434 Mediclaim Jobs - Page 13

Job Description (IFD) Communicating with clients and understanding the investigation requirements. • Meeting with clients to discuss the nature of the investigation. • Conducting field investigations on appointed cases, insurance claims, or client requests. • Conducting in-depth research on various appointed cases. • Decide the extent and validity of a claim, and in so doing, prevent fraudulent claims by determining the claim's authenticity. • Gathering and analyzing evidence reports. • Conducting photographic and audio surveillance to gather evidence • Reviewing and solving cases by authenticating insurance claims. • Coordinating with agents to understand insurance claims matters. • Answeri...

Role & responsibilities Serve as a point of contact for Insurance related inquiries Create a consistent, positive work atmosphere through the communication Close interaction with respective department at hospital To interact with hospital insurance patients. Interact with Hospital Management, Doctors, Medical and non-medical staff at the hospital To create awareness about insurance claims (reimbursement and cashless claims, pre & post hospitalization claims etc.) Collecting claim support documents from the patients / hospitals & coordinate with backend team to ensure smooth transfer of data to the TPA/Insurance Company. Send the pre auth request and follow up on cashless approval form insura...

Fortis Hospital Mohali is hiring for following vacancies; 1. OPD 2. IPD 3. TPA 4. Counsellor interested candidates can come directly for the interview as per schedule or share resume at baljinder.singh@fortishealthcare.com

Responsibilities: * Ensure accurate Hospital Billing of cash/insurance patients. * Manage TPA claims from submission to settlement * Collaborate with insurance companies on claim resolution and settlement. Please contact 9326009595

Perform daily SLA Analyze and review daily fraud reports Identify and report suspected frauds and risks Process Daily Payouts Accounts Verifications Updating routine records of findings and action taken along with proper reasoning Proactively highlighting the risk and fraud mitigation areas Responding to customer as we'll as internal queries with appropriate resolutions Requirement Has knowledge of card games Experience of working in fraud compliance domain in consumer facing Industry Excellent analytical, investigative and data interpretation skills High Conflict Management and Problem-Solving skill Ability to work under pressure and to deliver within given time frames Good interpersonal sk...

To ensure that all underwriting placement/ client service requirements of clients are met as per Company defined TATs Structuring and sourcing quotes for fire, marine, property, engineering, liability, motor and other miscellaneous insurance policies of clients Ensuring optimal product coverage & premium pricing Negotiating with insurers for best rates terms Vetting policy documents received from insurers in terms of terms, coverage, etc., Timely reconciliation of each account Ensuring timely updation of data details in appropriate tools solutions Effectively coordinating between client insurers for any document collection handover Effectively coordinating with the TPA for daily service requ...

Role & responsibilities To greet incoming patients or their representatives and to record complete information required for processing cashless facility. To hand over Pre-Auth form to patient and explain the procedure in detail. To process Initial approval, interim bill and final enhancement and co-ordinate with billing. To answer questions and to provide information directly to the person or on the telephone. For eg.Explaning Policy terms and conditions and hospital Policy regarding payment of bills. To prepare and maintain data of patients availing cashless facility and status, check payable report. To explain hospital regulations to patients, concerning Insurance process and discharge for...

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, inclu...

Responsibilities: * Manage claims from intake to settlement. * Adjudicate medical necessity & settle claims fairly. * Ensure timely claim payment & employer satisfaction. * Process mediclaim & health insurance claims accurately.

Key Responsibilities: Handle end-to-end reimbursement and cashless claims for corporate clients' employees and dependents. Scrutinize claim documents for completeness, medical validity, and compliance with policy terms. Coordinate with empaneled hospitals, insured members, and insurance companies for claim clarification, queries, and approvals. Maintain TAT and SLA commitments for smooth and timely processing. Ensure compliance with IRDAI guidelines and internal company SOPs. Update and manage claims data in the internal system accurately. Prepare and share MIS reports with internal stakeholders and corporate clients. Manage escalated and high-value claims with detailed attention and resolut...

Job Description Acts as an interface between the TPA, Insurance Company and the hospital. Responsible for investigation of suspicious claims. Effective usage of Fraud control measures. Act as a backend support to the TPA. Responsible for data mining and analytics related to Fraud and Investigation (IFD) Field visit for investigation purpose. Open to travel. Desired Candidates Profile Qualification Any Graduate Experience Fresher - 2 Years Exp. Profile – Executive If interested kindly share your resume to recruitment1@mdindia.com

Resolve customer queries over calls, chat Address and resolve customer complaint or issues related to healthcare services, ensuring a positive and satisfactory experience Inform customers about health plans, insurance coverage, and healthcare service Required Candidate profile Excellent communication skills in English Only B.Pharma/ M.Pharma/ D.Pharma passed Freshers or Experienced can apply Strong understanding of medical terminology Immediate Joiners Rotational shifts Perks and benefits Incentives Health Insurance

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...

