407 Tpa Jobs - Page 13

Minimum Mandatory Skill Set Computer Operations, Computer proficiency, MS Excel, Communication in English & Hindi, Open to work in shifts. Brief Job Profile Generic job profile includes document processing, Data entry process, Maintaining trackers, Escalate issues as required within organization and follow up to ensure timely resolution. Desired Competencies/ Skill Set Working knowledge of MS Excel with data entry speed and accuracy, ability to communicate in English and Hindi effectively, Insurance / Health Insurance Knowledge. Should be open to shift duties. Preferred Industry Health Insurance, TPA, BFSI, Healthcare

Minimum Mandatory Skill Set Computer Operations, Computer proficiency, MS Excel, Communication in English & Hindi, Open to work in shifts. Brief Job Profile Generic job profile includes document processing, Data entry process, Maintaining trackers, Escalate issues as required within organization and follow up to ensure timely resolution. Desired Competencies/ Skill Set Working knowledge of MS Excel with data entry speed and accuracy, ability to communicate in English and Hindi effectively, Insurance / Health Insurance Knowledge. Should be open to shift duties. Preferred Industry Health Insurance, TPA, BFSI, Healthcare

Minimum Mandatory Skill Set Computer Operations, Computer proficiency, MS Excel, Communication in English & Hindi, Open to work in shifts. Brief Job Profile Generic job profile includes document processing, Data entry process, Maintaining trackers, Escalate issues as required within organization and follow up to ensure timely resolution. Desired Competencies/ Skill Set Working knowledge of MS Excel with data entry speed and accuracy, ability to communicate in English and Hindi effectively, Insurance / Health Insurance Knowledge. Should be open to shift duties. Preferred Industry Health Insurance, TPA, BFSI, Healthcare

Minimum Mandatory Skill Set Computer Operations, Computer proficiency, MS Excel, Communication in English & Hindi, Open to work in shifts. Brief Job Profile Generic job profile includes document processing, Data entry process, Maintaining trackers, Escalate issues as required within organization and follow up to ensure timely resolution. Desired Competencies/ Skill Set Working knowledge of MS Excel with data entry speed and accuracy, ability to communicate in English and Hindi effectively, Insurance / Health Insurance Knowledge. Should be open to shift duties. Preferred Industry Health Insurance, TPA, BFSI, Healthcare

Minimum Mandatory Skill Set Computer Operations, Computer proficiency, MS Excel, Communication in English & Hindi, Open to work in shifts. Brief Job Profile Generic job profile includes document processing, Data entry process, Maintaining trackers, Escalate issues as required within organization and follow up to ensure timely resolution. Desired Competencies/ Skill Set Working knowledge of MS Excel with data entry speed and accuracy, ability to communicate in English and Hindi effectively, Insurance / Health Insurance Knowledge. Should be open to shift duties. Preferred Industry Health Insurance, TPA, BFSI, Healthcare

Minimum Mandatory Skill Set Knowledge of Processing of claims, quality check and adherence to TAT, computer skills, excel. Candidate should be open to work in 24X7X365 shifts Brief Job Profile Claims adjudication, Fraud and leakage control, Client/provider feedback, Team training and retention, Investigation Desired Competencies/ Skill Set MS Excel and MIS skills, Candidate having work experience of claim processing, Investigation, computer skills. Preferred Industry Health Insurance, TPA, Hospitals, Healthcare

Minimum Mandatory Skill Set Knowledge of Processing of claims, quality check and adherence to TAT, computer skills, excel. Candidate should be open to work in 24X7X365 shifts Brief Job Profile Claims adjudication, Fraud and leakage control, Client/provider feedback, Team training and retention, Investigation Desired Competencies/ Skill Set MS Excel and MIS skills, Candidate having work experience of claim processing, Investigation, computer skills. Preferred Industry Health Insurance, TPA, Hospitals, Healthcare

Urgent requirement for BHMS/BAMS-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 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.

