1024 Tpa Jobs - Page 13

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: MBBS 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.

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/ MBBS graduate. Good Medical & basic computer knowledge Should have completed internship (Provisional /Permanent Registration number is mandatory) Freshers can also apply. Work from office . Interview Timings-11am To 5pm(Monday To Saturday)

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: MBBS 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.

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.

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.

Job Description (IFD) Communicating with clients and understanding the investigation requirements. Meeting with clients to discuss the nature of the investigation. Conducting field investigations on appointed cases, insurance claims, or client requests. Conducting in-depth research on various appointed cases. Decide the extent and validity of a claim, and in so doing, prevent fraudulent claims by determining the claim's authenticity. Gathering and analyzing evidence reports. Conducting photographic and audio surveillance to gather evidence Reviewing and solving cases by authenticating insurance claims. Coordinating with agents to understand insurance claims matters. Answering to specific tri...

Job Description (IFD) Communicating with clients and understanding the investigation requirements. Meeting with clients to discuss the nature of the investigation. Conducting field investigations on appointed cases, insurance claims, or client requests. Conducting in-depth research on various appointed cases. Decide the extent and validity of a claim, and in so doing, prevent fraudulent claims by determining the claim's authenticity. Gathering and analyzing evidence reports. Conducting photographic and audio surveillance to gather evidence Reviewing and solving cases by authenticating insurance claims. Coordinating with agents to understand insurance claims matters. Answering to specific tri...

Role Overview: You will be joining Samved e-Care Pvt Ltd as a TPA Assistant in Ahmedabad, playing a crucial role in supporting cashless claim processing for affiliated hospitals. Your contribution will be vital in optimizing cashless claim procedures and ensuring timely submission and approval of claims. Key Responsibilities: - Support cashless claim processing and documentation. - Collaborate with hospitals, patients, and insurance TPAs for timely claim submission and approval. - Perform data entry, verification, and maintain accurate patient records. - Follow up on pending approvals and address discrepancies. - Assist in client communication and backend claim management. - Ensure adherence...

Santiniketan Medical College & Hospital seeks an experienced TPA Executive to manage cashless health insurance claims. Key duties include pre-authorization, patient coordination, and claims processing. Apply now to join our dedicated team.

Vacancy Announcement GK Superspeciality Hospital is a 100-bedded multispeciality healthcare facility located in Narnaul, Haryana. We are dedicated to providing top-tier medical care, offering a wide range of specialized services to cater to the diverse needs of our community. Our hospital is equipped with state-of-the-art medical technology and is supported by a team of highly experienced doctors, specialists, and paramedics who work together to ensure the best possible care for our patients. Currently, we are expanding our team and are looking for dynamic and dedicated candidates for the position of Front Desk and TPA Executives to strengthen our administrative and patient service team. Pos...

Vacancy Announcement GK Superspeciality Hospital is a 100-bedded multispeciality healthcare facility located in Narnaul, Haryana. We are dedicated to providing top-tier medical care, offering a wide range of specialized services to cater to the diverse needs of our community. Our hospital is equipped with state-of-the-art medical technology and is supported by a team of highly experienced doctors, specialists, and paramedics who work together to ensure the best possible care for our patients. Currently, we are expanding our team and are looking for passionate, skilled, and dedicated healthcare professionals. We invite applications from qualified and dedicated healthcare professionals for the...

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...

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 and Hindi CTC – Upto 3.5 LPA

Role & responsibilities Coordinate with healthcare providers, insurance companies, and patients to resolve claims-related issues. Process patient claims from admission to discharge, ensuring accurate billing and payment processing. Manage TPA (Third Party Administrator) operations, including CRM (Customer Relationship Management) systems. Handle customer queries related to medical insurance policies, claims status updates, and reimbursement procedures. Maintain accurate records of all interactions with customers and stakeholders. Job Requirements : Strong understanding of health insurance products, medical terminology, and regulations governing TPAs. Proficiency in using CRM software for man...

Role & responsibilities Coordinate with healthcare providers, insurance companies, and patients to resolve claims-related issues. Process patient claims from admission to discharge, ensuring accurate billing and payment processing. Manage TPA (Third Party Administrator) operations, including CRM (Customer Relationship Management) systems. Handle customer queries related to medical insurance policies, claims status updates, and reimbursement procedures. Maintain accurate records of all interactions with customers and stakeholders. Job Requirements : Strong understanding of health insurance products, medical terminology, and regulations governing TPAs. Proficiency in using CRM software for man...

We are The European Union (EU) is an economic and political partnership between 27 European countries It plays an important role in international affairs through diplomacy, trade, development aid and working with global organizations Abroad, the EU is represented through more than 140 diplomatic representations, known also as EU Delegations, which have a similar function to those of an embassy, The EU Delegation to Vietnam works in close coordination with the Embassies and Consulates of the 27 EU Member States We are a full-fledged diplomatic mission and represent the European Union in dealings with the Vietnamese government in areas that are part of the EUs remit, We offer The post of Offic...

Role: Executive/Sr Executive - Account Management (CRM) 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. Non voice coordinator 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. Interested candidates can share their resume for sarika.pallap@gmail.com or whatsapp on...

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 ...

About Rentokil PCI 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 ware...

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...

Role & responsibilities Processing of pre-authorization/cashless claim. Maintain processing TAT for pre-auth/cashless claim Must be able to analyze large amount of data, Identify patterns and draw conclusions from that data Must have previous experience of conducting audit, sampling and preparing reports Reviewing insurance policy documents to determine coverage limits, exclusions that may affect the claim. Reviewing medical bills, medical records, and other documentation to determine medical necessity and appropriate treatment. Preferred candidate profile Any Medical degree (Mandatory) Good communication skills Ability to multi-task Good interpersonal skills Should know internal systems Goo...

Roles and Responsibilities Manage insurance billing processes for patients, ensuring accurate and timely submission of claims. Coordinate with TPA (Third Party Administrator) teams to resolve any discrepancies or issues related to medical billing. Prepare and review discharge summaries, including patient care information, treatment details, and insurance coverage. Handle mediclaim cases by processing claims, resolving queries, and maintaining records. Desired Candidate Profile 2-5 years of experience in Insurance Billing or Medical Billing. Strong knowledge of IP (Insurance Policy), TPA, Patient Care, Claims Processing, Insurance Billing, Mediclaim. Excellent communication skills for effecti...

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...

Communicate with customers for their insurance claims and explain the process Follow up for and verify insurance claim documents Assist customers with claim filing process and keep the claim status updated Follow up with TPA / insurers for smooth and timely claim settlement Track claims on the insurers portal Claims end to end settlement/relationship with insurers/ good communication/ good knowledge of claims in Health insurance

As a Medical Officer at Medi Assist Insurance TPA Pvt Ltd, your role will involve processing claims such as preauthorization and reimbursement claims. Your key responsibilities will include: - Validating and processing claims within the specified turnaround time (TAT). - Utilizing your good communication skills and medical knowledge to effectively process claims. - Having knowledge of Third Party Administrator (TPA) processes will be considered an advantage. - Ensuring there are no financial implications for the organization during claim settlements. To excel in this role, you are required to have the following qualifications and skills: - Clinical knowledge along with TPA and medical knowle...