694 Tpa Jobs

To take daily rounds independently during assigned shifts and to countersign over all documentation done in progress sheet by Floor Managers. Routine rounds and coordination with consultants and documentation of their instructions / orders To evaluate and communicate with the consultants in case of critical clinical conditions/investigations for immediate actions. Filling the consent forms for ward procedures and counselling the Patient/relatives as and when required. Blood Requisition Form and Compatibility Reports to be filled/evaluated and countersigned properly. Transcribe and sign the daily medication orders in drug chart as per NABH guidelines. Patient Narcotics Sheet and Form 3E to be...

TPA/Ayushmaan Operator required for Basna near Raipur (C.G.)Location Note- Good Knowledge of TPA 1- Basna near Raipur C.G. Call/WhatsApp-8090286126/7897900209 Regards ARTI SONI Linking Jobs

Roles and Responsibilities Handle health claims from receipt to settlement, ensuring timely processing and quality service delivery. Conduct thorough audits on insurance claims, identifying areas for improvement and implementing corrective actions. Prepare accurate and detailed audit reports, highlighting key findings and recommendations. Manage email communication with clients, agents, and internal stakeholders regarding claim status updates and queries. Utilize MS Office skills to maintain efficient records management systems. Work location Vidal Health Insurance TPA PVT LTD 513-522, 5th Floor B Wing, Chintamani Plaza, Mohan Studio Compound, Andheri Kurla Road, Mumbai-400099 Contact No -86...

Role & responsibilities Play as an intermediate role Between the Insurance co. and Hospital and We Assist Team. Adjudicating cashless and Reimbursement claims with claim documents provided by help desk executive. Should be able to do claim tabulation to bifurcate payable and non-payable items as per the terms and conditions laid out in the insurance policy. Evaluating claims and posting remarks in whats app group and updating in CRM. Monitoring billing as per the Tariff. Managing claims escalations from hospitals. Responsible to handling queries raised by insurance company / TPAs Provide technical assistance and conduct training sessions for new processors on various health insurance policie...

Job Description: Executive/Sr Executive, Operations The Provider Payments and Reconciliation will be responsible for overseeing the payment process to healthcare providers, ensuring accurate and timely reconciliation, and managing the assigned geography. This is a full-time position, and occasional evening and weekend work may be required as job duties demand. Key Responsibilities : Provider Payments : Oversee the payment process to healthcare providers, ensuring payments are made accurately and on time. Reconciliation : Manage the reconciliation process, ensuring discrepancies between payments and services rendered are identified and resolved promptly. Stakeholder Communication : Maintain o...

About The Role Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years What would you do? We help insurers redefine their customer experience while accelerating their innovation agenda to drive sustainable growth by transforming to an intelligent operating model. Intelligent Insurance Operations combines our advisory, technology, and operations expertise, global scale, and robust ecosystem with our insurance transformation capabilities. It is structured to address the scope and complexity of the ever-changing insurance environment and offers a flexible operating mod...

About The Role Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years What would you do? We help insurers redefine their customer experience while accelerating their innovation agenda to drive sustainable growth by transforming to an intelligent operating model. Intelligent Insurance Operations combines our advisory, technology, and operations expertise, global scale, and robust ecosystem with our insurance transformation capabilities. It is structured to address the scope and complexity of the ever-changing insurance environment and offers a flexible operating mod...

About The Role Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years What would you do? We help insurers redefine their customer experience while accelerating their innovation agenda to drive sustainable growth by transforming to an intelligent operating model. Intelligent Insurance Operations combines our advisory, technology, and operations expertise, global scale, and robust ecosystem with our insurance transformation capabilities. It is structured to address the scope and complexity of the ever-changing insurance environment and offers a flexible operating mod...

Role & responsibilities: Outline the day-to-day responsibilities for this role. Preferred candidate profile: Specify required role expertise, previous job experience, or relevant certifications.

Key Responsibilities: Claims Management: Process and manage insurance claims efficiently, ensuring accuracy and adherence to company guidelines. Coordination: Collaborate with healthcare providers, insurance companies, and TPA entities to facilitate claim approvals and resolve discrepancies. Pre-Authorization: Counsel patients' families on pre-authorization processes and handle all related procedures, including billing and coordination with TPA companies. Documentation: Maintain accurate records of all TPA-related activities, ensuring compliance with regulatory standards. Qualifications EXPERTIA.AI Bachelor's degree in Healthcare Administration, Insurance, or a related field.Experience: At l...

Key Responsibilities: Claims Management: Process and manage insurance claims efficiently, ensuring accuracy and adherence to company guidelines. Coordination: Collaborate with healthcare providers, insurance companies, and TPA entities to facilitate claim approvals and resolve discrepancies. Pre-Authorization: Counsel patients' families on pre-authorization processes and handle all related procedures, including billing and coordination with TPA companies. Documentation: Maintain accurate records of all TPA-related activities, ensuring compliance with regulatory standards. Qualifications EXPERTIA.AI Bachelor's degree in Healthcare Administration, Insurance, or a related field.Experience: At l...

Role & responsibilities: Outline the day-to-day responsibilities for this role. Preferred candidate profile: Specify required role expertise, previous job experience, or relevant certifications.

