184 Mediclaim Jobs - Page 8

Managing CGHS, ECHS, CAPF and ESIC and All Government Portals: Medical file Audit Claim Processing Uploading Query Management Required Candidate profile Mandatory practical experience of government empanelment such as CGHS ECHS ESIC CAPF etc. and medical file audit and processing for Railways, CGHS, ECHS and other govt empanelment's.

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 insurance company. Efficiently and effectively handle grievance / issue raised by hospital staff & patients, escalate issue to the team leader, as when necessary. Follow-up and Updates to be given to the clients Required Skills and Experience Education: Any Diploma, Graduation, or Under Graduation. Experience: 6 months to 2 years in hospital or insurance roles (preferred). Strong communication and problem-solving skills. Ability to multitask, prioritize, and work efficiently. Detail-oriented with a professional and confidential approach.

We Have Urgent Requirement of TPA Manager

Team Resources (No of Vacancy & On-roll / off-roll): On Roll Product: SCF Relevant Experience: 4-6 years Location: Multiple Locations Desired Education: MBA mandatory (full time) Brief on the organisation About Profectus: Profectus Capital Private Limited is a Non-Banking Financial Company (NBFC) regulated by Reserve Bank of India (RBI). Profectus Capital offers financing solutions for SMEs operating in manufacturing and service clusters located at more than 22 locations since 2017. CRISIL has upgraded ratings of Profectus Capital Pvt. Ltd to A- (Stable) on July 30, 2021 Website: www.profectuscapital.com Follow us on LinkedIn: https: / / www.linkedin.com / company / profectuscapital / ?originalSubdomain=in Summary /Job Role: Job Description: Experience in sourcing Business for MSME Client base Supply Chain Finance/Working Capital. Experience in Anchor Relationship Management is added advantage. Ability to leverage the Tie Ups with Anchors for both sourcing as well as maintaining portfolio quality. Ability to interact with Promoters / Directors of customer companies on multiple issues such as pitching the loan product, Negotiation Skills, login documentation and guiding the customer on post sanction Documentation Completion. Basic Knowledge of Balance Sheet & Financial Ratios. Good verbal and written communication Skills. High Energy Levels and willingness to travel. Willingness to learn and improvise. High Confidence levels. Job specification: Education Qualification: MBA mandatory (full time) Total No of experience: 4 6 years Desired Skill Set: Functional Behavioural Technical Compensation & Benefits: Emoluments comparable to best of NBFCs. Configurable Salary structure for maximum tax-benefits Mediclaim for Self, Family and Parents with optional add-ons for In-laws Participation in Performance based Variable Pay plan, performance-based contests and offsite Job Designation: Branch Sales Manager(SCF) Job Location: Ahmedabad Bangalore Chennai Delhi Hyderabad Mumbai Apply for this position Allowed Type(s): .pdf, .doc, .docx By using this form you agree with the storage and handling of your data by this website. * Mobile No Send OTP Thanks for your interest in our services. We will get back to you very soon...

About Tech Mahindra Foundation (TMF): TMF is the corporate social responsibility arm of Tech Mahindra Limited, a Mahindra Group Company. Since 2006, the Foundation has been working tirelessly in the areas of education, employability, and disability with a keen focus on corporate volunteering. To know more about our SMART Academies, please visit: https://www.smart-academy.in/careers/ To know more about the organization, please visit: www.techmahindrafoundation.org At TMF, we believe our team members are the heartbeat of our organization. We foster a vibrant and inclusive workplace where every individual is cherished, respected, and empowered to thrive. We're on the lookout for an exceptional individual/s to join our team. If you enjoy teaching students and help them gain insights, then we currently have a position open in our Academics team. Please find below the detailed Roles and Responsibilities: Roles and Responsibilities: Planning of the teaching programmer including an orientation programmer in consultation with the HOD Academics. Planning for students Practical experience, ward assignments and trainings in consultation with the HOD Academics. Planning of curriculum with the cooperation and collaboration of the HOD Academics. Competent in Handling Hospital Front desk in terms of Patient Appointments and queries. Preferred Team handling exposure of patient care coordinators. Inbuilt empathy towards the patient and patient relatives. Knowledge of Hospital Billing components for IPD and OPD. Experience of handling TPA coordination and TPA queries for cashless facility. Knowledge of Hospital Billing and tax law applicable to the hospital or healthcare industry. Competent in Professional English (written and spoken) in terms of different professional - operational scenarios. Proficient in training to provide outstanding services and ensure customer satisfaction. To educate students on how to address customer concerns and complaints promptly and professionally. To respond to customer needs and requests in a timely manner. Competent in teaching telephone etiquettes and resolve queries. To train to resolve billing concerns of customers and handle card and cash transactions. Knowledge of healthcare operations and quality parameters. Excellent communication, IT Skills and people skills. Desired Skill Sets: Excellent professional knowledge. Excellent written and verbal communication skills. Good computer skills. Broad-minded personality, which is open and curious about new teaching methods, responsible, reliable, team-minded and resilient. Attention to detail, empathy and inclusive approach. Qualification: MBA/MHA Hospital and Healthcare management with 1 to 3 years of experience or any graduate with experience in hospital billing department with 3 to 4 years of experience. Experience : Minimum 2 years of Clinical experience with one year of experience working in Hospital billing department or 2-4 years of experience in Hospital Management. Location: Pen , Alibag, Kalyan, Mira bhayandar Term: 3-year fixed term contract Request you to please share your updated CV at shruti.m@techmahindrafoundation.org

