406 Tpa Jobs - Page 10

Role & responsibilities Responsible for entire branch management, handling complete operational activities, client/corporate servicing, and branch administration. Branch business retention & new business acquisition. Liasoning with Insurance Companies, Brokers, etc. Attending meetings of Corporates, Clients, Insurance Companies, etc. Build and maintain effective and influential relationships with the officials of Corporates, Clients, ICs, etc. Drafting forecasts and business plans. Managing budgets, allocating branch funds & petty cash mgt. Coordinating with various department of HO & Branches. Involvement in new projects planning and execution. Maintenance of the database of clients and corporate for the new business/es. Responsible for conducting briefing about any changes, new updates or process change from time to time. Preparing various report and analysis on regular basis and submit to the reporting manager & the HO. Ability to effectively deal with and manage stressful situation. Ability to work efficiently in a team, as well as an individual and take responsibilities. Open to travel to various cities/offices, as & when required. Thorough knowledge of the policy terms and conditions of various ICs. Maintain good CSAT level, client relationship mgt., etc Preferred candidate profile Familiarity with TPA/Insurance industry's rules and regulations regarding mediclaim business. Experience in operations mgt. /client servicing. Results driven and customer focused. Good in communication, presentation and interpersonal skills. TPA/IC experience of minimum 10-15 years. Interested candidates can share their updated resume to pnegi@mdindia.com

We are looking for a motivated and detail-oriented Customer Service Associate to support client servicing operations for group health insurance. This is a junior-level position suitable for candidates with prior experience handling TPA operations and servicing large corporate accounts (50+ clients). The role involves supporting claims, endorsements, and other service tasks as assigned, while also contributing to business development through referrals and account references. Key Responsibilities: Handle client service tasks including: Claims coordination and follow-ups with TPA/insurer. Policy endorsements (additions/deletions/changes). Documentation and query resolution. Maintain strong working relationships with assigned clients under the guidance of the reporting manager. Coordinate with internal teams and TPAs to ensure smooth and timely servicing. Meet performance targets related to service quality and client satisfaction. Generate references and account leads from previously serviced clients to support B2B sales efforts. Maintain accurate records and prepare reports as required. Undertake any additional responsibility as assigned by the reporting manager. Required Skills & Experience: 1-3 years of experience in a TPA, insurance company, or insurance broker firm handling group health insurance. Prior exposure to servicing 50+ corporate clients is preferred. Familiarity with claims process and endorsement documentation. Strong communication and interpersonal skills. Knowledge of the local language is essential. Basic MS Office skills (Excel, Word, Outlook). Ability to manage multiple tasks and work independently under supervision. Education: Graduate in any stream. Additional certification in insurance (preferred but not mandatory). What We Offer: Opportunity to grow within the client servicing domain. Exposure to B2B insurance operations and structured career progression. A performance-driven culture with mentorship and team support.

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 also apply. Work from office. Venue details: MDIndia Health Insurance TPA Pvt. Ltd., Raheja towers, Unit 005, Delta wing no-177, Beside LIC building, Annasalai, Chennai-600002.

Responsibilities: * Provide medical services to patients , do Medical examination , * Conduct stress tests, ECGs, TPAs, and other diagnostics. * Manage Staff Increasing footfall at centres

Responsibilities: * Lead claims settlements and operations on-site * Ensure compliance with HIPAA & insurance ops standards * Manage health claims of our patients from start to finish * Collaborate with stakeholders on claim resolution

Process cashless and reimbursment claims (Should have knowledge of processing retail policies of National/United/New India/Oriental insurance companies.