Learning & Development Product Team Junior Specialist (m/f/d) Driven by a global energy super cycle, Hitachi Energy is entering an exciting phase of growth. Our strategic talent initiatives are recognized as key drivers of our success. Over the next few years, we aim to attract, recruit, upskill, and retain thousands of colleagues. To achieve this, we are transforming our current Talent & Learning organization, part of Talent & Reward, HR, into three distinct yet interconnected global Talent Centers of Expertise (CoEs): Talent Planning & Acquisition (TPA) CoE, Learning & Development (L&D) CoE, and Talent Management (TM) CoE. As part of our Learning & Development (L&D) Center of Expertise, we are seeking a Learning & Development Product Team Junior Specialist to design, implement, and manage training initiatives that enhance employee skills and performance across the organization. In this newly created role, you will be part of a small, agile team responsible for shaping and executing the global L&D framework. You will play a key role in developing impactful learning experiences that support individual growth and organizational capability building. If youre curious, digitally agile, and eager to grow from the basics supporting learning journeys, managing digital platforms like Percipio, and contributing to team development join us and help shape impactful learning experiences! How You Will Make An Impact Design and implement global learning and development initiatives that support individual skill development. Develop engaging and effective learning content and resources tailored to diverse target groups. Leverage digital platforms and tools to deliver consistent, scalable, and impactful learning journeys. Remain well-informed about industry trends and emerging technologies to continuously refine learning experiences that meet evolving learner needs. Collaborate with the Talent Management CoE to identify and implement suitable development assessments. Coordinate with internal facilitator pools to ensure engaging and effective delivery of learning activities. Build and manage relationships with external vendors to enhance our learning offerings. Your background 3 years of international experience in Learning & Development, Organizational Development, or Leadership Development within HR Excellent verbal and written communication skills in English, other languages are a plus Project management and hybrid team collaboration skills, preferably gathered working cross-culturally in international organizations Familiarity with learning technologies, LMS platforms, and digital learning tools. Experience in designing learning and development programs Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint) More about us We offer you the opportunity to work with fantastic people and develop yourself on projects that present great technical challenges and have a real impact. We pride ourselves on offering a holistic range of competitive benefits to support your financial, physical and mental wellbeing and personal development. We want you to truly thrive with us, in work and out. We can provide more information during the recruitment process. Recruitment process flow: Phone screen with Talent Partner -> Teams interview with Hiring Manager Qualified individuals with a disability may request a reasonable accommodation if you are unable or limited in your ability to use or access the Hitachi Energy career site as a result of your disability. You may request reasonable accommodations by completing a general inquiry form on our website. Please include your contact information and specific details about your required accommodation to support you during the job application process. .

Select how often (in days) to receive an alert: Select how often (in days) to receive an alert: Accounting Admin III Jun 3, 2025 Bangalore, India, 560064 Who we are The opportunity Responsible for General Ledger, Intercompany including but not limited to General Ledger transactions, Support Balance sheet review, Intercompany reconciliations preparation, Billing and compliance with internal and business controls. Communication and (internal) stakeholder management with higher management levels within the Global Teva organization is required in this process. How you ll spend your day Technical/functional knowledge in Intercompany Accounting, Closing and reporting process area Handle various types of intercompany transactions such as sales of products, Transfer pricing agreement (TPA) transactions, services, inventory sales/purchases, cost allocations, royalties, Inhouse banking transactions. Ensure that accruals are properly recorded and analyzed Preparation of Journal Entries & Supporting schedule Perform Support monthly and quarterly close activities of multiple entities Analysis of the various accounts and variances per legal entities, obtain explanation on deviations and prepare a summarized reporting on a monthly basis within scheduled time Preparation monthly Intercompany reconciliations & clearance of reconciling/aged/disputed items. Hands on experience in submission of trial balance in HFM. Identify & drive process improvement, standardization opportunities in of processes and tasks across the team. Acting as a key contact for local teams for record-to-report related questions Ensuring that accounting books and records comply with accounting policies and regulations Provide supporting documents and explanations for all internal and external audit as and when required Knowledge on Accounts payable (AP) and Accounts receivable (AR) books. Your experience and qualifications University education in Accounting or Finance required Masters degree is preferred Minimum experience of 6+ years of closing & reporting, Intercompany experience Preferably familiar with USGAAP Working knowledge of internal controls Good working knowledge of SAP Good understanding of accounting processes and can follow accounting policies Good analytical skills and have hands on experience on working & clearance of reconciling items Fluent verbal and written communication in English Experience in a multinational firm or within a GBS (Global Business Service) is preferred Hands-on and proactive; strong organizational skills Sr Mgr Finance Operations Already Working @TEVA The internal career site is available from your home network as well. If you have trouble accessing your EC account, please contact your local HR/IT partner. Teva s Equal Employment Opportunity Commitment Teva Pharmaceuticals is committed to equal opportunity in employment. It is Tevas global policy that equal employment opportunity be provided without regard to age, race, creed, color, religion, sex, disability, pregnancy, medical condition, sexual orientation, gender identity or expression, ancestry, veteran status, national or ethnic origin or any other legally recognized status entitled to protection under applicable laws. We are committed to a diverse and inclusive workplace for all. If you are contacted for a job opportunity, please advise us of any accommodations needed to support you throughout the recruitment and selection process. All accommodation information provided will be treated as confidential and used only for the purpose of providing an accessible candidate experience.

