. Review and analyse tender documents from commercial and contractual point of view (Salient 3.conditions, list of clarifications, exceptions and deviations, risk identification and assessment).4.Prepare proposed risk mitigation plan from contractual point of view.5.Analyse reasons for delays and disruptions, identify client related reasons and issue notification and change orders to the client in consultation with the Project Manager. Scope Of Work- Shared Across Functionally o Support Project Manager in all contractual discussions with the client o Develop understanding of internal working of owner/ client s project management and other departments (like Legal, Finance, Operations) to ensure effective discussion/ resolution of contractual claims o Identify insurance requirements for the project, monitor renewal and closure of insurance policies o Provide inputs on local tax laws, IMPEX, INCOTERMS, FIDIC etc. to the Project Manager o Obtain validation on legal review from Legal function o Participate in pre-bid meetings and negotiations with client, seek commercial clarifications o Support project team on contract administration throughout the project lifecycle (change orders, scope extensions) o Provide inputs to Project Manager to prioritize change orders and build basis for negotiation with the client o Provide inputs to enable procurement and formulate back to back T&C for inclusion in agreements with subcontractors/ vendors. Behavioral Ability to work with multidisciplinary teams -Must be a professional of unquestionable integrity, credibility, and character -Good interpersonal and negotiation skills Technical 1) Experience of drafting of Agreements/ Contract 2) Good working knowledge of Indirect Taxation 3) Handled Insurance Claims 4) Experience of Claims Management

In this Role you will be Responsible For : - Read and understand the process documents provided by the customer - Analyze the insurance claims and process as per standard operating procedures - To understand and calculate (COB - Coordination of Benefit) the patients responsibility and perform insurance calculations - Familiarize, navigate multiple client applications and capture the necessary information to process insurance claims. Requirements for this role include: - 0 -1 Year of experience in any Healthcare BPO - University degree or equivalent that required 3+ years of formal studies - Candidates with good typing skills with 25 WPM or completed typewriting lower preferred or good to have - 1+ year(s) of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools. - Ability to work scheduled shifts from Monday-Friday 06:00 PM to 04:00 AM and to be flexible to accommodate business requirements - Ability to communicate (oral/written) effectively in English to exchange information with our client.

At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees are key factors in our company s growth, market presence and our ability to help our clients stay a step ahead of the competition. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here. NTT DATA, Inc. currently seeks a BPO HC & Insurance Operations Senior Representative to join our team in "Chennai" Positions General Duties and Tasks Required. In this Role you will be Responsible For : - Read and understand the process documents provided by the customer - Analyze the insurance claims and process as per standard operating procedures - To understand and calculate (COB - Coordination of Benefit) the patients responsibility and perform insurance calculations - Familiarize, navigate multiple client applications and capture the necessary information to process insurance claims Requirements for this role include: - 0 -1 Year of experience in any Healthcare BPO - University degree or equivalent that required 3+ years of formal studies - Candidates with good typing skills with 25 WPM or completed typewriting lower preferred or good to have - 1+ year(s) of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools. - Ability to work scheduled shifts from Monday-Friday 06:00 PM to 04:00 AM and to be flexible to accommodate business requirements - Ability to communicate (oral/written) effectively in English to exchange information with our client.In this Role you will be Responsible For : - Read and understand the process documents provided by the customer - Analyze the insurance claims and process as per standard operating procedures - To understand and calculate (COB - Coordination of Benefit) the patients responsibility and perform insurance calculations - Familiarize, navigate multiple client applications and capture the necessary information to process insurance claims Requirements for this role include: - 0 -1 Year of experience in any Healthcare BPO - University degree or equivalent that required 3+ years of formal studies - Candidates with good typing skills with 25 WPM or completed typewriting lower preferred or good to have - 1+ year(s) of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools. - Ability to work scheduled shifts from Monday-Friday 06:00 PM to 04:00 AM and to be flexible to accommodate business requirements - Ability to communicate (oral/written) effectively in English to exchange information with our client.