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 take necessary action for IR raised, reopening the claims, dummy claims as appropriate Review the feedback received from the customers. Rework on the low ratings and identify the areas of improvement and implement process improvements Team management Review on the low C-SAT/D-SAT to improve the communication quality or process gap if any as per the clients understanding/requirement. Coordinate with internal/external stakeholders and other regions on the support needed for the client requirements, like helpdesk , wellness-related activity and more. Preferred candidate profile 3-5 years of experience in people management and customer service & 7-8 years of overall experience in service industry

Job Title: Insurance Desk Executive TPA Coordination / Claims Specialist Location Options: KIMS Hospital, Nashik Survey No. 571/1A/1, Plot No. 63, Mumbai Agra Highway, Nashik, Maharashtra – 422001 KIMS Hospital, Thane West – Queens St, near Brentford Cooperative Society, Hiranandani Estate, Thane West, Maharashtra – 400615 Organization: Ayu Health Hospitals Experience Required: 0–2 years (Freshers are welcome to apply) Preferred Gender: Male Candidates Preferred Location: Candidates residing near hospital locations will be given preference About Ayu Health: Ayu Health is one of India’s fastest-growing healthcare networks, dedicated to making high-quality healthcare accessible and affordable for all. With a focus on technology-driven solutions, Ayu Health partners with reputed hospitals and clinics across the country to deliver standardized care, transparent pricing, and a seamless patient experience. We are on a mission to build India’s most trusted healthcare brand. Key Responsibilities: Handle insurance/TPA desk operations at the hospital premises Coordinate with TPA and insurance representatives for claim submission and follow-up Manage and organize patient insurance documentation accurately Track approvals, follow up on pending claims, and address rejections effectively Communicate professionally with patients, hospital staff, and insurance partners Support hospital administrative needs and maintain documentation records Multi-task and work collaboratively within the hospital environment Candidate Requirements: 0–2 years of experience in TPA coordination, insurance desk, or claims processing in hospitals (Freshers with good communication skills can apply) Strong interpersonal and communication skills Basic understanding of hospital processes is a plus Ability to manage documents and work efficiently under pressure Must be reliable, punctual, and a team player Preference will be given to candidates living nearby the hospital location Male Candidates only Immediate Joiners will be preferred

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

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 and implementation of business plans and goals

To contact the insured for Underwriting referred proposals to procure the complete medical history using Audio and/or Video tools. To Follow up with customer for past medical records and/or relevant health documents Maintain end to end TAT / SLAs. Required Candidate profile Location – Bangalore Candidate must know to speak excellent English. CTC – Upto 3.5 LPA.

Role & responsibilities Empanelment / TPA's / Insurance companies / Brokers / Corporate Companies Lead generation activities which include one on one screening with our consultants Corporate Engagements - webinars and Camps Visiting the clients and giving them information regarding hospital initiatives Preparing, maintaining and timely submission of MIS related to leads and conversions Follow up on Receivables from TPA's / Insurance companies Preferred candidate profile Graduate / MBA 3-8 years Perks and benefits Company standards

To process claims

Role & responsibilities Overall supervision, control on functioning of the Department. To attend to patient clarifications with regard to billing. To deal with billing clarifications/ information in respect to various Corporates/ Institutions having tie up with hospital. To follow-up on payment of outstanding dues with empanelled Corporate/ Institutions. To co-ordinate with Third Party Administrations (TPAs) and follow-up on payment of outstanding dues. To monitor the billing process, time taken for preparation of the final bill. To check the bills on a daily basis. To follow-up on dues from patients in case of default in payment. Training of staff in the department Provide data for Consultants/Doctors payments Defining IP Packages & Tariff and revising them from time to time as per decision of the Management. Any other work assigned by the Management from time to time. Preferred candidate profile Candidate must have Insurance Billing End to End process.

Job Title : Medical officer Open Positions: 2 Vacancies Location: Konankunte cross Job Summary: We are seeking candidates with a minimum of 1 year of experience in Indian health Insurance/TPA (Added Advantage) who have strong communication and along with good medical knowledge in Claims Adjudication. Qualifications : Degree in BAMS, BHMS, BSMS, or MBBS (strictly required). Candidates who can join immediately or within 15 days are preferred. Roles & Responsibilities: Ensuring accuracy and compliance in medical claims adjudication. Knowledge & Skill Requirements: Technical Competencies: Claims processing Preauthorization, Cashless, Reimbursement, Medical Adjudication, and Billing experience. Understanding of GIPSA/MA packages, SOC, and Tariff deviations. Identifying bill inflations in insurance billing. Knowledge of surgeries, advanced treatments, and procedure costs. Behavioral Competencies: Strong communication skills (verbal & written). Teamwork and collaboration. Time management and multitasking.