Select how often (in days) to receive an alert: Select how often (in days) to receive an alert: Accounting Admin III Jun 3, 2025 Bangalore, India, 560064 Who we are The opportunity Responsible for General Ledger, Intercompany including but not limited to General Ledger transactions, Support Balance sheet review, Intercompany reconciliations preparation, Billing and compliance with internal and business controls. Communication and (internal) stakeholder management with higher management levels within the Global Teva organization is required in this process. How you ll spend your day Technical/functional knowledge in Intercompany Accounting, Closing and reporting process area Handle various types of intercompany transactions such as sales of products, Transfer pricing agreement (TPA) transactions, services, inventory sales/purchases, cost allocations, royalties, Inhouse banking transactions. Ensure that accruals are properly recorded and analyzed Preparation of Journal Entries & Supporting schedule Perform Support monthly and quarterly close activities of multiple entities Analysis of the various accounts and variances per legal entities, obtain explanation on deviations and prepare a summarized reporting on a monthly basis within scheduled time Preparation monthly Intercompany reconciliations & clearance of reconciling/aged/disputed items. Hands on experience in submission of trial balance in HFM. Identify & drive process improvement, standardization opportunities in of processes and tasks across the team. Acting as a key contact for local teams for record-to-report related questions Ensuring that accounting books and records comply with accounting policies and regulations Provide supporting documents and explanations for all internal and external audit as and when required Knowledge on Accounts payable (AP) and Accounts receivable (AR) books. Your experience and qualifications University education in Accounting or Finance required Masters degree is preferred Minimum experience of 4+ years of closing & reporting, Intercompany experience Preferably familiar with USGAAP Working knowledge of internal controls Good working knowledge of SAP Good understanding of accounting processes and can follow accounting policies Good analytical skills and have hands on experience on working & clearance of reconciling items Fluent verbal and written communication in English Experience in a multinational firm or within a GBS (Global Business Service) is preferred Hands-on and proactive; strong organizational skills Sr Mgr Finance Operations Already Working @TEVA The internal career site is available from your home network as well. If you have trouble accessing your EC account, please contact your local HR/IT partner. Teva s Equal Employment Opportunity Commitment Teva Pharmaceuticals is committed to equal opportunity in employment. It is Tevas global policy that equal employment opportunity be provided without regard to age, race, creed, color, religion, sex, disability, pregnancy, medical condition, sexual orientation, gender identity or expression, ancestry, veteran status, national or ethnic origin or any other legally recognized status entitled to protection under applicable laws. We are committed to a diverse and inclusive workplace for all. If you are contacted for a job opportunity, please advise us of any accommodations needed to support you throughout the recruitment and selection process. All accommodation information provided will be treated as confidential and used only for the purpose of providing an accessible candidate experience.

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 : Claims can be submitted via online portals, email, fax, or physical mail, depending on the insurer's requirements. 2. Claim Verification and Validation Eligibility Check : Determine if the claim is within the policy coverage limits and terms. Verify that the claim type (medical, property damage, etc.) is covered under the insured's policy. Document Review : Confirm all necessary documents have been provided. Ensure the claim is free from errors, fraud, or inconsistencies. Request for Additional Information : If documents are missing or unclear, the insurer requests clarification or additional evidence. 3. Claim Adjudication Assessment of Claim : Evaluate the claim amount against the policy terms and coverage limits. Check deductibles, co-pays, and exclusions outlined in the policy. Reimbursement Calculation : Determine the payable amount after accounting for policy conditions like sub-limits, deductibles, or co-insurance clauses. Approval or Denial : Approve valid claims for reimbursement. Deny claims with proper reasoning if they fall outside policy coverage. 4. Reimbursement Processing Payment Authorization : Approved claims move to the payment stage after final authorization by the claims manager or automated systems. Payment Methods : Payments are issued via direct deposit, checks, or transfers to the insured or service provider, depending on the arrangement. Notification : The claimant receives a notification detailing the reimbursement amount, processing timelines, and any deductions applied. 5. Dispute Resolution (if applicable) Denial Appeals : If a claim is denied, the insured can appeal the decision with additional documentation or clarification. Resolution of Discrepancies : Address issues such as underpayments or errors in processing through negotiation or review. Customer Support : Insured parties can work with claims specialists to resolve questions about their claim or reimbursement status. 6. Final Documentation and Archiving Record Keeping : All claim-related documents and correspondence are archived for compliance and future reference. Regulatory Reporting : Ensure claims are processed in compliance with local, state, or federal regulations and report as needed.

