407 Tpa Jobs - Page 15

Urgent requirement for BDS/MBBS-Chennai( Kilpauk ) 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: MBBS / BDS graduate. MBBS Candidate Should be MCI Registered BDS Candidate Should be DCI Registered 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. No: 226 , OM Sakthi Towers Kilpauk Garden road, Kilpauk, Chennai-600010.

Urgent requirement for BHMS,BDS,BAMS -Hyderabad Fresher/Expereince candidate should have atleast 1 year of 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: BHMS,BDS,BAMS 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. Only Male Doctor required for Field Investigation

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

Handling day-to-day servicing requirements of clients in a timely basis to ensure complete customer satisfaction Effectively coordinating between client / insurers for any document collection / handover Effectively coordinating with the TPA for daily service requirements Ensuring that all operational requirements / processes are met as per Company defined TAT Communicating with internal & external stakeholders as needed based on business requirements Accountable for deliverables pertaining to the areas assigned and responsible for results. Basic knowledge of insurance / insurance products (EB at the minimum) Good communication skills Good interpersonal skills Proactive attitude for handling customer needs Multi-tasking & prioritizing Attention to detail Time management Willingness to learn

Walk-In Interview registration will end by 11:00AM Job responsibilities : Processing of Health Claims. Claim Registration and Claim Adjudication. Identifying the Frauds. Adhering to SLAs and processing the claims with in the TAT as per policy terms and conditions. Supporting CRM, Provider, sales and grievance teams Office Address: Tata AIG General Insurance Company Limited, C/o Imperial Towers, Floor-5, Landmark - Next to Metro (Ameerpet) Station, Ameerpet, Hyderabad

Venue Walk-In Interview on 30-May-2025, Registration will End by 11:00AM Responsibilities: Applying medical knowledge in evaluating the medical claim files to ascertain the medical admissibility. Must understand the policy wordings including Terms & conditions to adjudicate the Admissibility/Rejection. Processing of claims as per regulatory guidelines. Adhering to the TATs in processing. Quality review of processed files. Grievance redressal, handling escalations and Identifying the fraudulent claims. Required understanding and evaluation criteria: Qualified MBBS, BAMS, BHMS having all certificates in hand Preferably from Insurance and TPA experience Clinical Acumen/knowledge in terms of hospital and medical procedures Understanding of Treatment Protocol Understanding of Diagnostic Protocol Ready to work from Office, No Work from Home, open on rotational shifts/ rotational week offs Office Address: Tata AIG GIC Limited, C/o Imperial Towers, Floor-5, Landmark - Next to Metro (Ameerpet) Station, Ameerpet, Hyderabad, Telangana (State)

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 Hindi & Malayalam. CTC – Upto 3.5 LPA.

Role: Senior Executive/Team Lead CRM Job Responsibilities Client Servicing Resolving customer queries within TAT and ensuring smooth claim process Providing information to the customers and to respond to their claim related queries Coordinating with the customers/agents for cashless claim settlement Coordinating with internal stakeholders like enrolment, Account management, claims, investigation, support team to settle claims Transactional Activities To coordinate with inward team for claim receiving and claim registration Allocating new generated claims to processing team for action Liasoning with enrolment team to register the policy for cashless and reimbursement Coordination with regional agents, customers for claim related queries, settlement queries- cashless /reimbursement Answering incoming calls of all customers / agents / internal team Keep track of all customer queries with claim numbers and follow-up to verify thatall queries are resolved. Coordinating with cashless / pre auth team to ensure cashless is granted within TAT and to provide timely claim status. Query letter / Settlement letter should be explained properly to customers / agents on queries and deductions. Interested candidates can reach out via email at varsha.kumari@mediassist.in