Role & responsibilities Responsible for managing client servicing with key decision makers Addresses the gaps identified between client requirement & the service provided Ensure that the service is delivered in accordance with the agreed service level agreement Act as a point of contact for any escalation or feedback from clients Manage account renewal, customer support escalation Good Communication Skills Good knowledge of MS Office Open to travel Interested share their CV on 7058096238

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 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 deny the claims as per the terms and conditions within the TAT. Handle escalations and responding to mails accordingly. Qualification: BAMS BHMS Work from office only Interested candidates can send their CV to dona.antony@mediassist.in or WhatsApp to 9632777628

Roles and Responsibilities Candidate has to do TPA Empanelment. Candidate will handle entire billing part and documentation. TPA/Cashless /ECHS /CGHS /ESIC billing & documentation. Liaison with Govt. Health Departments. Liaison with Insurance Companies. Tie ups with Corporate Houses. Must be aware of norms of insurance sector. Desired Candidate Profile Good communication. Must have good command over MS Office. Candidate must have experienced in Third party/ Empanelment Corporate tie-ups. Must have experienced of Hospital. Must have Experienced TPA/Cashless/ECHS/CGHS processors. Perks and Benefits Performance based Incentives Interested candidates may share their cv on WhatsApp 8875029935 with be mention Details Total Experience Current City Current Company Home Town Current Salary Expected Salary Notice Period

We are hiring freshers or experienced medical officer to process the health insurance claims in TPA or Insurance companies. Educational Qualification: MBBS / BAMS / BHMS / BPT / MPT / BDS / Pharm D.

Greetings from Vidal Health Insurance TPA Pvt Ltd., Openings For Medical Officer!!! - Non Clinical Role Qualification -MBBS-MCI Reg Shift Timing - 6 Pm to 10 PM 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/Preauth. Play as an intermediate role between the Insurance co., and the Customer. Handling Customer queries and giving a prompt reply to the customers through email. Preparing the Weekly consolidated reports of the team and updating to the Management. Assigning and Resolving Customer Queries through email. Raising Shortfall whenever it is necessary. Approving and Rejecting of Claim/Preauth after all necessary checks I nterested Candidates can Whatsapp(no calls please ) your resume to Udaya Kumar R - 9940138034 or Apply in Naukri Itself. Regards Udaya Kumar R 9940138034

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 varsha.kumari@mediassist.in Thanks & Regards Varsjha Kumari Email - varsha.kumari@mediassist.in

Greeting from Medi assist TPA Pvt ltd. Hiring Medical officer for Insurance Claim processing Profile Location- Mumbai -Andheri East. Role - Medical officer Exp : 0-8 years Job description : * 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 Interested candidate can drop there resume in my Mail ID : varsha.kumari@mediassist.in We are looking for fresher or exp candidates BAMS, BHMS mail id - varsha.kumari@mediassist.in Thanks & Regards Email: varsha.kumari@mediassist.in

Urgent requirement for BHMS/BAMS/BDS doctors-Pune (Vadgaonsheri) 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 graduate. Good Medical & basic computer knowledge. Should have completed internship (Permanent Registration number is mandatory) Preferred -TPA or insurance sector Experience. 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

Roles and Responsibilities Manage client relationships through effective communication, ensuring high levels of satisfaction. Coordinate with internal teams to resolve claims-related issues and improve overall process efficiency. Develop strong leadership skills to motivate team members towards achieving targets. Analyze data using MIS tools to identify trends, risks, and opportunities for growth. Provide excellent customer service by responding promptly to queries from clients.