Specific Job Responsibilities 1. Explaining the concept of cashless & reimbursement to the patient & relatives 2. Filling Pre Auth forms. 3. Collecting all essential documents at the time of Admission. 4. Providing details/ information to the Billing/ Ward billing staff. 5. Faxing / Mailing documents as per requirement. 6. Taking continuous follow up for all the cases depending upon dire emergency for all admitted cases. 7. Informing all approval, Denial, Interims, Queries & final bill enhancements. 8. Reverting to the mails of TPA regarding cashless claims. 9. Checking any bill exceeding the authorized amount & forwarding interim bills. 10. Making check list for any short of documents of the admitted patient. 11. Co-ordinate with All TPAs, insurance companies and corporate. 12. Informing & counselling regarding the concepts of c0-payment/ Administrative charges /Non payable items deducted by TPA. 13. Explaining inclusions/ Exclusions in the policies. 14. Calculating exact deducted amount by the TPA / Insurance companies. 15. Discharging patient after completion of all the formalities. 16. Changing the bills from cashless to self-pay in case of denial. 17. Informing the list of planned admission to the admission department with details of the patients. 18. Bed release of discharged patient 1. Behavioral Competencies: Proactive Problem solving ability. Result oriented Good co-ordination skills Interested Candidates can share you updated resume on recuitment@noblehrc.com

Job Tile : Claims processing Doctor Job Description: Medical claims processor will have to look into claims where payment was denied. Commonly due to issues of insurance coverage eligibility , the claims handler may be tasked with reviewing documentation from the patient, their physicians, or the insurance. With the medical expertise ,need to master the various products and to apply the same during claim processing. Claims processors process any claim payments when applicable and must ensure they comply with federal, state, and company regulations and policies. List of Responsibilities: To validate the authenticity and the credibility of the claims. To coordinate with various persons (Claimant, Treating Physician, Hospital insurance desk, Field Visit Drs, Investigation officers)for hassle-free claim processing . To expertise ,the process of negotiation when necessitated. The claim handler owes a duty of care to the patient, ensuring that their needs are being met and that they re receiving the treatment or medicine they need. Job Qualifications and Requirements: Required BDS, BHMS, BAMS Graduates. Adapt and inbuilt the process of communication and coordination across the zones and the supporting verticals accordingly.

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

Assist in administrative tasks within the E.M.S. department. Manage and distribute departmental correspondence. Provide support in organizing departmental events and meetings. Ensure cleanliness and orderliness in the department. Assist in running errands and tasks as directed. TPA Department

Knowledge of BPO/KPO Industry and Life Insurance/Workers Compensation Domain. Knowledge of GL/AL and Life claims and other allied support for Leading Insurance TPA Must be capable of responding to client correspondence/queries Go-getter and ability to learn faster. Should have an eye for detail with good analytical skills. Flexible, highly motivated & Team player. Ability to work under pressure while delivering desired results. Documentation and Reporting skills. Excellent Communication Skills. Should be very good in Microsoft Office (Word, Excel, PPT, etc.) Must be willing to work in the US time zone (CST) also during weekend(rotational) Preferably Bangalore resource and ready to work from office.

Urgently hiring a Medical Officer – Team Lead with 5+ years in TPA or insurance. Must have strong process knowledge to lead and manage a team of 20 doctors effectively. interested candidates can send resumes to kalyan.r@isbsindia.in or 9866005517.