We are looking Billing Manager

Prudential s purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured, for our people, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and we support our people s career ambitions. We pledge to make Prudential a place where you can Connect, Grow, and Succeed. At Prudential Health India (PHI), we are on a mission to make Indians healthier, while bridging the health protection gap. This is a Zero to One team undertaking a greenfield health insurance deployment in India committed to building journeys that will truly empathize with the customer and offer a differentiated, bespoke experience. To partner us in this mission, we are looking for a talented Manager/Assistant Manager - Travel Insurance Operations Claims Management As a Manager / Assistant Manager - Travel Insurance Process, your typical week might include the following: Collaborate in designing, developing and implementing end-to-end insurance customer journeys to manage a customer-centric Travel Insurance experience. Collaborate in creating robust frameworks, business processes, and systems factoring in product coverages, features, claims-related information, and fraud engines that actively share information with products, pricing underwriting and sourcing channels Collaborate to develop and evolve detailed standard operating procedures for comprehensive and seamless functioning of onboarding, issuance, servicing claims management adjudication Collaborate with functions including but not limited to Technology, Product Actuarial, Marketing, Onboarding, Underwriting, Issuance, Claims, Compliance, Risk Management, and Finance; represent experience Function in cross-functional implementations Collaborate with Sales and Strategy for various partnerships and process setup. Review, examine, and calculate the eligible amount based on policy eligibility, examine claim forms and records to determine coverage and ensure claims of valid settlements are processed according to the company practice and procedures. Process approve non-medical claims with sharp FWA and Loss minimization approaches. Collaborate in setting up Third party Administrator assistance services for international travel claims. Coordinate with Travel Insurance assistance TPA for cashless hospitalization for international travel policy holders and Reimbursement cases at scale. Collaborate with medical team for creating guidance for processing teams for international travel medical hospitalization OPD claims Collaborate to manage vendors/ partners and Travel Insurance assistance TPAs to ensure a delightful customer experience while ensuring process rigor and SLAs Lead, manage, and develop your team, establish clear responsibilities for all team members build a strong culture of accountability and performance, manage training development of team members; enable teams with coaching structured skills to scale with business perform effectively You could be the right candidate if you Have 5-6 years of experience in Travel Insurance operations and claims management with at least 2-3 years experience in lead/ equivalent role. Expert knowledge of Travel Insurance product features, process, regulatory and compliance requirements and implementation and management of comprehensive Travel insurance operations claims management process. Aware of International Travel Insurance Medical Claims, terms systems Understand the International Travel Insurance TPA ecosystem and have experience of managing TPA model Have startup experience or setting up a team from scratch (Preferred but not mandatory) Can make informed decisions, swiftly and are adept at creative problem solving; have good judgment and analytical skills Have excellent verbal and written communication skills and strong negotiation skills. Thrive in environments that celebrate co-creation and collaboration. Have high resilience - can manage yourself, your teams and your peers when faced with ambiguity or failure This could be the gig for you if you Are passionate about consumer behavior and culture; enjoy spending time with customers to understand what they want. Have an attentive ear to listen to new ideas. Join hands with other colleagues to solve for the customer. Like to work in a culture where everyone can see what others are doing. Take help from others when stuck and encourage others when there are setbacks. Take full responsibility for your team s contribution output while thinking wing-to-wing across the organization. Have strong clinical knowledge and clinical decision-making skills Have built best-in-class processes from scratch Are passionate about leveraging digital tools to transform customer experience Location: Mumbai Title: Manager / Assistant Manager - Travel Insurance Operations Claims management Prudential is an equal opportunity employer. We provide equality of opportunity of benefits for all who apply and who perform work for our organisation irrespective of sex, race, age, ethnic origin, educational, social and cultural background, marital status, pregnancy and maternity, religion or belief, disability or part-time / fixed-term work, or any other status protected by applicable law. We encourage the same standards from our recruitment and third-party suppliers taking into account the context of grade, job and location. We also allow for reasonable adjustments to support people with individual physical or mental health requirements.

Prudential s purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured, for our people, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and we support our people s career ambitions. We pledge to make Prudential a place where you can Connect, Grow, and Succeed. At Prudential Health India (PHI), we are on a mission to make Indians healthier, while bridging the health protection gap. This is a Zero to One team undertaking a greenfield health insurance deployment in India committed to building journeys that will truly empathize with the customer and offer a differentiated, bespoke experience. To partner us in this mission, we are looking for a talented Business Solution Specialist - Claims As a Business Solution Specialist, your typical week might include the following Collaborate and co-create with cross functional workstreams for new products, processes, testing and implementation. Co-create, implement, launch, and manage a customer-centric Claims Management function/ workflow powered by Data Technology Ensure that processes technologies are designed focus on automation, scalability, and productivity Develop in-depth understanding of business processes, articulate use-cases, user-stories requirement documents/ change requests for identified features/ capabilities for applicable platforms and projects. Collaborate with functions including but not limited to Technology, Product Actuarial, Claims, Compliance, Risk Management, and Finance; Represent Claims Function in Technology Cross-functional implementations Review business process flow diagrams with Business Analyst to ensure comprehensive documentation a) Identify pain points, bottlenecks, redundancies, delays, errors, or any other areas to enhance the process and dig deeper to uncover the root causes of the identified pain points and inefficiencies b) Check if the current process complies with relevant regulations and industry standards including legal/ compliance/ data privacy. c) Review techniques such as flowcharts, BPMN diagrams, or process maps to illustrate the sequence of activities, decision points, inputs, outputs, and the roles involved in applicable business processes d) Undertake iterations in signed-off Business Process Flow, when required, in collaboration with stakeholders to refine and finalize the next version. Perform process impact analysis across various platforms, holding an end-to-end view of user journeys. Ensure that acceptance criteria are defined met; lead testing in collaboration with functional users including jointly preparation review of test plan, test cases, user acceptance testing. Continuous enhancement of Overall Rules for Allocation, Auto Adjudication, Data masters, fraud trigger creation and implementation for claims management process. Ensure 100% Tariff digitization for direct empanelment hospitals and preferred network Coordination with relevant partners (TPA/Agencies) required for robust digitally led claims management process. Collaborate with relevant stake holders, management Design and execute staggered plan for Inhouse Claims Process setup by Y3 You could be the right candidate if you Have atleast 10 years of total experience in health insurance functions and 3-5 years experience in Health Claims insurance is required. Have end-to-end knowledge of health insurance products, operations processes, and technology systems. Can understand high-level processes and can convert them into detailed business requirement documents. Have a proven track record of end-to-end implementation and business outcome delivery of significant insurance systems. an make informed decisions, swiftly and are adept at creative problem solving; have good judgment and analytical skills Have excellent verbal and written communication skills and strong negotiation skills. Thrive in environments that celebrate co-creation and collaboration. Have high resilience - can manage yourself, your teams and your peers when faced with ambiguity or failure This could be the gig for you if you Are passionate about consumer behaviour and culture; enjoy spending time with customers to understand what they want. Have an attentive ear to listen to new ideas. Join hands with other colleagues to solve for the customer. Like to work in a culture where everyone can see what others are doing. Take help from others when stuck and encourage others when there are setbacks. Take full responsibility for your team s contribution output while thinking wing-to-wing across the organization. Have strong clinical knowledge and clinical decision-making skills Have built best-in-class processes from scratch Are passionate about leveraging digital tools to transform customer experience Location: Mumbai Title: Business Solution Specialist - Claims Reporting to: Head Underwriting and Claims Management Prudential is an equal opportunity employer. We provide equality of opportunity of benefits for all who apply and who perform work for our organisation irrespective of sex, race, age, ethnic origin, educational, social and cultural background, marital status, pregnancy and maternity, religion or belief, disability or part-time / fixed-term work, or any other status protected by applicable law. We encourage the same standards from our recruitment and third-party suppliers taking into account the context of grade, job and location. We also allow for reasonable adjustments to support people with individual physical or mental health requirements.