At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees are key factors in our company s growth, market presence and our ability to help our clients stay a step ahead of the competition. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here. NTT DATA, Inc. currently seeks a BPO HC & Insurance Operations Senior Representative to join our team in "Chennai or Coimbatore " Positions General Duties and Tasks Required. In this Role you will be Responsible For : - Read and understand the process documents provided by the customer - Analyze the insurance claims and process as per standard operating procedures - To understand and calculate (COB - Coordination of Benefit) the patients responsibility and perform insurance calculations - Familiarize, navigate multiple client applications and capture the necessary information to process insurance claims Requirements for this role include: - 0 -1 Year of experience in any Healthcare BPO - University degree or equivalent that required 3+ years of formal studies - Candidates with good typing skills with 25 WPM or completed typewriting lower preferred or good to have - 1+ year(s) of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools. - Ability to work scheduled shifts from Monday-Friday 06:00 PM to 04:00 AM and to be flexible to accommodate business requirements - Ability to communicate (oral/written) effectively in English to exchange information with our client.In this Role you will be Responsible For : - Read and understand the process documents provided by the customer - Analyze the insurance claims and process as per standard operating procedures - To understand and calculate (COB - Coordination of Benefit) the patients responsibility and perform insurance calculations - Familiarize, navigate multiple client applications and capture the necessary information to process insurance claims Requirements for this role include: - 0 -1 Year of experience in any Healthcare BPO - University degree or equivalent that required 3+ years of formal studies - Candidates with good typing skills with 25 WPM or completed typewriting lower preferred or good to have - 1+ year(s) of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools. - Ability to work scheduled shifts from Monday-Friday 06:00 PM to 04:00 AM and to be flexible to accommodate business requirements - Ability to communicate (oral/written) effectively in English to exchange information with our client.

In this Role you will be Responsible For : - Read and understand the process documents provided by the customer - Analyze the insurance claims and process as per standard operating procedures - To understand and calculate (COB - Coordination of Benefit) the patients responsibility and perform insurance calculations - Familiarize, navigate multiple client applications and capture the necessary information to process insurance claims. Requirements for this role include: - 0 -1 Year of experience in any Healthcare BPO - University degree or equivalent that required 3+ years of formal studies - Candidates with good typing skills with 25 WPM or completed typewriting lower preferred or good to have - 1+ year(s) of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools. - Ability to work scheduled shifts from Monday-Friday 06:00 PM to 04:00 AM and to be flexible to accommodate business requirements - Ability to communicate (oral/written) effectively in English to exchange information with our client.

Interested Candidates may connect with Ms.Zoya Shamsi +91 7251000195 (11am-5pm) About the Role: We are seeking a highly motivated and experienced individual with a medical background to join our dynamic team as a Medical Claims Call Center Representative. In this role, you will be the frontline of our customer service, handling inbound calls related to medical claims and rejections. Your primary focus will be to provide exceptional customer service while resolving inquiries and concerns effectively, ensuring a positive experience for every Niva Bupa member. Key Responsibilities: Answer incoming customer calls promptly and professionally. Assist customers with navigating medical claims, including inquiries about submissions, rejections, and procedures. Provide accurate and detailed information about claim processes, documentation requirements, and insurance coverage. Investigate and resolve customer concerns with a focus on high satisfaction and clear communication. Collaborate with internal departments like claims processing to address complex issues and expedite resolutions. Maintain extensive knowledge of Niva Bupa products, medical billing codes, and claim procedures. Document customer interactions and update records accurately in our system. Identify and escalate critical or unresolved issues to the appropriate supervisor. Adhere to company policies, procedures, and compliance guidelines. Key Requirements: Education & Certificates: B.Pharm & M.Pharm. Minimum 1-3 years of call center experience, preferably in healthcare or medical insurance. Strong knowledge of medical terminology, insurance claim procedures, and billing codes. Excellent verbal and written communication skills. Ability to handle high call volumes and prioritize customer needs effectively. Strong problem-solving and decision-making abilities. Attention to detail and accuracy in data entry and documentation. Exceptional customer service skills with a friendly and professional demeanor. Proficiency in computer systems, including CRM software and Microsoft Office Suite. Ability to work effectively in a team-oriented environment. Flexibility to work various shifts as per business requirements. What you'll gain? A competitive salary package of up to Rs. 3.5 LPA, based on your experience and Interview performance. Be part of a growing and respected healthcare company. Make a real difference in the lives of our members by providing exceptional customer service. Work in a dynamic and supportive environment with opportunities for growth and development. Competitive salary and benefits package. Ready to join Niva Bupa and contribute to a team dedicated to improving lives? Apply today!