1. Claims Administration and Management Coordinate with branches in resolving the claims within the set SLAs / TATs; resolve any issue / concern Review the claim settlement status daily; guide team in addressing claims which exceed TAT; seek clarifications and resolve issues to ensure that the claims are processed at the earliest Conduct reviews (OFR / CFR) to identify problems within claims settlement and propose solutions; discuss the same with the superior and seek feedback / assistance in the same 2. TPA Management Connect with the TPA vendors and invite quotes; assess information like loss ratio/ service expectations, etc. ; Negotiate with the TPAs on different aspects; assess loss ratio and drive action to arrest the same by seeking assistance from underwriting team on premium / risk assessment, etc. Share policy details, benefits and nuances; train them on the specifics of the policy and how to administer the payment / claim processing 3. Report Generation (MIS) Generate MIS on set frequency and apprise relevant stakeholder of the claim status within the team Provide clarifications / reasons in case of delayed claim settlement 4. Team Training Lead training efforts for upskilling of team to better deliver in terms of claims administration, settlement, issue resolution, etc. Provide directions in planning and coordination of training efforts for team Motivate and retain key talent in the team 5. Process Improvement Collaborate with technology teams internally to drive implementation of tech-based platforms for claims processing, etc. Support different internal teams to come up with innovations / process improvement and drive its implementation for effective claims management 6. Team Development and Engagement Establish location wise performance expectations and evaluation metrics, and regularly review location wise performance Share information regarding business and key developments with the team proactively; guide them in utilizing their skills in the best possible manner Understand team grievances and guide for their effective resolution Identify and create development opportunities for team members to enhance functional knowledge

Job Profile: Background of having experience of dealing with insurance companies to settle the claims and working upon taking insurance policies at optimum cost preferably in group of companies. Person should have minimum 5-7 years of experience handling end to end process of managing all types of insurance instruments. Ability to prepare and present- Allocate MIS or related work. Commercial background and working on SAP. Good knowledge of Excel and reasonable communication/liasoning skills.

Handling TPA related all process from billing to co-ordinate with TPA companies. Maintaining & uploading patient's files on the portal. Handling billing Department, Implants bill updating & reconciliation.

Job description: Counsels patients on the reports given by the doctor. Co-ordination with Consultant / Centre Head on daily basis based on surgery advice and conversion. Maintain checklist as per the instruction given by the management. (Like Cataract, FFA, etc.,) Explain the tariff of the concern procedures / investigations to patients in detail. Maintain Counselor report on daily basis (Advise, Conversion and Patient wise details). Co-ordinating with TPA / Insurance Dept (Sending Pre-authorization, Getting Approval, Billing). Cross verifying all the relevant documents related to Credit billing before surgery. Maintaining Counselor Summary for all counseled patients. Doing Tele Calling and maintaining report for the same. Preparing Surgery list and handing over the same to concern doctor and centre head, one day before the surgery. Follow up with patients at all stages. Explain the tariff of the concern procedures / investigations to patients in detail. For More details contact HR - drop your cv on mariya.a@dragarwal.com or WhatsApp on 9712687709

Preferred candidate profile : Graduate with Minimum 4+ Years experience as Dispatch Executive in Hospital For inquiries, kindly reach out to - Mr. Hament, at 7011324972 or via email at hament.gautam@fortishealthcare.com

Roles and Responsibilities Improvement in overall TAT of preauthorization/ query/ discharge Minimal denials for admission, not justified/ prior information of suspected denials/ Timely information to all the stake holders for denials Audit of all TPA bills before uploading for cashless approvals Required corrections in summary , bill, OT sheets, etc. Regular maintenance of outstanding data/ follow up with TPA for enhancements/ counselling/patient for SI MIS: Maintain and generate process related data as and when required by the HOD Update patients and doctors about status of authorization Uphold basic standards of cleanliness of work place area as well as self-grooming, and demonstrate use of standard phrases and telephone etiquette during all points of customer interface .

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years About Accenture Accenture is a global professional services company with leading capabilities in digital, cloud and security.Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. We embrace the power of change to create value and shared success for our clients, people, shareholders, partners and communities.Visit us at www.accenture.com 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 unique needs of each market segment.Claim processing team collects end-end data dataDevelop and deliver business solutions that support the claims process across its lifecycle, including first notice of loss, claims investigation, payment administration or adjudication, provider reimbursement (health care), subrogation and recovery. What are we looking for Ability to establish strong client relationshipAbility to handle disputesAbility to manage multiple stakeholdersAbility to meet deadlinesAbility to perform under pressure- Roles and Responsibilities: In this role you are required to solve routine problems, largely through precedent and referral to general guidelines Your primary interaction is within your own team and your direct supervisor In this role you will be given detailed instructions on all tasks The decisions that you make impact your own work and are closely supervised You will be an individual contributor as a part of a team with a predetermined, narrow scope of work Please note that this role may require you to work in rotational shifts Qualification Any Graduation