Prudential s purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured, for our people, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and we support our people s career ambitions. We pledge to make Prudential a place where you can Connect, Grow, and Succeed. Prudential (UK) in partnership with HCL group plans to set-up a standalone Indian health insurance company to address the growing healthcare needs of the Indian consumer. This joint venture will combine Prudentials global expertise in insurance and financial services with HCL Group s experience in technology and healthcare solutions. Prudential, with its longstanding presence in India, already operates two leading businesses in life insurance and asset management with the ICICI Group. Prudential was also the proud sponsor of the 1983 Cricket World Cup, India s first World Cup Victory! Prudential Health India is a Zero to One team undertaking a no-legacy, greenfield health insurance deployment in India, building journeys that truly empathize with the customer and offer a differentiated experience. To partner with us in this mission, we are looking for a talented Assist Manager- Provider Network Management to join our Experience team in Mumbai. Assistant Manager - Provider Network Management As a Assistant Manager of Provider Network, your typical week might include the following Collaborate to Design, implement, launch, and manage a comprehensive provider network to facilitate experience workstreams. Collaborate with relevant stakeholders for initiating RFP process to facilitate partner onboarding. Coordinate with internal and external stakeholders for onboarding and maintain/manage relationships with the partner ecosystem. Test and share various functionalities with Network partners (including TPA) systems to ensure smooth operations. Gather and provide exact requirements needed for streamlining the process flow ensuring seamless customer experience. Develop and evolve detailed standard operating procedures to ensure comprehensive and seamless functioning of the network. Enable efficient claims management processes through well-defined SOPs. Design and ensure implementation of agreed SLA, monitor and publish dashboards for the performance matrix on periodic basis. Collaborate with internal and external stakeholders to test e2e and implement integration with the partner ecosystem Collaborate with various functions including Onboarding - Underwriting, Claims, Technology, Product, Health Management, Compliance and Finance. Engage with the provider network through effective communication and data-led analytics. Recognize and continuously train providers based on utilization patterns and performance metrics. Continuously monitor performance and utilization patterns to generate feedback loops and data analytics. You could be the right candidate if you Have a Degree or a Management degree (healthcare management is preferred) Have 4-6 yrs exp in provider network department of OPD/Insurance company Strong skills with respect to data analytics and stakeholder management Have an excellent understanding of procurement, negotiation, partner onboarding and outsourcing compliance processes Able to make quick decisions and have good judgment and analytical skills Have an excellent verbal and written communication skills and strong negotiation skills. Always open to embracing change and be able to manage it Have a fair understanding of startup challenges and passion to work in a Zero-to-One environment. This could be the gig for you if you Are passionate about consumer behavior and culture; enjoy spending time with customers/providers to understand what they really want. Have an attentive ear listen to new ideas. Thrive in environments that celebrate co-creation and collaboration Are passionate about leveraging digital tools to transform customer experience Like to work in a culture where everyone can see what others are doing Take help from others when stuck and encourage others when there are setbacks Take full responsibility for your team s contribution while thinking wing to wing across the organization; to solve for the customer What can make you extra special It s great if you have already read books like Never Split the difference: Negotiating as if your life depended on it. You have real stories to tell about how your team and you challenged convention and took the path less travelled. We are keen to listen to your story; doesn t matter if you tell these stories with a sigh or with excitement. We respect both versions. Truly. Location: Mumbai Reporting to: Lead Network Management Prudential is an equal opportunity employer. We provide equality of opportunity of benefits for all who apply and who perform work for our organisation irrespective of sex, race, age, ethnic origin, educational, social and cultural background, marital status, pregnancy and maternity, religion or belief, disability or part-time / fixed-term work, or any other status protected by applicable law. We encourage the same standards from our recruitment and third-party suppliers taking into account the context of grade, job and location. We also allow for reasonable adjustments to support people with individual physical or mental health requirements.

