705 Tpa Jobs - Page 21

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years About Accenture Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. Visit us at www.accenture.com What would you do We help insurers redefine their customer expe...

We are pleased to announce a walk-in interview for the role of Sales Executive & Operations Executive at Rentokil PCI , a leading organization committed to delivering excellence. Are you passionate about sales and looking for . Preference will be given to local candidates from Guwahati for ease of commuting. Candidates willing to relocate from nearby areas of Guwahati are also welcome to apply for this roles. Immediate joiners or candidates with a short notice period will be given preference. Experience: 0 to 5 years ( Graduate freshers are also welcome ). Qualification: Any graduate, preferably B.Sc. (Chemistry / Zoology / Agriculture). Valid driving license and two-wheeler are mandatory. I...

Responsibilities: * Manage clinic operations & staff * Oversee patient care & treatment plans * Conduct PAIENT counseling sessions * Monitor TPA & insurance claims * Ensure compliance with ECHS standards Accessible workspace

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 a PA and an RI claim and verify the necessary details accordingly. Verify the required documents for processing claims and raise an IR in case of an insufficiency. Coordinate with the LCM team in case of higher billing and with the provider team in case of non-availability of tariff. Approve or deny the claims as per the ...

Shubham Hospitals, Varanasi is looking for Medical Officer Senior to join our dynamic team and embark on a rewarding career journey. Diagnosing and treating patients' illnesses and injuries. Creating and maintaining patient medical records. Prescribing medication and therapies. Ordering and interpreting diagnostic tests. Referring patients to specialists as needed. Developing and implementing treatment plans. Educating patients about their health conditions and treatment options. Working closely with patients and their families, as well as other healthcare professionals.

TPA / Health Insurance Exp. is preferred Assessment of Health Claims Assessment of Treatment & Medication given in the papers sent for claim Cost optimization Approval of Claims for Processing MBBS , BHMS & BAMS Doctors only

Role & responsibilities To give Claims & Cashless/preauthorization, and scrutiny Medical Reimbursement Claims, and to Process Claims Third Party Administration (Health) services (TPA) Claims and Preauthorization Processing HealthCare Assistance Services High Ratio Claims Management in coordination with Networking and Empanelment Department Monitoring the overall operations of Claims and Preauthorization. Responsible for ensuring efficient response at the level of Preauthorization to maintain TAT. Ensure adherence to processes and controls. Creating the process for claim processing (Cashless and Reimbursement). Co-ordination between Network Hospitals/Preauthorization/Claims. Ensuring a high-q...

Role & responsibilities To give Claims & Cashless/preauthorization, and scrutiny Medical Reimbursement Claims, and to Process Claims Third Party Administration (Health) services (TPA) Claims and Preauthorization Processing HealthCare Assistance Services High Ratio Claims Management in coordination with Networking and Empanelment Department Monitoring the overall operations of Claims and Preauthorization. Responsible for ensuring efficient response at the level of Preauthorization to maintain TAT. Ensure adherence to processes and controls. Creating the process for claim processing (Cashless and Reimbursement). Co-ordination between Network Hospitals/Preauthorization/Claims. Ensuring a high-q...

Responsibilities: * Lead claims processing from intake to resolution. * Ensure compliance with regulatory requirements. * Optimize processes, reduce TAT & improve SLA. * Manage team performance and development. Annual bonus

Role & responsibilities Responsible for managing client relationships with key decision makers Subject matter expert for partners and internal staff for the assigned product Addresses the gaps identified between client requirement & the service provided Ensure that the service is delivered in accordance with the agreed service level agreement Act as a point of contact for any escalation or feedback from clients Collaborate with the other functional Group to evaluate the product performance and to recommend Refinements and improvements in service performance Establish and maintain on-going partner relationships and anticipate and resolve potential problems of the client Manage account renewal...

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 contribu...

JOB PURPOSE To handle statutory compliances for Bangalore & SSC Hyderabad locations , employee statutory benefit & employee insurance at group level ORGANISATION CHART KEY ACCOUNTABILITIES Accountabilities Key Performance Indicators Employee Insurance (GPA, GTI & GMI) Responsible for end to end insurance renewal process quotations, finalization, payments, policy generation Coordinate with partnered insurance companies, TPA and broking company for day to day operational issues related to endorsements, additions, deletions, corrections, claims, CD statements etc., Coordinate for providing CD statements / CD reconciliations to respective business for their accounting purpose and to obtain CD re...

Job description URGENT OPENING FOR MEDICAL OFFICER Workings Hours: 9 Hrs Work Mode : Office Key Responsibilities: Review and assess medical claims submitted by corporate clients against policy terms and medical guidelines. Analyze clinical documents such as medical reports, diagnostic tests, prescriptions, discharge summaries, and other relevant medical records. Verify the authenticity, appropriateness, and completeness of medical documentation related to claims. Provide medical expertise to determine the validity and admissibility of claims. Collaborate with claims processing and underwriting teams to resolve discrepancies or clarifications related to medical information. Identify potential...

