431 Mediclaim Jobs - Page 2

Key Responsibility: Respond to employee/corporate customer queries via e-mail/ phone in a timely and professional manner Coordinate with respective stake holders for cashless claim settlement and resolution Explain claim decisions, deductions and provide status updates clearly to customers and agents. Escalate unresolved issues following the defined escalation matrix to get quicker resolutions & communicate the same to the customers. Receive and verify the completeness of claim documents; advise on any pending or missing documents. Coordinate with the inward team for claim registration and ensure proper documentation flow. Allocate claims to the processing team for timely action. Liaise with...

Medical Officer - Claims Processing Job Title: Medical Officer Claims Processing Location: IBC Knowledge Park, Bangalore (Work from Office) Department: Central Claims Operations Control Room Job Type: Full-time Salary: 3,00,000 3,60,000 per annum About the Role We’re hiring Medical Officers (Claims Processing) for our Control Room team at IBC, Bangalore. The role involves end-to-end medical claim processing with focus on accuracy, coordination, and timely resolution. You’ll work closely with multiple departments to ensure smooth claim operations and compliance with TAT standards. Key Responsibilities Process medical claims accurately within defined timelines. Review and validate claim docume...

Manager / Assistant Manager Account Management - MediAssist Job Title: Manager / Account Management Company: Medi Assist Location: Bangalore CTC: 9 to 12 LPA Experience: 11 to 15 years Industry: Health Insurance / TPA / Healthcare Key Responsibilities:- Client Relationship & Strategy: Build and maintain long-term partnerships with insurers, corporate clients, and healthcare providers. Lead high-level review meetings and ensure strong relationship governance. Operations & Service Delivery: Oversee end-to-end account operations including claims, customer service, and issue resolution. Ensure compliance with TATs and SLAs. Performance Analysis & Reporting: Monitor KPIs, analyze client data, and...

Greeting from Medi assist TPA Pvt ltd. Hiring Medical officer for Insurance Claim processing Profile Location- Noida Sector 3 Role - Medical officer Exp : 0-3 years WORK FROM OFFICE ONLY. Job description : 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 ...

SUMMARY OF ROLE To support all our Healthcare Professionals with our internal payment queries to ensure they are paid on time and efficiently. Working with our internal and external Customers to clear up and chase any outstanding issues to prevent the processing and releasing of timesheet against all our payment methods. RESPONSIBILITIES To proactively work through all outstanding add shifts on Clarity which are booked on the bank System to ensure our Healthcare Professionals are paid without any delay Supporting and amend the Shift timings, Rates, wards and Hospitals Changing Payment method from Umbrella to PAYE and vice versa based on the request raised. Adding Missing Shifts (past dated) ...

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 we'll as external customers and their needs; and is committed to meeting the customers evolving, long-term needs the focus is on SERVICE Result Orientation Should be able to direct efforts towards developing and implementing realistic action plans to meet business objectives; with a sense of urgency the focus is on achieving RESULTS Initiative One must not only un...

POSITION: MEDICAL OFFICER/CONSULTANT PA/RI APPROVER PURPOSE OF ROLE: To scrutinize and process the claims within the agreed TAT by having an understanding of the policy terms & conditions while applying their domain medical knowledge. Designation : Medical Officer/Consultant Function : Claims PA/RI Approver Reporting to : Assistant Manager Claims Location : Pune Educational Qualification : BHMS, Bsc Nursing , BAMS, BPT, BDS, B. Pharma Shift : Rotational Shift (for female employee shift ends at 8:30 PM) Week offs : 6 rotational week offs Provided per month Management Level : Junior Management Level Industry Type : Hospital/TPA/Healthcare/Insurance Roles and Responsibilities : Check the medica...

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...

Role & responsibilities Prepare, verify, and submit TPA and insurance bills accurately and on time. Coordinate with TPA coordinators and insurance representatives for claim approvals and settlements. Handle pre-authorization requests and maintain all relevant documentation. Track claim status and follow up for pending or rejected claims. Reconcile TPA accounts and maintain updated records of claims, payments, and rejections. Assist in preparing MIS reports related to TPA billing and collections. Ensure compliance with hospital billing policies and TPA/insurance guidelines. Coordinate with the finance and accounts teams for payment postings and reconciliations. Address patient and TPA queries...

Skills: Godrej Forklift, Stacker, Hand Pallet Trolley, Battery operated platform trucks etc., Sales Skills/ Sales process training, Sound Communication skills in English/Hindi, Prospecting Skills, Product Presentation Skills, Sales Planning, Client Relationships, Negotiation skills,. Industry:Engineering. Location & no of position:Kolkata02, Siliguri01. Benefits:PF, Family Mediclaim, Gratuity, Bonus, Leave Encashment, Incentive etc.. Qualification:GRADUATE, Mechanical/Automobile/Electrical Engineering. (Btech /Diploma). Product & Brand to be handled:Godrej Forklift, Stacker, Hand Pallet Trolley, Battery operated platform trucks etc. Skills. Sales Skills/ Sales process training. Sound Communi...

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 dona.antony@mediassist.in Thanks & Regards Contact No-9632777628

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 dona.antony@mediassist.in Thanks & Regards Contact No-9632777628

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...