About the Company Loop Health is India s first Health Assurance company, founded in 2018, that combines group health insurance with unlimited primary care, preventive healthcare, and wellness services. Serving over 750,000 members across 1,000+ companies, Loop leverages technology and an in-house medical team to deliver holistic, people-centric healthcare. Job Summary The Endorsement and Enrolment Executive will be responsible for timely and accurate processing of enrolments, endorsements, and related policy servicing tasks for health insurance clients. The role requires coordination with insurers, internal teams, and clients to ensure policy records are up-to-date and compliant with regulatory norms. Key Responsibilities Enrolment: Process member enrolments (additions, deletions, changes) in GMC/GPA/GTL policies as per client and insurer requirements. Review and validate enrolment data received from clients or internal stakeholders. Upload and maintain accurate records in internal systems and insurer portals. Maintain the active roster and CD statements for the customers Endorsement: Handle policy endorsements such as member updates, change in coverage, corrections in personal details, etc. Coordinate with insurers for endorsement issuance and follow up for endorsement letters/certificates. Ensure timely communication of endorsements to clients with updated documentation. Documentation & Reporting: Maintain and update accurate records and trackers for all enrolment and endorsement activities. Prepare periodic MIS reports and dashboards for internal use and client reporting. Stakeholder Management: Coordinate with clients, TPA (Third Party Administrators), insurers, and internal sales/service teams to resolve queries or discrepancies. Provide support during policy renewal, including reconciliation of member lists and premium calculations. Key Requirements Education: Graduate in any discipline (preferably in Commerce, Business Administration, or related fields). Experience: 1 - 5 years of relevant experience in health insurance enrolments/endorsements or policy servicing at a broker Skills Strong attention to detail and accuracy Proficiency in MS Excel and data handling Good communication and coordination skills Knowledge of health insurance processes and terminology Ability to work under deadlines and handle multiple tasks Preferred Qualifications Prior experience using insurer portals or broker management software Understanding of group health insurance schemes and endorsements Basic understanding of insurance compliance and documentation norms What We Offer Opportunity to work in a growing and dynamic industry Learning and development support Collaborative and supportive team culture Competitive salary and benefits

About the Company Loop Health is India s first Health Assurance company, founded in 2018, that combines group health insurance with unlimited primary care, preventive healthcare, and wellness services. Serving over 750,000 members across 1,000+ companies, Loop leverages technology and an in-house medical team to deliver holistic, people-centric healthcare. Job Summary The Endorsement and Enrolment Executive will be responsible for timely and accurate processing of enrolments, endorsements, and related policy servicing tasks for health insurance clients. The role requires coordination with insurers, internal teams, and clients to ensure policy records are up-to-date and compliant with regulatory norms. Key Responsibilities Enrolment: Process member enrolments (additions, deletions, changes) in GMC/GPA/GTL policies as per client and insurer requirements. Review and validate enrolment data received from clients or internal stakeholders. Upload and maintain accurate records in internal systems and insurer portals. Maintain the active roster and CD statements for the customers Endorsement: Handle policy endorsements such as member updates, change in coverage, corrections in personal details, etc. Coordinate with insurers for endorsement issuance and follow up for endorsement letters/certificates. Ensure timely communication of endorsements to clients with updated documentation. Documentation & Reporting: Maintain and update accurate records and trackers for all enrolment and endorsement activities. Prepare periodic MIS reports and dashboards for internal use and client reporting. Stakeholder Management: Coordinate with clients, TPA (Third Party Administrators), insurers, and internal sales/service teams to resolve queries or discrepancies. Provide support during policy renewal, including reconciliation of member lists and premium calculations. Key Requirements Education: Graduate in any discipline (preferably in Commerce, Business Administration, or related fields). Experience: 1 - 5 years of relevant experience in health insurance enrolments/endorsements or policy servicing at a broker Skills Strong attention to detail and accuracy Proficiency in MS Excel and data handling Good communication and coordination skills Knowledge of health insurance processes and terminology Ability to work under deadlines and handle multiple tasks Preferred Qualifications Prior experience using insurer portals or broker management software Understanding of group health insurance schemes and endorsements Basic understanding of insurance compliance and documentation norms What We Offer Opportunity to work in a growing and dynamic industry Learning and development support Collaborative and supportive team culture Competitive salary and benefits

