323 Mediclaim Jobs - Page 10

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 a 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 deny the claims as per the ...

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 Assistan...

Job description URGENT OPENING FOR MEDICAL OFFICER Workings Hours: 9 Hrs Work Mode : Office Key Responsibilities: Review and assess medical claims submitted by corporate clients against policy terms and medical guidelines. Analyze clinical documents such as medical reports, diagnostic tests, prescriptions, discharge summaries, and other relevant medical records. Verify the authenticity, appropriateness, and completeness of medical documentation related to claims. Provide medical expertise to determine the validity and admissibility of claims. Collaborate with claims processing and underwriting teams to resolve discrepancies or clarifications related to medical information. Identify potential...

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

Coordinating with TPA/corporate companies for approval and claim processing, Primary responsibility of TPA and Corporate Head is Follow ups and Clearing of outstanding dues with TPA’s & other govt. agencies and split billing. Required Candidate profile Reporting of daily, weekly, monthly dues outstanding follow ups to the reporting mgr. Update received from any of the TPAs or Corporates to ensure the updates are informed to all the unit team.

Job Description : Overview: Ecorgy Solutions, a US-based healthcare BPO, seeks Client Relationship Officers (US Voice) to manage communication with patients, physicians, and vendors, ensuring efficient and professional service. Responsibilities: Answer incoming calls and assist with patient care needs. Schedule patient appointments in the practice management system. Provide information to physicians, patients, and family members. Maintain professionalism and friendliness in all interactions. Address inquiries and resolve issues efficiently. Ensure accuracy and timeliness in all tasks. Requirements: Strong command of English and excellent communication skills. 1 5 years of experience in inter...

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Associate Manager Qualifications: Any Graduation Years of Experience: 10 to 14 years Language - Ability: English(Domestic) - Advanced 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 wou...

Urgent requirement for BHMS,BDS,BAMS -Rajasthan(Jaipur) Freshers/candidate with clinical or TPA experience. Interested candidates can call on 9371762436 or share their updated resumes to career@mdindia.com Job Description: Scrutiny of medical documents and adjudication. Assess the eligibility of medical claims and determine financial outcomes. Identification of trigger factors of insurance related frauds and inform the concerned department. Determine accuracy of medical documents. Required Candidate profile: BHMS,BDS,BAMS graduate. Male candidate prefer. Good Medical & basic computer knowledge Should have completed internship (Permanent Registration number is mandatory) Freshers can also app...

Location City Pune Department Finance and Accounts Experience 0 - 2 Years Salary - INR Designation Associate Total Position 1 Employee Type Third Party Job Description Associate- Accounting JOB DESCRIPTION: 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...

Onsitego is India s leading after-sales service provider and offers Extended Warranty, Damage Protection, AMC Plans, and On-Demand Repair Services. We cover all electronic devices and home appliances. We are driven by the mission to consistently deliver WOW experiences to customers. Our customer obsession allows us to have the highest Net Promoter Score (NPS) globally in after-sales services. Our hassle-free & reliable services are widely available across electronic stores and online marketplaces. We are proud to have served 8 Million+ happy customers till date. We invite the brightest minds to join us in this journey that helps improve the lives of millions of device users across the countr...

We are hiring a dedicated and detail-oriented Insurance Claim & Survey Coordinator to handle claim processing and in-house claim evaluation for both Health Insurance and Motor Vehicle Insurance . The candidate will be responsible for guiding clients, assessing claim documents, and coordinating with insurers to ensure quick and hassle-free claim settlements. Key Responsibilities: Handle end-to-end processing of health and motor insurance claims . Collect, verify, and organize all claim-related documents including medical reports, bills, accident descriptions, repair invoices, FIRs (if required), and policy documents. Act as an in-house surveyor to evaluate claim documentation for accuracy and...

face-to-face.Greetings from the OnQ India team! We are Hiring for Experienced AR Calling. 1+ Year of experience can apply Roles and Responsibilities Review eligibility and benefits verification for treatments, hospitalizations, and procedures. Review claims for accuracy and insurance compliance to obtain any missing information. Prepare, review, and transmit claims using billing software, including electronic and paper claim processing. Follow up on unpaid claims within standard billing cycle timeframes. Check insurance payments for accuracy and compliance with contract discount. Call insurance companies regarding any discrepancy in payments if necessary. Identify and bill secondary or terti...

