694 Tpa Jobs - Page 13

Responsible to ensure quality of service given is equivalent to the set standards. Responsible to maintain payable status at its minimum; close follow up on critical issues. Random checking of bills in terms of their accuracy and make sure the corporate bills are prepared as per the agreements and prompt dispatch of the same with the help of credit cell. Responsible to record department MIS reports and submission of the same to higher authority Responsible to monitor the surgical package limits in terms of material consumption and professional charges. Systems & Procedures: Responsible to design, implement and refine systems to manage processes and to optimize performance. Responsible to dev...

Walkin : Mon to Sat between 11am to 3pm - Siruseri Unit Job Title: Insurance Co-ordinator Role & responsibilities: List out the total Number Of credit patients (All Insurance). To send the Pre- Authorization form to the concern insurance company. Explain the Admission & Discharge procedure to the patient & attenders also. All data's and activities should be computerized. Watch the approval status and query reply to be update shortly. To Proper communication about the patient Admission, Approval, Enhancement procedure, Discharge, Payment, and cancellation process. The most common job duties for a health unit coordinator are clerical tasks like answering phones and processing paperwork, includ...

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...

Samved e-Care Pvt Ltd is a prominent healthcare claim and TPA service provider in India, offering hospitals advanced claim processing solutions. We are currently seeking a diligent and detail-oriented TPA Assistant to become part of our team in Ahmedabad. The ideal candidate will have the opportunity to thrive in the healthcare administration sector and contribute to optimizing cashless claim procedures for our affiliated hospitals. As a TPA Assistant, your primary responsibilities will include supporting cashless claim processing and documentation, ensuring timely submission and approval of claims by collaborating with hospitals, patients, and insurance TPAs. You will be responsible for dat...

Role & responsibilities Preferred candidate profile

About the Role: The Associate Field Biologist/Field Biologist/Sr. Field Biologist shall be responsible for Pest Audits of Branch Large / HD Customers (having Third-party Audits- USFDA, AIB, BRC, FSSC, SQF, LEED, etc), Key national customers in various segments - Food & Pharma Mfg, w/h, Large food retailers (excluding QSRs, Fast food chains), Large ITES & MA s, etc. The incumbent will report administratively to the DM & functionally to Opex QA and work as a part of the multi-functional team involving collaboration with the internal & external stakeholders. Job Responsibilities: Carry out Pest Audits of Global accounts, Key designated NK accounts- Food & Pharma units, Food & Pharma warehouses,...

Management of master fees files. Management & control of fees booking entries in accounting software Tally. Controlling billing/invoicing across the country. Arrangements of TPA Service Charge Reports. Coordination with all outstation offices. Fees collection follow-up for early release of payment. Resolving queries from Insurance Companies regarding fees. Resolving system issues at Insurance Companies. Lower TPA fees rate confirmations & follow-ups with Insurance Companies and inter-departments. Liaising with officials of Insurance Companies for early settlement of fees and other queries. Reconciliation of pending fees in books of accounts. Fees MIS management required by Insurance Companie...

Hiring for Assistant Manager for Vidal Health Insurance TPA Pvt Ltd Job Title : CRM Assistant Manager Location: Gurgaon Industry : Health Insurance / Third Party Administration Role Objective To lead and optimize the organizations CRM strategy, ensuring seamless client interactions, data integrity, and service delivery across health insurance workflows. The CRM Manager acts as a bridge between technology, client servicing, and operational teams to enhance customer satisfaction and retention. Key Responsibilities Functional Area RM Strategy & Execution - Design and implement CRM strategies aligned with business goals - Drive customer engagement, retention, and satisfaction initiatives Client ...

Urgent requirement for Assistant MIS Manager (Pune) TPA experience. Interested candidates can call on 9371762436 or share their updated resumes to career@mdindia.com Job Description: Roles and Responsibilities Manage MIS operations, ensuring accurate and timely reporting of health insurance claims data. Develop and maintain advanced Excel models for data analysis, including pivot tables, HLOOKUPs, and VLOOKUPs. Create management reports using TPA's software to track key performance indicators (KPIs) such as claim processing times, denial rates, etc. Collaborate with internal stakeholders to identify business requirements and develop solutions that meet their needs. Ensure compliance with reg...

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 ...