About the Company Loop Health is India s first Health Assurance company, founded in 2018, that combines group health insurance with unlimited primary care, preventive healthcare, and wellness services. Serving over 750,000 members across 1,000+ companies, Loop leverages technology and an in-house medical team to deliver holistic, people-centric healthcare. Job Summary The Endorsement and Enrolment Executive will be responsible for timely and accurate processing of enrolments, endorsements, and related policy servicing tasks for health insurance clients. The role requires coordination with insurers, internal teams, and clients to ensure policy records are up-to-date and compliant with regulatory norms. Key Responsibilities Enrolment: Process member enrolments (additions, deletions, changes) in GMC/GPA/GTL policies as per client and insurer requirements. Review and validate enrolment data received from clients or internal stakeholders. Upload and maintain accurate records in internal systems and insurer portals. Maintain the active roster and CD statements for the customers Endorsement: Handle policy endorsements such as member updates, change in coverage, corrections in personal details, etc. Coordinate with insurers for endorsement issuance and follow up for endorsement letters/certificates. Ensure timely communication of endorsements to clients with updated documentation. Documentation & Reporting: Maintain and update accurate records and trackers for all enrolment and endorsement activities. Prepare periodic MIS reports and dashboards for internal use and client reporting. Stakeholder Management: Coordinate with clients, TPA (Third Party Administrators), insurers, and internal sales/service teams to resolve queries or discrepancies. Provide support during policy renewal, including reconciliation of member lists and premium calculations. Key Requirements Education: Graduate in any discipline (preferably in Commerce, Business Administration, or related fields). Experience: 1 - 5 years of relevant experience in health insurance enrolments/endorsements or policy servicing at a broker Skills Strong attention to detail and accuracy Proficiency in MS Excel and data handling Good communication and coordination skills Knowledge of health insurance processes and terminology Ability to work under deadlines and handle multiple tasks Preferred Qualifications Prior experience using insurer portals or broker management software Understanding of group health insurance schemes and endorsements Basic understanding of insurance compliance and documentation norms What We Offer Opportunity to work in a growing and dynamic industry Learning and development support Collaborative and supportive team culture Competitive salary and benefits

To manage insurance portfolio of all types of insurance policies & ensure adequate risk coverage at optimum costs and claims management. To procure various insurance policies with adequate coverage at optimum cost, ensure timely renewal of the insurance policies, and to ensure internal customer expectations for deliverables in terms of time, cost and service quality are met in line with business objectives. Proficient in managing insurance claims especially PDBI claims Good technical knowledge about insurance products, coverage features and claims process Coordination with cross functional teams within the Company, Subsidiaries, insurers, surveyors etc. Implement best practices as per company s guidelines. Ensure compliance of various processes and demonstrate through conduct of internal as well as external audit. Obtaining and compiling relevant information from various departments on insurance requirements. Understand various risks, suggest appropriate clauses / wordings in the insurance policies to mitigate the risks and get the desired insurance coverage. Review the performance of Insurers and TPA s and ensure prompt settlement of insurance claims within a stipulated time frame. Promptly address queries & concerns on Insurance matters. Conduct Knowledge sharing sessions to colleagues from other departments on the coverage under important insurance policies & the claims process. To manage insurance portfolio of all types of insurance policies & ensure adequate risk coverage at optimum costs and claims management. To procure various insurance policies with adequate coverage at optimum cost, ensure timely renewal of the insurance policies, and to ensure internal customer expectations for deliverables in terms of time, cost and service quality are met in line with business objectives. Proficient in managing insurance claims especially PDBI claims Good technical knowledge about insurance products, coverage features and claims process Coordination with cross functional teams within the Company, Subsidiaries, insurers, surveyors etc. Implement best practices as per company s guidelines. Ensure compliance of various processes and demonstrate through conduct of internal as well as external audit. Obtaining and compiling relevant information from various departments on insurance requirements. Understand various risks, suggest appropriate clauses / wordings in the insurance policies to mitigate the risks and get the desired insurance coverage. Review the performance of Insurers and TPA s and ensure prompt settlement of insurance claims within a stipulated time frame. Promptly address queries & concerns on Insurance matters. Conduct Knowledge sharing sessions to colleagues from other departments on the coverage under important insurance policies & the claims process. Graduate with Associate or Fellow from Insurance Institute of India, or MBA/PGDBA with insurance specialization, or BE with additional qualification specialized in insurance