To efficiently and effectively handle all IPD Billing related activities like registration and billing for patients to ensure smooth work flow: To be responsible for preparing all IPD bills and keeping its records as per set protocols. To keep yourself updated with information of all payer plans for different panel companies and TPAs. To review the payer plans and codes of different corporate & TPA and to ensure that same is updated in HIS and monitor its implementation also. To be responsible for keeping record for all correspondence done for IPD billing patients. To identify and resolve IPD patients billing complaints and to raise red flag to the concerned authority in case of any difficul...

Crucial role in managing the entire claims process — right from documentation and coordination to ensuring smooth and timely settlements.

Coordinating with TPA/corporate companies for approval and claim processing, Primary responsibility of TPA and Corporate Head is Follow ups and Clearing of outstanding dues with TPA’s & other govt. agencies and split billing. Required Candidate profile Reporting of daily, weekly, monthly dues outstanding follow ups to the reporting mgr. Update received from any of the TPAs or Corporates to ensure the updates are informed to all the unit team.

Bhagwan Mahaveer Cancer Hospital & Research Centre is looking for IPD Billing Executive to join our dynamic team and embark on a rewarding career journey. Generate invoices for clients using billing software Process payments and reconcile accounts Resolve billing issues and disputes with clients Maintain accurate and up-to-date billing records and documentation Monitor and track the billing process to ensure timely and accurate billing Communicate with clients to gather necessary information and resolve billing issues

Exciting Career Opportunity with MDIndia Health Insurance TPA Are you a Medical Graduate looking for a rewarding career in the Health Insurance Industry? Join MDIndia Health Insurance TPA, a leading Third-Party Administrator (TPA) in health insurance, and kick start your journey as a Medical Officer Why Join Us? - Expand Your Medical Expertise within the insurance and healthcare sectors - Work in a Corporate Environment with structured career growth - Gain Industry Exposure in medical claim assessment - Attractive Salary & Benefits Role & Responsibilities - Medical claim assessment & adjudication - Coordination with hospitals & insurance providers - Reviewing medical documents & policy guide...

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management Associate Manager Qualifications: Any Graduation Years of Experience: 10 to 14 years Language - Ability: English(Domestic) - Advanced About Accenture Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. Visit us at www.accenture.com What wou...

About Rentokil PCI Rentokil PCI is the leading pest control service provider in India. A Rentokil Initial brand, Rentokil PCI was formed in 2017 through a joint venture (JV) between Pest Control India, the number one pest control company in India, and Rentokil, the world s leading pest control brand. Rentokil PCI aims to set new standards for customer service having operations across 300 locations in India. About the Role: OE / Sr. OE shall be owner of his / her assigned service areas within the Branch in terms of operations related actions as given in job responsibilities, and shall be responsible for providing qualified Technicians for execution of services. Responsible for Resi, SA, SMEs....

About Medhavi Skills University: . About Medhavi Foundation: Established in 2012, the Medhavi Foundation is the parent body of Medhavi Skills University. It is a Section 8 Not-For-Profit company and is a recognized training partner for the National Skill Development Corporation (NSDC). The Medhavi Foundation is empaneled with the Ministry of Skill Development and Entrepreneurship as a Third-Party Aggregator (TPA) and Basic Training Provider for the promotion of apprenticeship training under the National Apprenticeship Promotion Scheme. The foundation has trained 2,20,000+ candidates and placed 1,90,000+ candidates in 20+ states. We have collaborated with 46 Skill Academies & Pradhan Mantri K...

Role & responsibilities Managing empanelment and receivables processes with TPAs and health insurance companies to ensure a streamlined and efficient revenue cycle Ensuring timely renewal of agreements with TPAs and insurers Leading negotiations and finalization of tariffs and treatment packages with TPAs and insurance partners Overseeing the negotiation, renewal, and management of GIPSA empanelments Driving business growth through strategic engagement with TPA and insurance partners Preferred candidate profile Any Graduate or Post Graduate with 8 to 12 years of relevant experience of NABH / JCI Hospitals.

Role & responsibilities 1. Client Relationship Management: a. Serve as the lead point of contact for all customer account management matters. b. Build and maintain strong, long-lasting client relationships. c. Develop trusted advisor relationships with key accounts, customer stakeholders, and executive sponsors. 2. Sales and Business Development: a. Oversee a portfolio of assigned customers. b. Develop new business from existing clients. c. Actively seek new sales opportunities. d. Identify areas of improvement to meet sales quotas. 3. Cross-Functional Collaboration: a. Collaborate with internal departments (including Customer Service and Product Development) to improve the entire customer e...

Check the medical admissibility of claim by confirming diagnosis and treatment details Verify the required documents for processing claims and raise an information request in case of an insufficiency Approve or deny claims as per T&C within TAT If candidates are interested please drop your update resume/CV on varsha.kumari@mediassist.in Thanks & Regards Varsjha Kumari Email - varsha.kumari@mediassist.in

Role & responsibilities To Maintain corporate clients To maintain Insurance in TPA To do the employee engagement activities Need to take care of Health camps and training programs Preferred candidate profile Any Degree or Marketing experience with min 2 to 5 years. Contact : recruitment@kaminenihospitals.com