Vidal Health Insurance TPA is hiring for Executive for Client Servicing Roles and Responsibilities: Key Responsibilities: 1 . Management of query related to Claims and Cashless at Level 1. 2.Reports on top corporate/insurance companies/brokers to be reviewed with Leadership Team 3. Fulfilment of SLAs of top stakeholders for the respective region. 4. Oversee timely submission of MIS reports 5. Relationship with HO of Insurance Companies, Brokers if required. 6. Oversee department functions like the Customer Care, Claims, Contact Centre and related functions. Qualification & Experience required: Experience: Minimum Graduation with 1-2 years of experience in Customer Service with good com skill...

A Private Multispecialty Hospital at North Delhi requires following manpower in following post and department: - PCS Head - Staff Nurse - Front office Executive - MT Discharge (TPA) Salary as per Norms

Greetings from Vidal Health Insurance TPA Pvt Ltd., Openings For District Medical Officer!!! - Non Clinical Role Qualification -MBBS-MCI Reg Experience - 0 to 1 Year Job Location - Chennai Roles and Responsibilities Involved in analyzing medical reports and do medical Audit at the Hospitals. Should have medical knowledge. Providing quality services. Updating the new medical terms and conditions as per the policy. Should be good knowledge in Academics. Resolving Claims related queries and discrepancies, Following up and responding to queries of customers. Approving and Rejection of Payments to the Customers with all verification. Updating the Status of the Customers about the respective Claim...

Roles and Responsibilities Will be responsible for handling Corporate Clients such as Banks / Govt., Departments / PSU / IT Companies / Educational institutions, etc., for brand building, conducting camps and managing strong relationships with customers Area Mapping, cold calling, prospecting, negotiation, freezing on commercials, and closing of deals with the necessary documentation Helping the clients to understand various product offerings and solutions available with Dr. Agarwals Handling all B2B activities in order to increase footfalls in the hospital Responsible for revenue and growth of the assigned center Required Skills and experience Experience in business development and B2B acti...

As a TPA Executive at Cygnus Superspeciality Hospital, Kurukshetra, your role involves efficiently managing insurance and TPA-related activities. You will: - Coordinate with TPAs and insurance companies for pre-authorizations, approvals, and claim settlements. - Verify insurance documents and patient eligibility for cashless treatments. - Prepare, submit, and track insurance claims as per guidelines. - Maintain accurate documentation of approvals, rejections, and pending claims. - Assist patients with insurance-related queries and ensure a smooth discharge process. - Collaborate with billing, accounts, and admissions teams to ensure accurate claim processing. - Adhere to hospital and TPA com...

Roles and Responsibilities: 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 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 d...

Roles and Responsibilities: 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 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 d...

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...

JD Account Management- Senior Executive Job Responsibilities: Client Servicing Receive and check claim documents for completeness and advice employees regarding pending documents, if any. Track and control documents to ensure TAT of claims/cards as per SLA. Feedback from Insurers and Corporates. Additional revenue opportunities from existing Corporates. Respond to queries from the employees of the corporate through e-mails. Maintain weekly reports on claims and queries and the TAT of the same Escalate issues as per the escalation matrix. To attend to any other assignments assigned to you from time to time. Respond to queries from the employees of the corporate over Phone Maintain weekly repo...

Vidal is hiring for Assistant Manager role in CRM Client Servicing Job Title : Assistant Manager -CRM-Client Servicing -TPA Industry Industry : TPA Location: Gurgaon Only candidates from the Health Insurance and TPA industry will be considered for this role. Applicants from other industries are kindly requested not to apply as domain-specific experience is essential. Key Responsibilities: 1 . Management and Retention of Top corporate for the region. 2. Reports on top corporate/insurance companies/brokers to be reviewed with Leadership Team and proactively act on issues before escalations. 3. Fulfilment of SLAs of top stakeholders for the respective region. 4. Oversee timely submission of MIS...

Qualification: BDS/ BHMS + MHA Key Responsibilities: Experience in TPA, Insurance Company, UTI TSL , Hospital Sector Understanding of the product and provide training and product demo to new and existing clients Team management/ handing team of Medical officers / quality analysts Handling operations of the accounts Meeting and understanding of the customer requirements, plan implementation Travel to the customer's site as and when required for training and implementing Ensure service levels are maintained at hospitals Establish objectives and operational criteria for accounts managed. Understand the requirements of Clients regularly and implement the process at hospitals. Motivating / retain...

Qualification: BDS/ BHMS + MHA Key Responsibilities: Experience in TPA, Insurance Company, UTI TSL , Hospital Sector Understanding of the product and provide training and product demo to new and existing clients Team management/ handing team of Medical officers / quality analysts Handling operations of the accounts Meeting and understanding of the customer requirements, plan implementation Travel to the customer's site as and when required for training and implementing Ensure service levels are maintained at hospitals Establish objectives and operational criteria for accounts managed. Understand the requirements of Clients regularly and implement the process at hospitals. Motivating / retain...

Candidates with experience in Life/Annuity Insurance product conversion from one admin system to another is very helpful An ideal candidate will require working knowledge to expertise on many of the following: Working daily reconciliation reports and performing root cause analysis for life products (traditional life, universal life, ISWL, Indexed UL). Thorough understanding and experience working with the following product elements: Market Value Adjustment (MVA) Bailout/Caps/Floor rates Free Withdrawal Minimum Gtd Cash Value Premium based bonus (additional X bps credited assuming Prem Paid > Set limit) Account Value based bonus (additional Y bps credited assuming Account Value > Set Limit) M...