About the Company Loop Health is India s first Health Assurance company, founded in 2018, that combines group health insurance with unlimited primary care, preventive healthcare, and wellness services. Serving over 750,000 members across 1,000+ companies, Loop leverages technology and an in-house medical team to deliver holistic, people-centric healthcare. Job Summary The Endorsement and Enrolment Executive will be responsible for timely and accurate processing of enrolments, endorsements, and related policy servicing tasks for health insurance clients. The role requires coordination with insurers, internal teams, and clients to ensure policy records are up-to-date and compliant with regulatory norms. Key Responsibilities Enrolment: Process member enrolments (additions, deletions, changes) in GMC/GPA/GTL policies as per client and insurer requirements. Review and validate enrolment data received from clients or internal stakeholders. Upload and maintain accurate records in internal systems and insurer portals. Maintain the active roster and CD statements for the customers Endorsement: Handle policy endorsements such as member updates, change in coverage, corrections in personal details, etc. Coordinate with insurers for endorsement issuance and follow up for endorsement letters/certificates. Ensure timely communication of endorsements to clients with updated documentation. Documentation & Reporting: Maintain and update accurate records and trackers for all enrolment and endorsement activities. Prepare periodic MIS reports and dashboards for internal use and client reporting. Stakeholder Management: Coordinate with clients, TPA (Third Party Administrators), insurers, and internal sales/service teams to resolve queries or discrepancies. Provide support during policy renewal, including reconciliation of member lists and premium calculations. Key Requirements Education: Graduate in any discipline (preferably in Commerce, Business Administration, or related fields). Experience: 1 - 5 years of relevant experience in health insurance enrolments/endorsements or policy servicing at a broker Skills Strong attention to detail and accuracy Proficiency in MS Excel and data handling Good communication and coordination skills Knowledge of health insurance processes and terminology Ability to work under deadlines and handle multiple tasks Preferred Qualifications Prior experience using insurer portals or broker management software Understanding of group health insurance schemes and endorsements Basic understanding of insurance compliance and documentation norms What We Offer Opportunity to work in a growing and dynamic industry Learning and development support Collaborative and supportive team culture Competitive salary and benefits

About the Company Loop Health is India s first Health Assurance company, founded in 2018, that combines group health insurance with unlimited primary care, preventive healthcare, and wellness services. Serving over 750,000 members across 1,000+ companies, Loop leverages technology and an in-house medical team to deliver holistic, people-centric healthcare. Job Summary The Endorsement and Enrolment Executive will be responsible for timely and accurate processing of enrolments, endorsements, and related policy servicing tasks for health insurance clients. The role requires coordination with insurers, internal teams, and clients to ensure policy records are up-to-date and compliant with regulatory norms. Key Responsibilities Enrolment: Process member enrolments (additions, deletions, changes) in GMC/GPA/GTL policies as per client and insurer requirements. Review and validate enrolment data received from clients or internal stakeholders. Upload and maintain accurate records in internal systems and insurer portals. Maintain the active roster and CD statements for the customers Endorsement: Handle policy endorsements such as member updates, change in coverage, corrections in personal details, etc. Coordinate with insurers for endorsement issuance and follow up for endorsement letters/certificates. Ensure timely communication of endorsements to clients with updated documentation. Documentation & Reporting: Maintain and update accurate records and trackers for all enrolment and endorsement activities. Prepare periodic MIS reports and dashboards for internal use and client reporting. Stakeholder Management: Coordinate with clients, TPA (Third Party Administrators), insurers, and internal sales/service teams to resolve queries or discrepancies. Provide support during policy renewal, including reconciliation of member lists and premium calculations. Key Requirements Education: Graduate in any discipline (preferably in Commerce, Business Administration, or related fields). Experience: 1 - 5 years of relevant experience in health insurance enrolments/endorsements or policy servicing at a broker Skills Strong attention to detail and accuracy Proficiency in MS Excel and data handling Good communication and coordination skills Knowledge of health insurance processes and terminology Ability to work under deadlines and handle multiple tasks Preferred Qualifications Prior experience using insurer portals or broker management software Understanding of group health insurance schemes and endorsements Basic understanding of insurance compliance and documentation norms What We Offer Opportunity to work in a growing and dynamic industry Learning and development support Collaborative and supportive team culture Competitive salary and benefits

