1024 Tpa Jobs - Page 11

About The Role Skill required: Retirement Solutions - Data Entry Services Designation: Customer Service Analyst Qualifications: Any Graduation Years of Experience: 3 to 5 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 model that can meet the u...

Role & responsibilities Overall formalities of cashless procedure. Working directly with the insurance company, healthcare provider, and patient to get a claim processed and paid Handling all pre-authorization approval under Insurance Policy. Re-solving the query related to Hospital & Customers. Handling and Re-confirming all incoming & outgoing E-mails. Follow up of documentation of above procedures and registers. Handling the pre approval procedure according to Insurance & TPA MOU and others. Handling final proceedings of Insurance Company bills. Handling Corporate Clients under Insurance Policy. Collecting the information required to create a claim Reviewing and appealing unpaid and denie...

Job Discerption: Leadership Develop, implement, and monitor the investigation strategy aligned with organizational objectives. Establish policies, protocols, and SOPs for investigation and fraud detection. Coordinate with insurers, providers, and internal teams to streamline investigation processes. 2. Operational Management Supervise and guide investigation officers, field investigators, and analysts. Ensure timely allocation, completion, and closure of investigation cases. Maintain robust documentation and MIS for all investigation activities. 3. Fraud Detection & Control Identify patterns, trends, and high-risk areas in claims processing. Lead initiatives for early detection of fraud and ...

Role Overview: The Head of Cashless Department will be responsible for managing end-to-end cashless authorization services of the TPA, ensuring compliance with insurer SLAs and IRDAI guidelines, while driving operational efficiency, cost control, and customer satisfaction. Key Responsibilities: Lead and manage the cashless operations team across regions. Ensure timely pre-authorization approvals within insurer SLAs. Maintain compliance with IRDAI regulations and internal SOPs. Coordinate with insurers, providers, and brokers for escalations and special approvals. Monitor high-value claims, deviations, and potential fraud risks. Drive process improvements, automation, and MIS reporting. Train...

Role Overview: The role is responsible for handling tariff negotiations with network hospitals, addressing cases where providers are violating agreed tariff terms, ensuring compliance with insurer/PPN guidelines, and protecting the organization from revenue leakage and penalties. Key Responsibilities: Monitor and identify tariff violations by hospitals in coordination with cashless and claims teams. Engage with hospitals to negotiate and enforce agreed tariff structures. Escalate repeated non-compliance cases to higher management/insurers for action. Maintain strong relationships with hospital administrators to ensure cooperation. Document all negotiation outcomes and update tariff records i...

Role Overview: The Manager will be responsible for supervising and coordinating the day-to-day operations of the Cashless Department, ensuring timely pre-authorization processing, adherence to SOPs/SLAs, compliance with IRDAI guidelines, and smooth communication with insurers, hospitals, and internal teams. Key Responsibilities: Manage daily cashless authorization workflow and ensure TAT compliance. Review and approve high-value or complex pre-authorization cases. Ensure adherence to insurer guidelines, SOPs, and IRDAI regulations. Handle escalations from hospitals, insurers, and brokers. Monitor team performance, allocate workloads, and conduct training. Coordinate with Provider Network, Cl...

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 : Manage the performance of the key accounts in the branches. Set goals and targets for the teams. Monitor and review the performance of the team periodically. Preparation of reports which will be shared with other teams. Understand the training needs of team members, develop them through training, coaching and mentoring sessions. Handle escalations and associated documentation if any. Preferred candidate profile : Education: Min Graduation completion. Experience: 7+ years of experience with broker or hospital or insurance background preferred. Managed large accounts in a TPA/insurance/hospital background with ability to handle 10-20 team members. Location: Bangalore-...

Job purpose To manage the end-to-end claims reimbursement process efficiently and accuratelyensuring timely claim submission, verification, adjudication, and resolution—while maintaining compliance, improving customer satisfaction, and contributing to the organization’s operational excellence. Duties and responsibilities 1. Claim Submission Initiation : The insured individual or the service provider submits a claim to the insurance company for reimbursement. Required Documentation : Policy details (policy number, coverage specifics). Proof of service or expense (invoices, bills, or receipts). Supporting documents (e.g., medical reports, repair estimates, or loss reports). Submission Channels...

About Rentokil PCI Rentokil PCI is the leading pest control service provider in India. A Rentokil Initial brand, Rentokil PCI was formed in 2017 through a joint venture (JV) between Pest Control India, the number one pest control company in India, and Rentokil, the world's leading pest control brand. Rentokil PCI aims to set new standards for customer service having operations across 300 locations in India. For more details: https://www.rentokil-pestcontrolindia.com Our Family Of Businesses Rentokil Pest Control is the world's leading commercial pest control company, operating in 70 countries and ranked in the top 3 in 65 of those countries. Ranking in the top 3 in 38 of the 44 countries we ...

