705 Tpa Jobs - Page 23

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...

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 th...

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 (Claima...

1. Looking after the corporate client & their empanelment’s 2. Preparing bills of TPA, ESIC, ECHS, CGHS and other Private clients Independently. 3. Handling all queries related to patients. Call me on +91 97739 85718

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

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

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

1. Claims Administration and Management Coordinate with branches in resolving the claims within the set SLAs / TATs; resolve any issue / concern Review the claim settlement status daily; guide team in addressing claims which exceed TAT; seek clarifications and resolve issues to ensure that the claims are processed at the earliest Conduct reviews (OFR / CFR) to identify problems within claims settlement and propose solutions; discuss the same with the superior and seek feedback / assistance in the same 2. TPA Management Connect with the TPA vendors and invite quotes; assess information like loss ratio/ service expectations, etc. ; Negotiate with the TPAs on different aspects; assess loss rati...

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

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

Job description: Counsels patients on the reports given by the doctor. Co-ordination with Consultant / Centre Head on daily basis based on surgery advice and conversion. Maintain checklist as per the instruction given by the management. (Like Cataract, FFA, etc.,) Explain the tariff of the concern procedures / investigations to patients in detail. Maintain Counselor report on daily basis (Advise, Conversion and Patient wise details). Co-ordinating with TPA / Insurance Dept (Sending Pre-authorization, Getting Approval, Billing). Cross verifying all the relevant documents related to Credit billing before surgery. Maintaining Counselor Summary for all counseled patients. Doing Tele Calling and ...

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

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

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years About Accenture Accenture is a global professional services company with leading capabilities in digital, cloud and security.Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than...

About the Role The Sr BA role is part of the Territory Planning & Analytics (TP&A) team in GSSO. The TP&A team is focused on designing the optimal territory investment, design and alignment strategy to maximize Sales (and Services) productivity. This is an internal consulting team that partners with Gartner s sales leaders to determine where, when, and how the company should direct its substantial investment in incremental sales professionals. The individual in this role will collaborate with sales leaders to guide strategic investment and go-to-market decisions at regional and global levels. What you will do: Stakeholder Management & Collaboration Partner with Gartner s sales leaders to def...

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 expertis...

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 expertis...

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 expertis...

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 expertis...

Role & responsibilities Sending Monthly Reports to insurance co (new additions, deletions etc) He/she will be a SPOC for all employees with reference to handling queries regarding their medical benefits/hospitalizations To close Service tickets pertaining to medical matters within a specified TAT Managing emergency support to employees Liasing closely with the insurance company for faster processing of claims Monitoring CD balance and replenishing the same in co-ordination with the accounts team

Role & responsibilities Manage insurance claims from receipt to settlement, ensuring timely processing and resolution. Coordinate with TPAs (Third Party Administrators) for claim adjudication and settlement. Handle mediclaim claims, health insurance claims, and other types of general insurance policies. Ensure accurate billing and reconciliation of patient accounts. Maintain records of all interactions with patients, providers, and insurers. Preferred candidate profile 5-8 years of experience in insurance coordination or TPA coordination role. Strong knowledge of insurance billing, claims processing, and claims settlement procedures. Proficiency in handling multiple tasks simultaneously unde...

Responsibilities: Process customer orders accurately and efficiently Maintain accurate records and reports on billing activities Prepare and send out invoices promptly Manage credit accounts and collections RGHS/Ayushman Bharat billing

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 my Mail ID - varsha.kumari@mediassist.in Thanks & Regards Varsha Kumari Email - varsha.kumari@mediassist.in

Hiring Executive CRM (Corporate and Client Relationship) Company - MD India Health Insurance TPA Job Description 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 relatio...

Position Medical Officer Location Mumbai (Andheri East, Saki Naka) Basic Responsibilities Call prospective customer of insurer for taking medical history through structured tele medical interview. Ask reflex questions in case of any medical adversity. Take complete details of investigation and treatment completed by customer. The doctors need to work from office for 8 hrs. Qualification BAMS/ BHMS/ BDS/ BUMS/ BEMS/BSMS Shift Timing: 8 hrs day shift Skills Fresher doctors are welcome or some prior exposure or sound understanding of Tele/Video MER process. Permanent or provisional registration number is a MUST. Excellent written and verbal communication skills You have Eye for details, Good Co...