About the Company Loop Health is India s first Health Assurance company, founded in 2018, that combines group health insurance with unlimited primary care, preventive healthcare, and wellness services. Serving over 750,000 members across 1,000+ companies, Loop leverages technology and an in-house medical team to deliver holistic, people-centric healthcare. Job Summary The Endorsement and Enrolment Executive will be responsible for timely and accurate processing of enrolments, endorsements, and related policy servicing tasks for health insurance clients. The role requires coordination with insurers, internal teams, and clients to ensure policy records are up-to-date and compliant with regulatory norms. Key Responsibilities Enrolment: Process member enrolments (additions, deletions, changes) in GMC/GPA/GTL policies as per client and insurer requirements. Review and validate enrolment data received from clients or internal stakeholders. Upload and maintain accurate records in internal systems and insurer portals. Maintain the active roster and CD statements for the customers Endorsement: Handle policy endorsements such as member updates, change in coverage, corrections in personal details, etc. Coordinate with insurers for endorsement issuance and follow up for endorsement letters/certificates. Ensure timely communication of endorsements to clients with updated documentation. Documentation & Reporting: Maintain and update accurate records and trackers for all enrolment and endorsement activities. Prepare periodic MIS reports and dashboards for internal use and client reporting. Stakeholder Management: Coordinate with clients, TPA (Third Party Administrators), insurers, and internal sales/service teams to resolve queries or discrepancies. Provide support during policy renewal, including reconciliation of member lists and premium calculations. Key Requirements Education: Graduate in any discipline (preferably in Commerce, Business Administration, or related fields). Experience: 1 - 5 years of relevant experience in health insurance enrolments/endorsements or policy servicing at a broker Skills Strong attention to detail and accuracy Proficiency in MS Excel and data handling Good communication and coordination skills Knowledge of health insurance processes and terminology Ability to work under deadlines and handle multiple tasks Preferred Qualifications Prior experience using insurer portals or broker management software Understanding of group health insurance schemes and endorsements Basic understanding of insurance compliance and documentation norms What We Offer Opportunity to work in a growing and dynamic industry Learning and development support Collaborative and supportive team culture Competitive salary and benefits

About the Company Loop Health is India s first Health Assurance company, founded in 2018, that combines group health insurance with unlimited primary care, preventive healthcare, and wellness services. Serving over 750,000 members across 1,000+ companies, Loop leverages technology and an in-house medical team to deliver holistic, people-centric healthcare. Job Summary The Endorsement and Enrolment Executive will be responsible for timely and accurate processing of enrolments, endorsements, and related policy servicing tasks for health insurance clients. The role requires coordination with insurers, internal teams, and clients to ensure policy records are up-to-date and compliant with regulatory norms. Key Responsibilities Enrolment: Process member enrolments (additions, deletions, changes) in GMC/GPA/GTL policies as per client and insurer requirements. Review and validate enrolment data received from clients or internal stakeholders. Upload and maintain accurate records in internal systems and insurer portals. Maintain the active roster and CD statements for the customers Endorsement: Handle policy endorsements such as member updates, change in coverage, corrections in personal details, etc. Coordinate with insurers for endorsement issuance and follow up for endorsement letters/certificates. Ensure timely communication of endorsements to clients with updated documentation. Documentation & Reporting: Maintain and update accurate records and trackers for all enrolment and endorsement activities. Prepare periodic MIS reports and dashboards for internal use and client reporting. Stakeholder Management: Coordinate with clients, TPA (Third Party Administrators), insurers, and internal sales/service teams to resolve queries or discrepancies. Provide support during policy renewal, including reconciliation of member lists and premium calculations. Key Requirements Education: Graduate in any discipline (preferably in Commerce, Business Administration, or related fields). Experience: 1 - 5 years of relevant experience in health insurance enrolments/endorsements or policy servicing at a broker Skills Strong attention to detail and accuracy Proficiency in MS Excel and data handling Good communication and coordination skills Knowledge of health insurance processes and terminology Ability to work under deadlines and handle multiple tasks Preferred Qualifications Prior experience using insurer portals or broker management software Understanding of group health insurance schemes and endorsements Basic understanding of insurance compliance and documentation norms What We Offer Opportunity to work in a growing and dynamic industry Learning and development support Collaborative and supportive team culture Competitive salary and benefits

About the Company Loop Health is India s first Health Assurance company, founded in 2018, that combines group health insurance with unlimited primary care, preventive healthcare, and wellness services. Serving over 750,000 members across 1,000+ companies, Loop leverages technology and an in-house medical team to deliver holistic, people-centric healthcare. Job Summary The Endorsement and Enrolment Executive will be responsible for timely and accurate processing of enrolments, endorsements, and related policy servicing tasks for health insurance clients. The role requires coordination with insurers, internal teams, and clients to ensure policy records are up-to-date and compliant with regulatory norms. Key Responsibilities Enrolment: Process member enrolments (additions, deletions, changes) in GMC/GPA/GTL policies as per client and insurer requirements. Review and validate enrolment data received from clients or internal stakeholders. Upload and maintain accurate records in internal systems and insurer portals. Maintain the active roster and CD statements for the customers Endorsement: Handle policy endorsements such as member updates, change in coverage, corrections in personal details, etc. Coordinate with insurers for endorsement issuance and follow up for endorsement letters/certificates. Ensure timely communication of endorsements to clients with updated documentation. Documentation & Reporting: Maintain and update accurate records and trackers for all enrolment and endorsement activities. Prepare periodic MIS reports and dashboards for internal use and client reporting. Stakeholder Management: Coordinate with clients, TPA (Third Party Administrators), insurers, and internal sales/service teams to resolve queries or discrepancies. Provide support during policy renewal, including reconciliation of member lists and premium calculations. Key Requirements Education: Graduate in any discipline (preferably in Commerce, Business Administration, or related fields). Experience: 1 - 5 years of relevant experience in health insurance enrolments/endorsements or policy servicing at a broker Skills Strong attention to detail and accuracy Proficiency in MS Excel and data handling Good communication and coordination skills Knowledge of health insurance processes and terminology Ability to work under deadlines and handle multiple tasks Preferred Qualifications Prior experience using insurer portals or broker management software Understanding of group health insurance schemes and endorsements Basic understanding of insurance compliance and documentation norms What We Offer Opportunity to work in a growing and dynamic industry Learning and development support Collaborative and supportive team culture Competitive salary and benefits

