323 Mediclaim Jobs - Page 6

Hiring for the position of Executive CRM (Corporate Relationship Management) Job Description 1. Responsible for developing the corporate customer base for MDIndia Health Insurance Services. 2. Map the territory and maintain a strong pipeline of potential customers. 3. Establish Contacts with key persons at the corporate and understand the current levels of Health Insurance services and needs. 4. Develop strong relationship with Insurance Companies/Brokers. 5. Promptly attending Emails, Phone calls, Whats App messages of Clients. 6. Maintain proper MIS & Internal reports and present it to the management. 7. Ability to work independently, achieve targets and be absolutely result oriented. Skil...

Vidal is hiring for claim Processor Designation: Executive-Claims Location: Gurgaon, Key Responsibilities: Review and validate claim documents submitted by hospitals or insured members Scrutinize medical records and bills for completeness and accuracy Apply policy terms, conditions, and exclusions to adjudicate claims Perform ICD and procedure coding as per ailment and treatment Coordinate with medical officers for clinical opinion when required Maintain claim logs and update CRM systems with claim status Ensure adherence to defined SLAs and minimize processing errors Flag suspicious or potentially fraudulent claims for investigation Communicate with stakeholders for clarifications or missin...

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1. Employee Lifecycle Management 2. Onboarding & Induction 3. Employee Experience & Engagement 4. Internship & Development Programs 5. HR Administration & Compliance 6. Exit Management Qualifications: Bachelor's/masters degree in human resources, Business Administration, or related field. 47 years of progressive experience in HR operations or business partnering roles. Understanding of HR policies, labor laws, and compliance requirements. Proficient in HRMS tools, Excel, and data reporting.

Job Description Coordinate with patients, insurance companies, and internal departments for smooth processing of cashless claims. Facilitate timely pre-authorization approvals and ensure all required documents are submitted. Maintain records of all TPA communications and claim documents. Handle queries from patients and their attendants regarding insurance claims. Follow up with TPAs/insurance companies for pending approvals and payments. Reconcile TPA receivables and ensure timely payment posting and recovery. Assist the billing team in preparing final bills for insured patients. Ensure compliance with hospital policies and insurance guidelines. Regularly update TPA software and internal MI...

Hiring for the position of Sr. Executive CRM (Corporate Relationship Management) Job Description 1. Responsible for developing the corporate customer base for MDIndia Health Insurance Services. 2. Map the territory and maintain a strong pipeline of potential customers. 3. Establish Contacts with key persons at the corporate and understand the current levels of Health Insurance services and needs. 4. Develop strong relationship with Insurance Companies/Brokers. 5. Promptly attending Emails, Phone calls, Whats App messages of Clients. 6. Maintain proper MIS & Internal reports and present it to the management. 7. Ability to work independently, achieve targets and be absolutely result oriented. ...

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...

Require GP or any types of doctors for Medical Insurance company . Candidates should have experience in settling Medical Claims. This job is work from home so interested candidates please email your CV on bhavesh.exova@gmail.com

KEY RESPONSIBILITIES 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 ADDITIONAL SKILLS • Good communication • Familiarity with Computers and interest in learning on the job. ACADEMIC & PROFESSIONAL QUALIFICATIONS • BHMS/BAMS/BDS HR Pratiksha Shitole, Sr.Executive Talent Acquisition, MDIndia Health Insurance TPA Pvt. Ltd. S. No. 46/1, E-space, A-2 Building, 3rd floor, Pune Nagar Road, Vadgaonsheri, Pune 411014. Email Address: hr9@mdindia.com Contact No. 7058036074

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 ...

Urgent opening for TPA Medical Officer/customer service manager profile in Raipur, Rajkot, Kanpur, Baramati, Trivandrum locations. Graduate Medical background, MR (B pharma), BHMS, BAMS/ MBA in Hospital Administration. 2+ Years working experience in health insurance/health insurance TPA at Hospital handling/audit Candidate must have excellent knowledge of health insurance / Health TPA domain. Candidate must have excellent bill/medical negotiation skills & customer handling skills.Good communication skills in Hindi/English and regional language of the state/region .Ready to relocate himself/herself at location within India as may be required according to the job requirement. Candidate must ow...

Cashless Executive, TPA Executive, Insurance Executive Responsibilities: Patient Eligibility Verification: Claim Processing: Pre-authorization and Approvals: Coordination: Status Tracking and Follow-up: Cashless Admission Facilitation:

Key Roles : Ensure accurate documentation and timely claim settlement Follow up with TPA and Govt. bodies for approvals/payments Strong knowledge of Govt. healthcare panels (ECHS, CGHS, ESIC, etc.) Experience in hospital billing & claim processing Annual bonus Provident fund Health insurance

Managing CGHS, ECHS, CAPF and Ayushman Bharat Government Portals: Claim Processing Audit Uploading Query Management Reconciliation and Recovery Management. Annual bonus Provident fund Health insurance

TPA Executive to manage pre-authorizations, insurance claims & coordination with TPAs and government health scheme. The role requires accurate documentation, timely claim submissions, & effective communication with internal departments and insurers. Required Candidate profile Graduate with 1–3 years of hospital TPA experience. Proficient in handling CGHS, ECHS, PMJAY claims, insurance coordination, billing & documentation. Strong communication, MS Office & software skills.