DATAMARK, Inc. is seeking a dedicated Trainer for our Back Office operations. In this critical position, you will be responsible for designing, delivering, and managing training programs that equip our back office staff with the necessary skills and knowledge to perform their duties efficiently and effectively. Your role as a Trainer will encompass identifying training needs, creating comprehensive training materials, and conducting engaging training sessions to enhance team performance. You will work closely with management to ensure that training programs align with the goals of the organization. The ideal candidate will possess a blend of instructional expertise and a deep understanding o...

To identify, source and secure both long term and short-term pest control & prevention business opportunities. To develop new business opportunities within current and new customer bases in accordance with the sales strategy. To look after client retention by ensuring customers ongoing expectations is met. To manage day to day sales activities, including proposal, service agreement, and prospecting and market development. To support the service team by providing customer feedback. To develop good client relationships. To provide reports as per the requirement. To assist with debt collection Do you have what it takes? If you want to be considered for this role you will need: Graduate or MBA F...

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

Role & responsibilities Excellent MS Office knowledge, Good Typing speed (35 words per minute). Candidate should be open to work in 24X7X365 environment. Preferred candidate profile Reimbursement billing & Registration, data handling, Error resolve, working on mail and condonation with RM Team. Knowledge of Indian Health Care and prior experience in Health Insurance Claim Processing, Good Clinical Acumen Preferred Industry Health Insurance/TPA/Hospital / Clinical Practice/heath care/ wellness etc.. Preferred Location Ahmedabad, Bangaluru Chandigarh, Chennai Dehradun, Hyderabad Indore, Kochin Kolkata, Mumbai Nagpur, Noida Surat, Vadodara

Role & responsibilities Excellent MS Office knowledge, Good Typing speed (35 words per minute). Candidate should be open to work in 24X7X365 environment. Preferred candidate profile Reimbursement billing & Registration, data handling, Error resolve, working on mail and condonation with RM Team. Knowledge of Indian Health Care and prior experience in Health Insurance Claim Processing, Good Clinical Acumen Preferred Industry Health Insurance/TPA/Hospital / Clinical Practice/heath care/ wellness etc.. Preferred Location Ahmedabad, Bangaluru Chandigarh, Chennai Dehradun, Hyderabad Indore, Kochin Kolkata, Mumbai Nagpur, Noida Surat, Vadodara

Role & responsibilities Excellent MS Office knowledge, Good Typing speed (35 words per minute). Candidate should be open to work in 24X7X365 environment. Preferred candidate profile Reimbursement billing & Registration, data handling, Error resolve, working on mail and condonation with RM Team. Knowledge of Indian Health Care and prior experience in Health Insurance Claim Processing, Good Clinical Acumen Preferred Industry Health Insurance/TPA/Hospital / Clinical Practice/heath care/ wellness etc.. Preferred Location Ahmedabad, Bangaluru Chandigarh, Chennai Dehradun, Hyderabad Indore, Kochin Kolkata, Mumbai Nagpur, Noida Surat, Vadodara

Role & responsibilities Excellent MS Office knowledge, Good Typing speed (35 words per minute). Candidate should be open to work in 24X7X365 environment. Preferred candidate profile Reimbursement billing & Registration, data handling, Error resolve, working on mail and condonation with RM Team. Knowledge of Indian Health Care and prior experience in Health Insurance Claim Processing, Good Clinical Acumen Preferred Industry Health Insurance/TPA/Hospital / Clinical Practice/heath care/ wellness etc.. Preferred Location Ahmedabad, Bangaluru Chandigarh, Chennai Dehradun, Hyderabad Indore, Kochin Kolkata, Mumbai Nagpur, Noida Surat, Vadodara