About Rentokil PCI About the Role: The Operations Manager shall be responsible for the entire Operations of the Branch and will manage all the operations colleagues directly (Technicians, Service Planners, OE, AOM). The JD lists down duties and responsibilities of Operations Manager to be positioned in Large Branches. The incumbent will report to the Branch Manager and will have to work as part of a multi-functional team and this involves collaboration with the internal team and external stakeholders. Job Responsibilities: Core Operations Ensure only qualified (trained & certified) and competent manpower (Technicians, OE, planner) are assigned jobs & deployed at site. Coach & train OEs & AOM in order to improve their Technical & operational capability. Ensure service SOP compliance and quality of service delivery by effective supervision of Team - on the job as per company SOPs Ensure compliance with the contractual obligations of NKA clients are Conduct Pest Audit of NKA and close customer audit non-conformities Ensure the Operations Team completes Pest audit as per iCABs/contract agreement using rAuditor, and closes customer audit non-conformities (external / internal) Conduct daily & weekly review meeting of OEs/AOM and monthly operations meeting with Technicians Approval of conveyance amount for all the AOMs Ensure customer complaints are attended within 24 hours & resolved with reduction in escalation. In case any of the Operations colleagues are on leave or position is vacant, should ensure entries are made in iCABS to achieve operations KPI of Branch. Advance Operations Succession planning: Ensure availability of qualified Technician, OEs, SP, AOM as per branch business plan to meet new sales as per sales forecast. Ensure SHE golden rule, PN, SRA and ATEX compliance in the Branch. Monitor and maintain material consumption, Overtime Hrs. as per Branchs AOP target OM to monitor and ensure daily chemical consumptions are updated in NAV by respective team members and before month closing confirm Physical stock and NAV stock are matching. Maintaining Optimum Stock Level and Ensuring Indents are raised after checking requirement and stock. Track, Monitor and ensure input costs at all major sites as per gross margin agreed & implement action plans to bring it within limits in Branch Actively drive Service & Product Leads and ensure Branchs AOP targets are met Surprise visits to KA and NKA to ensure compliance with the contractual agreement and support Technicians and OEs Analyse service complaints, prepare action plan, guide OEs/AOMs to ensure AOP targets are met Inventory: analyse material consumption and optimise consumption- prepare action plan, guide OEs/AOMs to ensure AOP targets are met Ensure strict implementation of Service SOPs, SHE golden rules, SRA, PN and use of Approved Preparations List products. Identify & resolve Service delivery issues in coordination with the Branch Manager Provide technical and operational support to OEs and AOM Ensure termination notifications are attended effectively and promptly. Analyse and take appropriate actions in case of any deviation that could impact service quality or productivity of technicians like- overcommitments, recommendation regarding night service (if it is not needed), covered area mismatch, etc Monitor and drive SOS, service productivity and efficiency Monitor and ensure 100% PMI audits are completed as contract agreement. Monitor Branchs SCP usages and Active devices. Ensure that the usage is always about 95% & active device count is always 100%. Analyses visit extraction notes for all high infestation related service visits on daily basis & take action Ensure that the services of NKA are delivered through the certified technicians & with SCP only. This is MANDATORY Ensure Branch CVC scores as per target and increase in promoters numbers based on resolution of grievances of detractors/passive Visit customers (along with OEs, AOM) and help resolve issues highlighted by customers/OE/AOM. Ensure the team adheres to the safety guidelines and conducts SRAs as per the set process Coach and motivate Technician by route riding through OE/OM for quality service Lead generation. Also guide how to conduct techno commercial audit by analysing the suitable need at the customers site. Key Result Areas: ToS improvement- 60-75% (as per branch AoP target) Manpower Management: 100% availability of qualified Technician, planner, OEs and AOM as per business plan Delivered MTD SOS >95% and Technicians productivity - R/FTE, Visit/FTE as per branch AOP targets Complaint management: Ensure reduction in Call Outs and increase CVC score as per AOP targets Manage material consumption with improved Branch monitoring and Optimise the material consumption by implementing innovation as per branch AOP targets. 100% TPA and Development plan based Technicians grading Ensure 100% usage of SCP devices & all devices are active throughout the year in respective branch Deliver budgeted Service Leads and encourage & motivate technicians to submit the Service Leads as per AOP target Retain & grow existing customers to improve Customer Retention as per AOP target 100% PMI target as per iCABs are achieved of the branch as per contract agreements myR Usage for customer reviews, trend analysis & going paperless Self learning and development- Above 90% score in online assessment. Deliver agreed SHE Plan- LTAR Target | WDLR Target Educational Qualification / Other Requirement: Minimum B. Sc. (Chemistry / Zoology / Agriculture) 3-4 yrs of experience in operations of pest management or service industry is desirable Profi