Job Description: Skills Required: Strong leadership, team management skills with Excellent communication and interpersonal skills Comprehensive understanding of hospital admission processes and billing systems Customer service oriented with problem-solving capabilities Ensuring accurate billing for services provided to inpatient (hospitalized) patients, including room charges, medical procedures, medications, and consultations. Leading and managing the team responsible for processing and generating bills for inpatient services. Collaborating with other departments like clinical, pharmacy, and insurance for timely and accurate billing. Overseeing day-to-day administration, directing and contr...

Inpatient/Outpatient Billing. Overseas/Corporate/Insured/TPA billing. Payment Tracking. Bed Management. TPA files follow-up and closure. Tracking of discounts/Cancelled bills/refunds/free bills/posting of packages. Service Recovery in the billing Area. Training of the HIS modules in billing with the power users.

Job Description (IFD) Communicating with clients and understanding the investigation requirements. • Meeting with clients to discuss the nature of the investigation. • Conducting field investigations on appointed cases, insurance claims, or client requests. • Conducting in-depth research on various appointed cases. • Decide the extent and validity of a claim, and in so doing, prevent fraudulent claims by determining the claim's authenticity. • Gathering and analyzing evidence reports. • Conducting photographic and audio surveillance to gather evidence • Reviewing and solving cases by authenticating insurance claims. • Coordinating with agents to understand insurance claims matters. • Answeri...

Company Overview: 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. Our plans are widely available across retail stores and online marketplaces. 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 invite the brightest minds to join us in this journey that helps improve the lives of millions of d...

Job Summary: We are looking for a dynamic and experienced Manager Employee Benefits to join our team in Bangalore. The ideal candidate will have strong experience in employee benefits program management, relationship management, data analytics, and coordination with insurers and TPAs. Prior experience in a brokerage firm will be an added advantage. Key Responsibilities: 1. Client Relationship & Account Management: Act as the primary point of contact for assigned corporate clients. Build and maintain strong relationships with HR and employee stakeholders. Conduct regular review meetings with clients to understand needs, resolve issues, and offer strategic advice. Support renewals and policy u...

Urgent requirement for BHMS/BAMS/BDS -Chennai(Annasalai) 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: BAMS / BHMS / BDS graduate. Male candidate prefer. Good Medical & basic computer knowledge Should have completed internship (Permanent Registration number is mandatory) Freshers can als...

Role & responsibilities - Due Diligence - Document Indexing & Management - Sanction Screening - Compliance checks - Premium Bordereaux Processing - Knowledge of insurance systems like Acturis, Applied Epic/Eclipse will be added advantage - Experience in the insurance sector, preferably with brokers or MGAs, will be an added advantage - Familiarity with Lloyds systems integration (XIS, XCS, ICOS/IPOS) is a plus - Updating the process documents - Providing supporting documents during various internal/external audits - Advance excel knowledge Preferred candidate profile Need Fresher or who have experience into claims and settlement Must be fluent with communication

Job Title: Hospital Billing Executive Qualification: Any Graduate Job Type: Full-Time Job Summary: We are seeking a detail-oriented and experienced Billing Executive to join our hospital's finance and accounts team. The ideal candidate will have a strong background in hospital billing processes, insurance claims, and patient account management. Key Responsibilities: Generate accurate inpatient and outpatient bills in accordance with hospital policies. Verify patient insurance details and coordinate with TPA (Third-Party Administrators). Ensure proper documentation for billing, including medical records, investigations, and doctors notes. Process and submit insurance claims within stipulated ...

We are looking for candidate with Experience into Brokerage Calculations, Renewals, QuoteSharing , Booking Revenue. Preferred candidate profile Ensure Brokerage is calculated Properly Understanding of Insurance Services Excellent Written and Oral Communications

We are looking for candidate with Employee Data, Premium Calculation , Exp into GPA , GMC, GTA , GTL will be aded advantage. Preferred candidate profile Ensure Brokerage is calculated Properly Understanding of Insurance Services Excellent Written and Oral Communications

Role & responsibilities Ensure team members are visiting the customers place as per the schedule Monitor the team members activity in terms of volumes (documents collected) Review the queries received from the customer and the responses from the team members Help team members in resolving escalationsfrom customers Review the reports sent by the team members and take necessary actions (issues with respect to claim registrations) based on the report. Coordinate with front end team and help in getting the claims registered Conduct weekly/monthly one on one review with the team membersto understand their concerns and help simplify the process Review the claims dump along with front end team and ...

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 ...