Job Overview: We are looking for a person who has possesses understanding in the insurance industry, including premium, claims, reserves, and treaty types, with strong accounting knowledge. Key Responsibilities Claim Intake and Assessment: Receiving and logging new claims, verifying policy details, and assessing the validity of the claim based on policy conditions. Information Gathering: Collecting necessary information and documentation from claimants, witnesses, and other relevant parties, including photographs, reports, and financial records. Liaison: Maintaining communication with claimants, solicitors, loss adjusters, and other professionals involved in the claim process. Documentation and Reporting: Maintaining accurate records of all claim-related activities, preparing reports, and ensuring compliance with company procedures and regulations. Customer Service: Providing excellent customer service to claimants throughout the claim process, addressing their inquiries and concerns. Fraud Detection: Identifying and investigating potential fraudulent claims. Compliance: Ensuring compliance with all relevant regulations and guidelines, including those set by the Financial Conduct Authority (FCA). Required Skills and Qualifications: Communication Skills: Excellent verbal and written communication skills for interacting with various parties. Analytical Skills: Ability to analyze information, assess claims, and make informed decisions. Organizational Skills: Ability to manage a large workload, prioritize tasks, and meet deadlines. Customer Service Skills: Ability to provide excellent customer service and build rapport with claimants. Knowledge of Insurance: Understanding of insurance principles, policy wording, and claims handling procedures. Attention to Detail: Ability to pay close attention to detail when reviewing documents and assessing claims. Problem-Solving Skills: Ability to identify and resolve issues that arise during the claim process. Qualifications: Graduate What We Offer Joining QX Global Group means becoming part of a creative team where you can personally grow and contribute to our collective goals. We offer competitive salaries, comprehensive benefits, and a supportive environment that values work-life balance. Work Model Location: Vadodara Model: WFO (Indian Shift)

Candidate should have a min of 1 to 4 years of experience in P&C or Specialty Insurance BPO service provider Must have managed FNOL (First notify of loss), FROI (First report of injury), Document Management & Payments Processing Good Communication Required Candidate profile Practical know-how of using MS Office application Mandatory: Graduate or Postgraduate from any background Desirable: Insurance / Risk management Commitment to achieving deadlines Good communication

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. Astha Saklani 7087994355 HRD

Job Title: US Insurance Process Voice Location: Bangalore Job Type: Full-Time & US Shifts Job Summary: We are looking for dynamic and customer-focused individuals to join our US Insurance Voice Process team. As a voice process associate, you will be responsible for handling inbound/outbound calls related to insurance policies, claims, billing, and customer queries for US-based clients. This role requires excellent communication skills, attention to detail, and a strong understanding of insurance practices. Key Responsibilities: Handle inbound and outbound calls from US customers regarding insurance inquiries. Assist clients with policy information, renewals, claims processing, premium payments, and policy changes. Provide accurate and timely information while ensuring first-call resolution. Update and maintain customer records in the system as per client requirements. Follow compliance and confidentiality regulations. Escalate complex queries to appropriate departments or supervisors. Meet performance metrics including call quality, average handling time (AHT), and customer satisfaction (CSAT). Requirements: High School Diploma or equivalent (Bachelors degree preferred). 0–4 years of experience in US Insurance Process or international voice process (preferred). Excellent verbal communication and listening skills (neutral accent preferred). Knowledge of US insurance terminologies (Life, Health, Auto, or Property & Casualty). Familiarity with CRM systems and basic computer skills. Willingness to work in night shifts or rotational shifts (US time zones). Ability to work under pressure in a target-driven environment. Preferred Skills: Prior experience in a BPO handling US clients. Understanding of US healthcare or property & casualty insurance processes. Typing speed of 30+ WPM with high accuracy. What We Offer: Competitive salary + performance-based incentives & shift allowance. Training on US insurance products and systems. Opportunity to work with global insurance clients. Growth opportunities and internal mobility. Contact point : Nancy - 9686682465 / 7259027295 / 7760984460 / 7259027282 / 9900024811

Job Title: Customer Support Executive - Insurance (Female Candidates Only) Company: Royal Sundaram General Insurance Department: Customer Support Location: Gurgaon Work Mode: Hybrid Experience Required: Minimum 1 Year (Insurance Industry) CTC Offered: 3.00 to 4.00 LPA Preferences: Female Candidates Only Job Description: Royal Sundaram General Insurance is looking for passionate and customer-centric professionals to join our Customer Support team in Gurgaon. The ideal candidate will have prior experience in the insurance industry and be committed to delivering exceptional service to our customers. Key Responsibilities: Handle inbound and outbound customer queries related to policies, claims, and services Assist customers with policy renewals, endorsements, and grievance redressal Coordinate with internal teams to ensure prompt issue resolution Maintain accurate records of customer interactions in the system Ensure high levels of customer satisfaction and service quality Follow compliance and quality guidelines of the insurance sector Candidate Profile: Minimum 1 year of experience in customer support within the insurance industry Strong communication and interpersonal skills Good command over English and Hindi Ability to handle pressure and multitask Basic proficiency in MS Office and CRM tools Female candidates only (as per team diversity goals) Benefits: Competitive CTC Hybrid work model Growth opportunities within a leading insurance brand Supportive team culture Interested candidates can apply directly through Naukri.com or share their resume at [Ravinder.Rohilla@royalsundaram.in].