About Rentokil PCI Rentokil PCI is the leading pest control service provider in India. A Rentokil Initial brand, Rentokil PCI was formed in 2017 through a joint venture (JV) between Pest Control India, the number one pest control company in India, and Rentokil, the world's leading pest control brand. Rentokil PCI aims to set new standards for customer service having operations across 300 locations in India. For more details: https://www.rentokil-pestcontrolindia.com About The Role OE / Sr. OE shall be owner of his / her assigned service areas within the Branch in terms of operations related actions as given in job responsibilities, and shall be responsible for providing qualified Technicians...

Role & responsibilities Job description: Expr: 5-10 years Salary : company standard Working mode : Work from office Job Title : Operation JD : Skills & Competencies: Strong coordination and communication skills. Knowledge of insurance and medical check-up processes preferred. Ability to handle multiple stakeholders (clients, diagnostic centres, doctors). Proficiency in MS Office, PPT, Advance excel and reporting tools. Attention to detail and customer-centric approach. Qualification & Experience: Graduate (preferably in Healthcare/Management)./Graduation mandatory 5-10 years of experience in insurance operations, healthcare coordination, or similar roles. Experience in pre-insurance medical ...

About The Role Skill required: Retirement Solutions - Data Entry Services Designation: Customer Service Associate Qualifications: Any Graduation Years of Experience: 1 to 3 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 model that can meet the...

About The Role Skill required: Retirement Solutions - Data Entry Services Designation: Customer Service Associate Qualifications: Any Graduation Years of Experience: 1 to 3 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 model that can meet the...

About The Role Skill required: Retirement Solutions - Data Entry Services Designation: Customer Service Analyst Qualifications: Any Graduation Years of Experience: 3 to 5 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 model that can meet the u...

About The Role Skill required: Retirement Solutions - Data Entry Services Designation: Customer Service Specialist Qualifications: Any Graduation Years of Experience: 7 to 11 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 model that can meet t...

About The Role Skill required: Retirement Solutions - Data Entry Services Designation: Customer Service Associate Qualifications: Any Graduation Years of Experience: 1 to 3 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 model that can meet the...

About The Role Skill required: Retirement Solutions - Data Entry Services Designation: Customer Service Analyst Qualifications: Any Graduation Years of Experience: 3 to 5 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 model that can meet the u...

About The Role Skill required: Retirement Solutions - Data Entry Services Designation: Customer Service Analyst Qualifications: Any Graduation Years of Experience: 3 to 5 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 model that can meet the u...

About The Role Skill required: Retirement Solutions - Data Entry Services Designation: Customer Service Analyst Qualifications: Any Graduation Years of Experience: 3 to 5 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 model that can meet the u...

About The Role Skill required: Retirement Solutions - Data Entry Services Designation: Customer Service Analyst Qualifications: Any Graduation Years of Experience: 3 to 5 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 model that can meet the u...

Role & responsibilities Plan and execute Insurance/TPA tie ups across Matcare/IVF centres Guide and monitor unit level teams in Insurance claims processing Query resolution from Insurance/TPAs in coordination with unit admin/clinical teams Ensuring timely receivables from Insurance/TPAs as per agreed SLA’s Ensuring insurance deductions/rejections are at a minimum Timely Insurance/TPA renewals

Role & responsibilities Plan and execute Insurance/TPA tie ups across Matcare/IVF centres Guide and monitor unit level teams in Insurance claims processing Query resolution from Insurance/TPAs in coordination with unit admin/clinical teams Ensuring timely receivables from Insurance/TPAs as per agreed SLA’s Ensuring insurance deductions/rejections are at a minimum Timely Insurance/TPA renewals

Role & responsibilities Plan and execute Insurance/TPA tie ups across Matcare/IVF centres Guide and monitor unit level teams in Insurance claims processing Query resolution from Insurance/TPAs in coordination with unit admin/clinical teams Ensuring timely receivables from Insurance/TPAs as per agreed SLA’s Ensuring insurance deductions/rejections are at a minimum Timely Insurance/TPA renewals

Role & responsibilities Plan and execute Insurance/TPA tie ups across Matcare/IVF centres Guide and monitor unit level teams in Insurance claims processing Query resolution from Insurance/TPAs in coordination with unit admin/clinical teams Ensuring timely receivables from Insurance/TPAs as per agreed SLA’s Ensuring insurance deductions/rejections are at a minimum Timely Insurance/TPA renewals