299 Tpa Jobs - Page 2

Role & responsibilities Excellent MS Office knowledge, Good Typing speed (35 words per minute). Candidate should be open to work in 24X7X365 environment. Preferred candidate profile Reimbursement billing & Registration, data handling, Error resolve, working on mail and condonation with RM Team. Knowledge of Indian Health Care and prior experience in Health Insurance Claim Processing, Good Clinical Acumen Preferred Industry Health Insurance/TPA/Hospital / Clinical Practice/heath care/ wellness etc.. Preferred Location Ahmedabad, Bangaluru Chandigarh, Chennai Dehradun, Hyderabad Indore, Kochin Kolkata, Mumbai Nagpur, Noida Surat, Vadodara

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 the 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. o To partner with us in this mission, we are looking for a talented Specialist - Regulatory Escalations to join our Customer Service team in Mumbai. Your typical week might include the following: Ensuring timely, fair, and effective handling of grievances received via IGMS and complaints which will be reported to IGMS / Bima Bharosa Portal. Exposure on handling complaints received via PHI escalation touchpoints, social media, regulatory portals (NCH, etc), as per the defined turn-around-time. Ensure timely handing of Ombudsman and legal cases as well. Act as a voice of customer for PHI by raising timely red flags which shall be instrumental in fixing gaps and enhancing service experience. Work collaboratively with internal and external teams like Distribution, Branch, Claims, Underwriting, Legal, Medical services TPA etc. to expedite complaint resolution. Be aware of all compliance related requirements. Participate in closure of process enhancement recommendations, risk identifications along with a future fix. Participate and drive service recovery initiatives to ensure enhanced customer experience and re-instil customer trust in PHI. You could be the right candidate if you: Have 6-7 years of experience with 4-5 years of complaints handling experience health insurance, general insurance or financial services industry. Have strong knowledge of IRDA guidelines, compliance protocols and insurance related grievance mechanisms. Have the ability to manage diverse teams and stakeholders, regulatory bodies and ensure cross-functional collaboration. Possess excellent communication and negotiation skills. Have a Bachelor s degree from a recognized University Are a highly driven individual who goes that extra mile to deliver an outstanding product to the business team and end users/customers. Have demonstrated the ability to work in a fast paced and hyper-growth environment using agile methodologies where Customer and Distributor expectations can be changing This could be the gig for you if you Are passionate about bringing truly consumer centric ideas and products into reality and have an attentive ear listen to new ideas. Thrive in environments that celebrate co-creation and collaboration. Are passionate about leveraging new age digital tools and technologies 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 output while thinking wing to wing across the organization; to solve for the customer. What can make you extra special if you Have walked extra mile in solving business problems by adopting offbeat path Proven track record of exceeding Service level expectations from stakeholders. Demonstrate visible leadership supporting colleagues in a diverse, inclusive, and collaborative team environment. Be a team player who is goal orientated, committed, and an advocate and early adopter of change. A proven track record working in complex business environments executing and delivering initiatives across multiple domains, stakeholder groups and technology solutions. 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. If you think this is the one for you, drop in a line with your story at careers@prudentialhealth.in . We are eager to catch-up!

Role & responsibilities Claims adjudication, claims approval, TAT, accuracy, productivity, claims cost, fraud and leakage control, client/provider feedback, team training and retention Preferred candidate profile Processing claims, quality check and adherence to TAT, fraud triggers, fraud risk assessment, computer skills. Candidate should be open to work in 24X7X365 environment Microsoft office proficiency Knowledge of Indian Health Care and prior experience in Health Insurance Claim Processing, Good Clinical Acumen Minimum 1-3 Years Preferred Industry Health Insurance/TPA/Hospital / Clinical Practice/heath care/ wellness etc.. Minimum- Medical Graduate (BDS/BAMS/ BHMS/BPT/ BUMS) Preferred Location Indore Surat Mumbai Nagpur Chennai Bangalore Kochi Kolkata Noida Hyderabad Vishakapatnam Chandigarh Vadodara

