323 Mediclaim Jobs

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Roles and Responsibilities: Check the medical admissibility of a claim by confirming the diagnosis and treatment details. Scrutinize the claims, as per the terms and conditions of the insurance policy. Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiation of open billing and package etc. Understand the process difference between PA and an RI claim and verify the necessary details accordingly. Verify the required documents for processing claims and raise an IR in case of an insufficiency. Coordinate with the LCM team in case of higher billing and with the provider team in case of non-availability of tariff. Approve or d...

Role & responsibilities Processing of pre-authorization/cashless claim. Maintain processing TAT for pre-auth/cashless claim Must be able to analyze large amount of data, Identify patterns and draw conclusions from that data Must have previous experience of conducting audit, sampling and preparing reports Reviewing insurance policy documents to determine coverage limits, exclusions that may affect the claim. Reviewing medical bills, medical records, and other documentation to determine medical necessity and appropriate treatment. Preferred candidate profile Any Medical degree (Mandatory) Good communication skills Ability to multi-task Good interpersonal skills Should know internal systems Goo...

Roles and Responsibilities Manage insurance billing processes for patients, ensuring accurate and timely submission of claims. Coordinate with TPA (Third Party Administrator) teams to resolve any discrepancies or issues related to medical billing. Prepare and review discharge summaries, including patient care information, treatment details, and insurance coverage. Handle mediclaim cases by processing claims, resolving queries, and maintaining records. Desired Candidate Profile 2-5 years of experience in Insurance Billing or Medical Billing. Strong knowledge of IP (Insurance Policy), TPA, Patient Care, Claims Processing, Insurance Billing, Mediclaim. Excellent communication skills for effecti...

Roles and Responsibilities: Check the medical admissibility of a claim by confirming the diagnosis and treatment details. Scrutinize the claims, as per the terms and conditions of the insurance policy. Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiation of open billing and package etc. Understand the process difference between PA and an RI claim and verify the necessary details accordingly. Verify the required documents for processing claims and raise an IR in case of an insufficiency. Coordinate with the LCM team in case of higher billing and with the provider team in case of non-availability of tariff. Approve or d...

Roles and Responsibilities: Check the medical admissibility of a claim by confirming the diagnosis and treatment details. Scrutinize the claims, as per the terms and conditions of the insurance policy. Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiation of open billing and package etc. Understand the process difference between PA and an RI claim and verify the necessary details accordingly. Verify the required documents for processing claims and raise an IR in case of an insufficiency. Coordinate with the LCM team in case of higher billing and with the provider team in case of non-availability of tariff. Approve or d...

TPA/Ayushmaan Operator required for Basna near Raipur (C.G.)Location Note- Good Knowledge of TPA 1- Basna near Raipur C.G. Call/WhatsApp-8090286126/7897900209 Regards ARTI SONI Linking Jobs

Mega Walk-in Drive US Healthcare (Claims Adjudication) Date: 19th & 20th September 2025 Time: 11:30 AM 4:00 PM Venue: Sagility, KCT Tech Park, Thudiyalur Rd, Saravanampatti, Coimbatore, Tamil Nadu 641049 We Are Hiring Experienced Professionals! Join our growing team in US Healthcare Claims Adjudication Minimum Requirement 3.6+ years of experience in US Healthcare (Claims Processing & Adjudication) Additional Opportunities in Sagility : We have openings for WFM & Training functions Also for Internal Contact Center Operations (Inbound calls) Open Positions Team Leader Operations Quality Specialist Subject Matter Expert (SME) Process Trainer Quality Team Leader Assistant Manager Operations Depu...

Roles and Responsibilities: Check the medical admissibility of a claim by confirming the diagnosis and treatment details. Scrutinize the claims, as per the terms and conditions of the insurance policy. Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiation of open billing and package etc. Understand the process difference between PA and an RI claim and verify the necessary details accordingly. Verify the required documents for processing claims and raise an IR in case of an insufficiency. Coordinate with the LCM team in case of higher billing and with the provider team in case of non-availability of tariff. Approve or d...

Roles and Responsibilities: Check the medical admissibility of a claim by confirming the diagnosis and treatment details. Scrutinize the claims, as per the terms and conditions of the insurance policy. Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiation of open billing and package etc. Understand the process difference between PA and an RI claim and verify the necessary details accordingly. Verify the required documents for processing claims and raise an IR in case of an insufficiency. Coordinate with the LCM team in case of higher billing and with the provider team in case of non-availability of tariff. Approve or d...

About Us: Medi Assist is India's leading Health Tech and Insure Tech company focused on administering health benefits across employers, retail members, and public health schemes. We consistently strive to drive innovation and participate in such initiatives, to lower health care costs. Our Health Benefits: Administration model is designed to deliver the tools necessary for a health plan to succeed, whether its our modular claims management system, our technology that unveils data to make important decisions, or our service solutions built around the voice of the customer. In short, our goal is to link our success to that of our members Roles and Responsibilities: Check the medical admissibil...