Urgent requirement for BHMS/BAMS/BDS/MBBS-Pune (Vadgaonsheri) Freshers/candidate with clinical or TPA experience Interested candidates can call on 7391042258 (Sneha- HR department) or share their updated resumes to recruitment@mdindia.com Roles and 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. Required Candidate profile: BAMS / BHMS / BDS/ MBBS graduate. Good Medical & basic computer knowledge Should have completed internship (Provisional /Permanent Registration number is mandatory) Freshers can also apply. Work from office . Interview Timings-11am To 5pm(Monday To Saturday) Venue Details: MDIndia Health Insurance TPA Pvt. Ltd. S. No. 46/1, E-space, A-2 Building, 4th floor, Pune Nagar Road, Vadgaonsheri, Pune 411014

TPA Liaison: Serve as the primary point of contact between the hospital and TPAs, ensuring smooth claims processing and reimbursement. Collaborate with TPAs to verify patient eligibility, approve pre-authorizations, and facilitate smooth discharge procedures. Ensure timely submission of claims, follow up on outstanding claims, and resolve any discrepancies or issues related to TPA reimbursements. Corporate Client Coordination: Act as a liaison for corporate clients, addressing their queries and ensuring employees medical needs are met efficiently. Coordinate with corporate clients to manage employee health programs, including corporate insurance policies, wellness programs, and preventive health check-ups. Assist in the onboarding of corporate clients and ensure smooth setup for hospital services under corporate agreements. Claims Management: Monitor, track, and process claims submitted by patients under TPA and corporate agreements. Ensure all claims meet the required documentation and regulatory standards. Resolve claim issues and disputes in a timely manner, coordinating with both internal departments and external stakeholders. Documentation and Reporting: Maintain accurate records of all communications, claims, approvals, and payments from TPAs and corporate clients. Prepare regular reports on claims processing status, pending approvals, and financial reconciliations for internal and external stakeholders. Ensure all documentation is organized, up-to-date, and compliant with hospital policies and industry regulations. Customer Service: Provide exceptional customer service to patients, TPAs, and corporate clients by addressing inquiries and concerns promptly. Ensure patients and their families understand the process of claiming insurance and managing payments through TPAs or corporate policies. Cross-Functional Collaboration: Work closely with the billing, finance, and medical teams to ensure that patient care is seamless, and claims are processed efficiently. Collaborate with other hospital departments (admissions, discharge, accounts) to resolve any patient-related issues concerning TPA and corporate coverages. Compliance and Regulations: Stay updated with the latest regulations, policies, and procedures related to TPAs, corporate healthcare programs, and insurance claims. Ensure all processes align with the hospitals standards, legal requirements, and industry best practices. Key Skills and Qualifications: Education: Bachelors degree in healthcare management, business administration, or related fields. Experience: 1-2 years of experience in TPA management, corporate healthcare coordination, or insurance claims processing is preferred. Skills: Strong communication and interpersonal skills to interact with TPAs, corporate clients, and internal teams. Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint) and hospital management systems. Ability to handle sensitive and confidential patient information. Attention to detail and strong organizational skills to manage multiple tasks simultaneously. Problem-solving skills to resolve claims and coordination issues. Working Environment: The role typically operates in an office setting within the hospital or remotely, with periodic visits to patient care areas or meetings with external stakeholders. The job may involve working with insurance companies, corporate representatives, and patient families, requiring professional demeanor and strong customer service skills.

Post: Billing Sr. Executive/ Executive, OPD/IPD Billing, Patient Care Executive, Front Office Executive Hospital Name: Batra Heart & Multispeciality Hospital, Sector-31, Faridabad Qualification: Graduation Experience: Minimum 2 Years of Experience (Hospital / Healthcare Experience is Must) Gender : Male/Female Interview Time: 11am to 4pm Candidates can attend walking interview at the hospital location at Batra Heart and Multispeciality Hospital, spring Filed Colony, Sector 31, Faridabad. Or send their CV at hr@batrahealthcare.com (with Current Salary & expected salary) Job Description: Preparing final billing during patient discharge Responsible for patient admission & IPD Billing, Patient Investigation Billing,, Good knowledge of patient procedures, doctor visits, specialty charges etc. Daily follow up with the patients for payment Assessing the billing for rich amount Preparing and submitting billing data and medical claims to insurance companies. Ensuring the patients medical information & Billing is accurate and up to date. Preparing bills and invoices, and documenting amounts due for medical procedures and services. Collecting and reviewing referrals and pre-authorizations. Monitoring and recording late payments. Following up on missed payments and resolving financial discrepancies. Examining patient bills for accuracy and requesting any missing information. Investigating and appealing denied claims. Helping patients develop patient payment plans. Maintaining billing software by updating rate change, cash spread sheets, and current Good knowledge in on line payments like Google, paytm, direct account, credit cards etc. Analyzing the bill summary, payment terms in mid of treatment Good knowledge in TPA, Panel, and Govt. panels, ECHS, CHHS etc. Computer knowledge is must. HIS software knowledge must Good communication good knowledge of patient handling, counselling & Patient care Thanks & Regards HR Team

Urgent requirement for MBBS,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: MBBS ,BHMS,BDS,BAMS graduate. Male candidate prefer. Good Medical & basic computer knowledge Should have completed internship (Permanent Registration number is mandatory) Freshers can also apply. Work from office. Venue details: MDIndia Health Insurance TPA Pvt. Ltd Naval Tower, J.L.N. Marg, 4 & 6th Floor, Near Fortis Hospital, Jaipur 302017 .