Role & responsibilities Claims adjudication, claims approval, TAT, accuracy, productivity, claims cost, fraud and leakage control, client/provider feedback, team training and retention Preferred candidate profile Processing claims, quality check and adherence to TAT, fraud triggers, fraud risk assessment, computer skills. Candidate should be open to work in 24X7X365 environment Microsoft office proficiency Knowledge of Indian Health Care and prior experience in Health Insurance Claim Processing, Good Clinical Acumen Minimum 1-3 Years Preferred Industry Health Insurance/TPA/Hospital / Clinical Practice/heath care/ wellness etc.. Minimum- Medical Graduate (BDS/BAMS/ BHMS/BPT/ BUMS) Preferred Location Indore Surat Mumbai Nagpur Chennai Bangalore Kochi Kolkata Noida Hyderabad Vishakapatnam Chandigarh Vadodara

Role & responsibilities Claims adjudication, claims approval, TAT, accuracy, productivity, claims cost, fraud and leakage control, client/provider feedback, team training and retention Preferred candidate profile Processing claims, quality check and adherence to TAT, fraud triggers, fraud risk assessment, computer skills. Candidate should be open to work in 24X7X365 environment Microsoft office proficiency Knowledge of Indian Health Care and prior experience in Health Insurance Claim Processing, Good Clinical Acumen Minimum 1-3 Years Preferred Industry Health Insurance/TPA/Hospital / Clinical Practice/heath care/ wellness etc.. Minimum- Medical Graduate (BDS/BAMS/ BHMS/BPT/ BUMS) Preferred Location Indore Surat Mumbai Nagpur Chennai Bangalore Kochi Kolkata Noida Hyderabad Vishakapatnam Chandigarh Vadodara

Role & responsibilities Claims adjudication, claims approval, TAT, accuracy, productivity, claims cost, fraud and leakage control, client/provider feedback, team training and retention Preferred candidate profile Processing claims, quality check and adherence to TAT, fraud triggers, fraud risk assessment, computer skills. Candidate should be open to work in 24X7X365 environment Microsoft office proficiency Knowledge of Indian Health Care and prior experience in Health Insurance Claim Processing, Good Clinical Acumen Minimum 1-3 Years Preferred Industry Health Insurance/TPA/Hospital / Clinical Practice/heath care/ wellness etc.. Minimum- Medical Graduate (BDS/BAMS/ BHMS/BPT/ BUMS) Preferred Location Indore Surat Mumbai Nagpur Chennai Bangalore Kochi Kolkata Noida Hyderabad Vishakapatnam Chandigarh Vadodara

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

Manage Risk Investigation for Controlling Mortality and reduction in Crude Death Rate Identify patterns of Sales Malpractices and work with Linkages to facilitate field Will be primary responsible for the coordination and handling of investigation agencies that carry out field verifications on behalf of Max Life. Monitoring and controlling the work done by the Risk verification agencies regularly. Ensure that the quality of the reports submitted by the agency is good. Identify new agencies for conducting verifications. Create effective MIS/ database of all investigations/cases handled Develops fraud investigation and fraud reporting standards and procedures, monitors compliance, and contributes to quality improvements and the improvement of fraud risk management practices and policies. To effectively conduct the regular activities of the UW risk management Unit & minimize fraud losses & carry out effective risk management with Due Diligence. Meet the requirements of Anti-Fraud & Risk management department goals. Measures of Success Reduction of fraud incidence Incidence of fraudulent death claim drop Desired qualification and experience Graduate/Post Graduate in any discipline preferably in Insurance, Life Sciences, Commerce or medicine. 4+ years experience in Life/Health Insurance/TPA/ other Operations preferably in claims management and processing Should be we'll versed with MS office, particularly MS Excel. Knowledge and skills required High analytical skills Strong on core values of Max Life Strong communication (verbal and written), interpersonal, and influencing skills.

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.