705 Tpa Jobs - Page 24

Role & responsibilities • Scrutiny of medical documents and adjudication. • Assess the eligibility of medical claims and determine financial outcomes. • Identification of trigger factors of insurance related frauds and inform the concerned department. • Determine accuracy of medical documents ADDITIONAL SKILLS • Good communication • Familiarity with Computers and interest in learning on the job. Pratiksha Shitole, Sr.Executive Talent Acquisition, MDIndia Health Insurance TPA Pvt. Ltd. S. No. 46/1, E-space, A-2 Building, 3rd floor, Pune Nagar Road, Vadgaonsheri, Pune 411014. Email Address: hr9@mdindia.com Contact No. 7058036074 Visit us @ www.mdindiaonline.com

Roles and Responsibilities Candidate has to do TPA Empanelment. Candidate will handle entire billing part and documentation. TPA/Cashless /ECHS /CGHS /ESIC billing & documentation. Liaison with Govt. Health Departments. Liaison with Insurance Companies. Tie ups with Corporate Houses. Must be aware of norms of insurance sector. Desired Candidate Profile Good communication. Must have good command over MS Office. Candidate must have experienced in Third party/ Empanelment Corporate tie-ups. Must have experienced of Hospital. Must have Experienced TPA/Cashless/ECHS/CGHS processors. Perks and Benefits Performance based Incentives Interested candidates may share their cv on WhatsApp 8875029935 wit...

Claims Executive- EB website Link: www.dishainsurance.com Job Summary: We are seeking a qualified Claims executive to help our clients in claims and any other query solution through their own skills. Our ideal Claims executive has to have in-depth knowledge of and experience with the Claim process, Policy terms and conditions, relationship building and MIS management. We are seeking a quick learner with strong communication skills, and someone with a track record of success who can inspire the same in others Roles & Responsibilities: One stop solution for all client queries and requirements Represent our company, with a comprehensive understanding of our services in the area of claim process...

Role & responsibilities Checking bill as MOA Deduction analysis Knowledge of TPA norms,AL and portal Knowledge of NHA and ECHS portal Preferred candidate profile

Hiring TPA Incharge/Officer for a hospital in Gurgaon. Min 4 yrs exp in TPA desk. Must handle claims, pre-auths, billing, discharges & patient queries. Strong communication & TPA workflow knowledge required. Send cv on-82808 33507

Hiring Clinical Investigator for Mohali location ! Eligibility Criteria: Education BHMS,BAMS,MBBS,BPT Candidates with prior US Healthcare or Clinical experience will be preferred. Noncertified Physicians can apply however should be ready to complete the same within specified timeline. (CPC/CIC) Good communication skills. Candidates with corporate experience will be preferred. Immediate joiners preferred. Should be ready to work from office. Should be ready to work in night shift. Job Location - Mohali Interested candidates can share resume - Jitendra.pandey@cotiviti.com Regards, Jitendra 7350534498

Hiring Clinical Doctors for Medical coding role in Mohali !! Eligibility Criteria: Education BHMS,BAMS,MBBS,BPT Candidates with prior US Healthcare or Clinical experience will be preferred. Fresher Physicians can also apply with good clinical knowledge. Noncertified Physicians can apply however should be ready to complete the same within specified timeline. (CPC/CIC) Good communication skills. Candidates with corporate experience will be preferred. Immediate joiners preferred. Should be ready to work from office. Should be ready to work in night shift. Job Location - Mohali Interested candidates can share resume - Jitendra.pandey@cotiviti.com Regards, Jitendra 7350534498

: Job Purpose Procurement of Engineering Materials for Maintenance, Packaging materials for Packaging & Service support for all maintenance activities. Job Context & Major Challenges Job Context: The global aluminum market is valued at USD 87.84 billion in 2021 and is expected to grow 7.5 % (CAGR) from 2022 to 2030. Increase in demand for lightweight and durable extruded products is driving the growth. Top aluminum extruders are investing and creating tough competition. Hindalco Industries Limited have acquired the extrusion business of SAPA located at Kuppam, Andhra Pradesh with effect from 01 Feb 2022 through Business Transfer Agreement This plant is first of its kind, across the globe to ...

Job Purpose Procurement of Engineering Materials for Maintenance, Packaging materials for Packaging & Service support for all maintenance activities. Job Context & Major Challenges Job Context: The global aluminum market is valued at USD 87.84 billion in 2021 and is expected to grow 7.5 % (CAGR) from 2022 to 2030. Increase in demand for lightweight and durable extruded products is driving the growth. Top aluminum extruders are investing and creating tough competition. Hindalco Industries Limited have acquired the extrusion business of SAPA located at Kuppam, Andhra Pradesh with effect from 01 Feb 2022 through Business Transfer Agreement This plant is first of its kind, across the globe to ha...

Roles and Responsibilities Manage end-to-end claims processing, including investigation, settlement, and reconciliation. Oversee insurance billing and TPA (Third Party Administrator) processes. Ensure compliance with regulatory requirements and industry standards for healthcare services. Develop and implement effective strategies to reduce claim denial rates and improve revenue cycle management. Collaborate with internal stakeholders to resolve complex claims issues.

Candidates with >5 years experience in TPA/Insurance Desk, apply for the position of Senior Manager.

Accuracy in Inpatient Billing. Effectively monitoring of day-to-day activities Resolve customer complaints or answer customers' questions regarding policies and procedures. Supervise the work of office, administrative, or customer service employees to ensure adherence to quality standards, deadlines, and proper procedures, correcting errors or problems. Provide employees with guidance in handling difficult or complex problems or in resolving escalated complaints or disputes. Implement corporate or departmental policies, procedures, and service standards in conjunction with management. Discuss job performance problems with employees to identify causes and issues and to work on resolving probl...

Making different types of bills like ECHS/CGHS and other panels. Intrested Candidate can share their resume on himanshi.singla@aimsindia.com

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Process - Postpay Clinical Primary Responsibilities This process works on identifying discrepancies between medical...

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 intern...

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) Fresher...

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 ...

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 hos...

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 regiona...

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 ...

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 ...