Role & responsibilities Excellent MS Office knowledge, Good Typing speed (35 words per minute). Candidate should be open to work in 24X7X365 environment. Preferred candidate profile Reimbursement billing & Registration, data handling, Error resolve, working on mail and condonation with RM Team. Knowledge of Indian Health Care and prior experience in Health Insurance Claim Processing, Good Clinical Acumen Preferred Industry Health Insurance/TPA/Hospital / Clinical Practice/heath care/ wellness etc.. Preferred Location Ahmedabad, Bangaluru Chandigarh, Chennai Dehradun, Hyderabad Indore, Kochin Kolkata, Mumbai Nagpur, Noida Surat, Vadodara

Role & responsibilities Claims adjudication, claims approval, TAT, accuracy, productivity, claims cost, fraud and leakage control, client/provider feedback, team training and retention Preferred candidate profile Processing claims, quality check and adherence to TAT, fraud triggers, fraud risk assessment, computer skills. Candidate should be open to work in 24X7X365 environment Microsoft office proficiency Knowledge of Indian Health Care and prior experience in Health Insurance Claim Processing, Good Clinical Acumen Minimum 1-3 Years Preferred Industry Health Insurance/TPA/Hospital / Clinical Practice/heath care/ wellness etc.. Minimum- Medical Graduate (BDS/BAMS/ BHMS/BPT/ BUMS) Preferred L...

Role & responsibilities Claims adjudication, claims approval, TAT, accuracy, productivity, claims cost, fraud and leakage control, client/provider feedback, team training and retention Preferred candidate profile Processing claims, quality check and adherence to TAT, fraud triggers, fraud risk assessment, computer skills. Candidate should be open to work in 24X7X365 environment Microsoft office proficiency Knowledge of Indian Health Care and prior experience in Health Insurance Claim Processing, Good Clinical Acumen Minimum 1-3 Years Preferred Industry Health Insurance/TPA/Hospital / Clinical Practice/heath care/ wellness etc.. Minimum- Medical Graduate (BDS/BAMS/ BHMS/BPT/ BUMS) Preferred L...

Role & responsibilities Claims adjudication, claims approval, TAT, accuracy, productivity, claims cost, fraud and leakage control, client/provider feedback, team training and retention Preferred candidate profile Processing claims, quality check and adherence to TAT, fraud triggers, fraud risk assessment, computer skills. Candidate should be open to work in 24X7X365 environment Microsoft office proficiency Knowledge of Indian Health Care and prior experience in Health Insurance Claim Processing, Good Clinical Acumen Minimum 1-3 Years Preferred Industry Health Insurance/TPA/Hospital / Clinical Practice/heath care/ wellness etc.. Minimum- Medical Graduate (BDS/BAMS/ BHMS/BPT/ BUMS) Preferred L...

Role & responsibilities Claims adjudication, claims approval, TAT, accuracy, productivity, claims cost, fraud and leakage control, client/provider feedback, team training and retention Preferred candidate profile Processing claims, quality check and adherence to TAT, fraud triggers, fraud risk assessment, computer skills. Candidate should be open to work in 24X7X365 environment Microsoft office proficiency Knowledge of Indian Health Care and prior experience in Health Insurance Claim Processing, Good Clinical Acumen Minimum 1-3 Years Preferred Industry Health Insurance/TPA/Hospital / Clinical Practice/heath care/ wellness etc.. Minimum- Medical Graduate (BDS/BAMS/ BHMS/BPT/ BUMS) Preferred L...

Looking after all insurance matters of Mfg. & EPC Cos of group . Profile includes –Record of all Ongoing Policy, Renewal, Dealing with insurance Co for new Coverage ,Premium Negotiations. Claims settlement, insurance of Group, Individual & family etc Required Candidate profile Profile includes – Record of all Ongoing Policy, Renewal, Dealing with insurance Co for new Coverage , Premium Negotiations. Claims settlement, insurance Management of Group, Individual & family etc