Greetingd from Niva Bupa! Key Roles & Responsibilities: Answer incoming customer calls in a professional and timely manner. Assist customers with inquiries including medical claims and rejections. Provide accurate and detailed information about claim procedures, documentation requirements, and coverage. Investigate and resolve customer concerns, ensuring high levels of customer satisfaction. Collaborate with internal departments, such as claims processing to address and resolve complex issues. Maintain thorough and up-to-date knowledge of products, medical billing codes, and claim processes. Document customer interactions and update customer records accurately in the system. Identify and esc...

Role & responsibilities 1. General Insurance Management Procure and renew policies for Property All Risk, FLOP/MLOP, Marine, Motor, and Liability. Coordinate risk inspections, asset valuations, and insurance audits. Ensure adequate coverage of plant, stock, and machinery. 2. Employee Insurance (GMC, GPA, GTLI) Design and manage group insurance programs. Align policies with HR grades and employee categories. Organize employee awareness and communication sessions. 3. Claims Management Oversee fire, machinery breakdown, transit, and liability claims. Manage employee health & life claims with TPAs and brokers. Drive claim analytics, MIS dashboards, and settlements. 4. Stakeholder Collaboration C...

Hiring Clinical Doctors for Medical coding role in Mohali !! Job Location - Mohali Role : Auditor I (IPDRG) Eligibility Criteria: Education BHMS,BAMS,MBBS,BPT Candidates with prior US Healthcare or Clinical experience will be preferred. Fresher Physicians can also apply with good clinical knowledge. Noncertified Physicians can apply however should be ready to complete the same within specified timeline. (CIC) Good communication skills. Candidates with corporate experience will be preferred. Immediate joiners preferred. Should be ready to work from office. Should be ready to work in night shift. Interested candidates can share resume - abdul.rahuman@cotiviti.com Regards, Abdul Rahuman 9080276...

We are seeking a dynamic and detail-oriented Insurance Professional for the Legal Department to manage end-to-end insurance policy administration, claims processing, and risk management across multiple sites. The ideal candidate will have experience in insurance handling, preferably in the solar sector, and the ability to manage and coordinate across teams and insurance partners. COMPENSATION & BENEFITS: Medical Insurance Performance Incentives Cool Work Environment Travel Reimbursement (as per company policy) Exposure to challenging legal and insurance portfolios Supportive team and professional development ABOUT SADBHAV FUTURETECH LIMITED: Company Size - ~100 employees Headquarters - Gurga...

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 Function Medical Officer/Consultant Claims PA/RI Approver Reporting to Location Assistant Manager Claims Mumbai Educational Qualification Shift BHMS, , BAMS, MBBS(Indian registration Required) Rotational Shift (for female employee shift ends at 8:30 PM) 6 rotational week offs Provided per month Week offs Related courses attended None Management Level Junior Management Level Industry Type Hospital/TPA/Healthcare/Insurance Roles and Check the medical ...

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

1. Looking after the corporate client & their empanelment’s 2. Preparing bills of TPA, ESIC, ECHS, CGHS and other Private clients Independently. 3. Handling all queries related to patients. Call me on +91 97739 85718

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...

ABOUT US: About Rentokil Initial Hygiene Rentokil Initial Hygiene India, operating in more than 75 countries is the trusted hygiene solution provider globally. Together with 100 years of experience with tailored solutions to meet customised business needs, assuring 100% peace of mind with Rentokil Initial services. Rentokil Initial offers the widest range of washroom hygiene services including the provision and maintenance of products such as air fresheners, sanitisers, feminine hygiene units, hand dryers, soap dispensers, floor protection mats. For more details: https://www.initial.com/in/ About the Role: The Store Manager / Store Executive will be responsible for managing the inventory. Th...

Role & responsibilities i) Health Check-Ups Annual medical health check-ups for all employees are planned and scheduled on time, and reports for critical illness are to be shared within 1 hour from the incident reported. ii) Claim Reimbursement Employee claim reimbursement is to be processed and paid out within defined timeline from the final bill submission iii) Employee Connect Ensuring employees who are unwell/hospitalised are met/spoken to and tracking records of such employees are maintained every week. Providing on-time information to employees related to the ESIC / Mediclaim process and generating unique code from ICICI iv) Process Information Annual Health Check-ups as per schedule O...