As a diligent individual within the role, you will be responsible for verifying TPA documents before submission. It will be essential to maintain accurate records of all TPA cases, including approvals and rejections, to facilitate audits and follow-up procedures effectively. Effective communication with insurance companies and TPA coordinators will be crucial in addressing queries and ensuring all necessary information is provided. Furthermore, you will play a key role in preparing and submitting final discharge summaries, bills, and other essential documents required for claim settlement. Monitoring the approval status and handling enhancement requests will also be part of your responsibili...

Manage insurer & client coordination, handle policies, endorsements, and claims, resolve escalations, build strong broker/client relations, lead servicing team, ensure seamless delivery & represent company in insurer meetings. Provident fund

Role & responsibilities Graduate Medical background, MR (B pharma), BHMS, BAMS/ MBA in Hospital Adminstration 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 own vehicle to travel in various hospital assigned to him Candidate must be computer literate and shall possess...

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

This position is responsible for providing administrative support to colleagues in the Talent & Culture function to ensure the timely and accurate delivery of Talent & Culture initiatives and projects. Process day-to-day Talent & Culture administration in an accurate and timely manner Conduct regular file audit for candidate files. Prepare new ambassador s personal files including all necessary forms, document and information. End to End process of Pre-Employment Medicals/Food Handlers renewal test and report administration Ensure that Health and safety policies of ESIC, Group Medical Coverage, Group Personal Accident and Group Term Life Insurance are periodically reviewed and renewed Assist...

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

Graduate Medical background, MR (B pharma), BHMS, BAMS/ MBA in Hospital Adminstration 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 own vehicle to travel in various hospital assigned to him Candidate must be computer literate and shall possess skills including but no...

Graduate Medical background, MR (B pharma), BHMS, BAMS/ MBA in Hospital Adminstration 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 own vehicle to travel in various hospital assigned to him Candidate must be computer literate and shall possess skills including but no...

table {mso-displayed-decimal-separator:"\."; mso-displayed-thousand-separator:"\,";} tr {mso-height-source:auto;} col {mso-width-source:auto;} td {padding-top:1px; padding-right:1px; padding-left:1px; mso-ignore:padding; color:black; font-size:11.0pt; font-weight:400; font-style:normal; text-decoration:none; font-family:Calibri, sans-serif; mso-font-charset:0; text-align:general; vertical-align:bottom; border:none; white-space:nowrap; mso-rotate:0;} .xl54 {font-family:Mulish; mso-generic-font-family:auto; mso-font-charset:0; text-align:left; vertical-align:middle; border:.5pt solid windowtext; white-space:normal;} .xl62 {color:black; font-family:Mulish; mso-generic-font-family:auto; mso-font...

TPA Executive - Hospital or insurance

Role & responsibilities 1) 1-3 years working experience in health insurance/health insurance TPA at Hospital handling/audit 2) Candidate must have excellent knowledge of health insurance / Health TPA domain. 3) Candidate must have excellent bill/medical negotiation skills & customer handling skills. 4) Good communication skills in Hindi/English and regional language of the state/region. 5) Ready to relocate himself/herself at location within India as may be required according to the job requirement . 6)Candidate must own vehicle to travel in various hospital assigned to him 7) MS Office and excel Preferred candidate profile Proficient in handling complex situations and customers. Candidate m...

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...

Key Result Areas Supporting Actions To build an ecosystem that would assess/ recommend/ decision the viability of credit lending proposals based on institutionalized processes and dynamic market information The role needs to mitigate the title risk in retail loan proposals/facilitate the approving authority to take decision on the proposal. To be responsible for ensuring the legal assessment, approval and recommendation of all retail/ prime/affordable/CF proposals. Reviewing of PDD/ escrow, maintaining MIS and monitoring of exceptions. Formulation of product/policy/procedures by interacting with internal/external stakeholders in the field of legal due diligence during the entire life-cycle o...

Job Description 1 Graduate Medical background, MR (B pharma), BHMS, BAMS/ MBA in Hospital Adminstration 2 2+ Years working experience in health insurance/health insurance TPA at Hospital handling/audit 3 Candidate must have excellent knowledge of health insurance / Health TPA domain. 4 Candidate must have excellent bill/medical negotiation skills & customer handling skills. 5 Good communication skills in Hindi/English and regional language of the state/region. 6 Ready to relocate himself/herself at location within India as may be required according to the job requirement 7 Candidate must own vehicle to travel in various hospital assigned to him 8 Candidate must be computer literate and shall...

• 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...