Adhere billing process guidelines Review claims, Verify coverage Assist with inquiries Prepare claim forms & documents & timely claim processing Record Keeping & upload files on the portal Assist pre-authorizations Resolve billing issues/escalation Required Candidate profile Any graduation or BBA/BHA min. 1 year Billing Experience is preferred Please Email your resume at hr@jimsh.org

About the role : We are looking for a Dedicated Claims Specialist with a strong background in medical and health insurance, particularly in group medical corporate policies . The ideal candidate should have 2-4 years of experience in claims processing or CRM roles. Key Responsibilities: Handle end-to-end processing of reimbursement claims for group medical corporate policies. Provide excellent customer service by addressing claims-related queries via Freshchat, Ozontel, and Freshdesk. Analyze medical documentation, policy terms, and conditions to ensure accurate claim assessment and processing. Liaise with internal teams, insurers, TPA s, and hospitals to ensure seamless claims settlement and timely resolutions. Manage claims escalations, ensuring prompt resolution while maintaining a customer-centric approach. Required Skills: In-depth knowledge of corporate group medical insurance policies and claims processing. Ability to understand medical terminology, treatment procedures, and health-related documentation. Proficient in Ozontel, Freshdesk, or similar customer support and claims management tools. Strong communication and problem-solving skills to manage customer relationships and resolve issues effectively. Attention to detail to ensure accuracy in claim processing and documentation review. Ability to collaborate effectively with cross-functional teams, including insurance partners and hospital networks. Qualifications: Bachelor s degree in healthcare, insurance, or related field preferred. 2-4 years of experience in claims processing, CRM role preferably within group medical corporate policies.

About the role : We are looking for a Dedicated Claims Specialist with a strong background in medical and health insurance, particularly in group medical corporate policies . The ideal candidate should have 2-4 years of experience in claims processing or CRM roles. Key Responsibilities: Handle end-to-end processing of reimbursement claims for group medical corporate policies. Provide excellent customer service by addressing claims-related queries via Freshchat, Ozontel, and Freshdesk. Analyze medical documentation, policy terms, and conditions to ensure accurate claim assessment and processing. Liaise with internal teams, insurers, TPA s, and hospitals to ensure seamless claims settlement and timely resolutions. Manage claims escalations, ensuring prompt resolution while maintaining a customer-centric approach. Required Skills: In-depth knowledge of corporate group medical insurance policies and claims processing. Ability to understand medical terminology, treatment procedures, and health-related documentation. Proficient in Ozontel, Freshdesk, or similar customer support and claims management tools. Strong communication and problem-solving skills to manage customer relationships and resolve issues effectively. Attention to detail to ensure accuracy in claim processing and documentation review. Ability to collaborate effectively with cross-functional teams, including insurance partners and hospital networks. Qualifications: Bachelor s degree in healthcare, insurance, or related field preferred. 2-4 years of experience in claims processing, CRM role preferably within group medical corporate policies.

About the role : We are looking for a Dedicated Claims Specialist with a strong background in medical and health insurance, particularly in group medical corporate policies . The ideal candidate should have 2-4 years of experience in claims processing or CRM roles. Key Responsibilities: Handle end-to-end processing of reimbursement claims for group medical corporate policies. Provide excellent customer service by addressing claims-related queries via Freshchat, Ozontel, and Freshdesk. Analyze medical documentation, policy terms, and conditions to ensure accurate claim assessment and processing. Liaise with internal teams, insurers, TPA s, and hospitals to ensure seamless claims settlement and timely resolutions. Manage claims escalations, ensuring prompt resolution while maintaining a customer-centric approach. Required Skills: In-depth knowledge of corporate group medical insurance policies and claims processing. Ability to understand medical terminology, treatment procedures, and health-related documentation. Proficient in Ozontel, Freshdesk, or similar customer support and claims management tools. Strong communication and problem-solving skills to manage customer relationships and resolve issues effectively. Attention to detail to ensure accuracy in claim processing and documentation review. Ability to collaborate effectively with cross-functional teams, including insurance partners and hospital networks. Qualifications: Bachelor s degree in healthcare, insurance, or related field preferred. 2-4 years of experience in claims processing, CRM role preferably within group medical corporate policies.