- Corporate Health insurance sales - B2B Sales - work ex as insurance broker/direct insurance sales - client acquisition and retention

- Corporate Health insurance sales - B2B Sales - work ex as insurance broker/direct insurance sales - client acquisition and retention

- Corporate Health insurance sales - B2B Sales - work ex as insurance broker/direct insurance sales - client acquisition and retention

- Develop new branches - Make annual budget/plan - Develop beat-plan for individual team members based on prioritized customer segments - Liasion with underwriting team - Lead a team of sales professionals Required Candidate profile - Must have exp. in group health/ corporate health insurance - Should have exp. in brokerage firm - Should be comfortable in field for client meetings

Focus on Health clients/companies Responsibility of building and maintaining relation with clients. Sales process: lead generation, closing Lead and be accountable for the client proposals, Contracts & documentation following company procedures Required Candidate profile Must have exp. in Corporate helath insurance sales

Job Title: TPA Manager Location: Miri Piri Institute of Medical Science & Research, Shahabad Markanda, Kurukshetra (Haryana) Hospital Strength: 420+ bedded upcoming super-specialty hospital & upcoming medical college (100 MBBS seats) Position Overview We are seeking an experienced and detail-oriented TPA Manager to lead and manage all Third-Party Administrator (TPA), insurance, CGHS, ECHS, and Ayushman cases. The role involves overseeing pre-authorization, billing, claims settlement, and ensuring smooth coordination between patients, TPAs, and hospital departments while maintaining compliance and accuracy. Key Responsibilities Handle end-to-end TPA, Insurance, Ayushman, CGHS, and ECHS cases....

Process & Manage Insurance Claims. Provide support to Policy Holder, to manage & maintain the accurate data. To insure timely settlements of the claims. Co-ordinate with Companies of Insurance & Healthcare providers.

TATA AIG General Insurance Company Limited is looking for Deputy Manager - Health Claims to join our dynamic team and embark on a rewarding career journey Assist the Manager in the day-to-day operations of the business, including setting goals, developing strategies, and overseeing the work of team members Take on leadership responsibilities as needed, including managing team members and making decisions in the absence of the Manager Identify and address problems or challenges within the business, and develop and implement solutions Collaborate with other departments and teams to ensure smooth and efficient operations Maintain accurate records and documentation Contribute to the development ...

Location City Pune Department Finance and Accounts Experience 0 - 1 Years Salary 180000 - 240000 INR Designation Associate Total Position 1 Employee Type Permanent Job Description Associate- Accounting Primary Responsibilities: Accounting concepts Processing Required to have a good knowledge of transaction processing Understanding of concepts of accounts payable/ accounts receivable and the complete cycle of P2P/ O2C. Strong analytical skills and comfortable working on Excel. Core Competencies: Service Orientation Should be aware of both - the internal as well as external customers and their needs; and is committed to meeting the customers evolving, long-term needs the focus is on SERVICE Re...

Claims Management: Process, submit, and follow up on insurance claims, resolving discrepancies and denials with insurance providers. Patient Assistance: Educate patients on their insurance coverage and benefits and assist them with understanding their bills and statements. Liaison with Insurers: Serve as a point of contact between the hospital and insurance companies, ensuring proper communication and adherence to policies. Data and Reporting: Maintain accurate patient insurance information in the billing system and prepare reports on billing and insurance activities. Compliance: Ensure adherence to hospital policies and insurance regulations and guidelines Skills: Excellent communication an...

About Us: Medi Assist is India's leading Health Tech and Insure Tech company focused on administering health benefits across employers, retail members, and public health schemes. We consistently strive to drive innovation and participate in such initiatives, to lower health care costs. Our Health Benefits: Administration model is designed to deliver the tools necessary for a health plan to succeed, whether its our modular claims management system, our technology that unveils data to make important decisions, or our service solutions built around the voice of the customer. In short, our goal is to link our success to that of our members Roles and Responsibilities: Check the medical admissibil...

About Us: Medi Assist is India's leading Health Tech and Insure Tech company focused on administering health benefits across employers, retail members, and public health schemes. We consistently strive to drive innovation and participate in such initiatives, to lower health care costs. Our Health Benefits: Administration model is designed to deliver the tools necessary for a health plan to succeed, whether its our modular claims management system, our technology that unveils data to make important decisions, or our service solutions built around the voice of the customer. In short, our goal is to link our success to that of our members Roles and Responsibilities: Check the medical admissibil...

Responsibilities: * Manage health claims from submission to payment * Ensure compliance with regulatory requirements * Collaborate with medical providers on claim resolution * Review insurance policies and procedures

Position: Medical Officer (Doctor) - TPA for Insurance and Risk Analysis Location: Gurgaon Job Type: Full-time About Policybazaar For Business Policybazaar, the flagship platform of PB Fintech Ltd., is Indias largest online insurance marketplace, acclaimed by Frost & Sullivan. Established in 2008, Policybazaar has revolutionized insurance with unmatched awareness, choice, and transparency. Introducing Policybazaar for Business, a dedicated service designed to meet the unique insurance needs of enterprises. Launched in 2021, it offers a robust portfolio of 15+ business insurance products tailored to diverse sectors, scales, and risk profiles. Policybazaar for Business aims to fortify Indias f...