Job Summary: The Counsellor is responsible for providing complete pre-operative and post-operative guidance to patients, ensuring they are well-informed about their procedures, lens options, costs, and pre-surgery instructions. The role also involves coordinating between patients, doctors, anesthetists, billing, and insurance departments for smooth surgical scheduling and patient satisfaction. Key Responsibilities: 1. Patient Counselling & Information: Explain to patients the details of their surgery (e.g., cataract or other procedures). Provide information about available lens types, anesthesia procedures, and the surgical process. Ensure that patients clearly understand their treatment pla...

Billing & Claims Processing: Generate and verify patient bills for ECHS beneficiaries as per CGHS/ECHS rate lists. Ensure proper documentation (OPD/IPD case papers, prescriptions, lab/radiology reports, etc.) is attached with each bill. Required Candidate profile Bachelor’s degree in Commerce, Business Administration, or a related field. Knowledge of ECHS/CGHS billing procedures is preferred. Prior experience in hospital billing.

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 sarika.pallap@mediassist.in Thanks & Regards dona.antony@mediassist.in Contact No-9632777628

Responsibilities: * Process claims from intake to payment * Collaborate with stakeholders on claim resolution * Ensure accurate adjudication & payment processing * Meet service level agreements (SLAs) for turnaround time

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we're looking for an Entry-Level Quantitative Market Researcher to join our team. We need someone with a sharp eye for detail and strong skills in Microsoft Excel and PowerPoint. you'll be a key part of our research team, ensuring all project materials are accurate and consistent. This involves meticulously checking questionnaires, data, presentations, and reports for errors in everything from typos and scale usage to numbers and formatting. you'll also be responsible for transforming data from Excel into clear, accurate charts in PowerPoint. Excel Proficiency: You will check Excel data tables from the data processing team and pull the correct numbers for charts in PowerPoint. PowerPoint Ski...

Role & responsibilities Act as the primary liaison between the employees and insurance providers related to claims, escalations, queries related to insurance policies. Support employee queries related to insurance policies, benefits, and claim status. Maintain and update insurance databases accurately and in a timely manner. Preparing claims data related to reimbursement claims, cashless claims, claims settlement timelines etc. Preparing Microsoft presentations for various data. Preferred candidate profile Bachelors degree in any discipline; MBA HR is a plus. Good Proficiency in Microsoft Excel skills: VLOOKUP, Pivot Tables, COUNTIF, IF statements, data validation, etc and MS Presentation. G...

Greetings from Sagility . Sagility has huge openings for BDS/ MDS graduates in US healthcare organization Job Description: Interpret all types of Medical records Must have worked in Health care TPA/ must have worked a medical officer in any recognized TPA CPT & ICD 9 & 10 Coding Interpret medical necessity in contrast to clinical policies / guidelines Interpret medical data and provide accurate clinical review Identify Cost Savings within Medical Claims Itemized bill review (IBR) for Institutional claims Qualification & Skills: BDS/ MDS Graduation with Internship Interested Candidates can share the CV's to Yuva Indira. K @ 7200012804/ Share their CV's through mail yuvaindira.k@sagilityhealth...

Urgent Opening for IPD Billing at Fortis Hospital Kalyan Qualification - Any Graduate Experience - 8 to 12 Yrs of Experience Knowledge of IPD Billing, GIPSA, TPA Billing, CGHS, Looking for Hospital Experience Candidate I nterested candidate can call on 7977763787 or Email - kln.hr@fortishealthcare.com Note - Sunday Not Working

Job Description: Check the medical admissibility of a High Value claim, scrutinize and process it as per terms & conditions of insurance policy. Handle escalations, customer queries and responding to mails accordingly Effectively manage the team so that the targets are met while reducing the no. of IRs raised. Ensure that the claims are approved or denied as per the terms and conditions within the TAT. Provide supportive and positive experience to the new joiners and train them. Gather inputs from various sources and keep up-to-date on the new policies or changes in existing policies and intimate the Configuration team and the CRM team Manage a group of claim processors, guide and coach them...

Role & responsibilities Claims Processing & Coordination Facilitate the Green Channel process to ensure zero waiting time for patient admissions and discharges. Support the end-to-end processing of cashless and reimbursement claims efficiently. Liaise with the Head Office to resolve claim-related issues promptly. Address and resolve patient grievances related to claims processing, escalating unresolved issues when necessary Collaborate with hospital staff to ensure seamless admission and discharge procedures for insured patients. Adhere to strict protocols to prevent fraudulent activities in claims processing. Enhance customer satisfaction by reducing waiting time for admissions, claims, and...

Role & responsibilities Handle claim submission, follow-up, and settlement with TPAs and government panels. Track outstanding payments and prepare periodic reconciliation reports. Coordinate with TPAs, insurance companies, and internal departments for claim clarifications. Maintain records of claims, payments, and rejections in both Excel and Tally. Post settlement entries, adjustments, and payment receipts in Tally. Prepare monthly outstanding and collection status reports for management review. Ensure timely submission of required documents for pending claims. Follow up on delayed or short payments and resolve discrepancies. Maintain communication logs and documentation for all settlement ...