1031 Tpa Jobs - Page 26

Urgent opening for TPA Medical Officer/customer service manager profile in Raipur, Rajkot, Kanpur, Baramati, Trivandrum locations. Graduate Medical background, MR (B pharma), BHMS, BAMS/ MBA in Hospital Administration. 2+ Years working experience in health insurance/health insurance TPA at Hospital handling/audit Candidate must have excellent knowledge of health insurance / Health TPA domain. Candidate must have excellent bill/medical negotiation skills & customer handling skills.Good communication skills in Hindi/English and regional language of the state/region .Ready to relocate himself/herself at location within India as may be required according to the job requirement. Candidate must ow...

Urgent opening for TPA Medical Officer/customer service manager profile in Raipur, Rajkot, Kanpur, Baramati, Trivandrum locations. Graduate Medical background, MR (B pharma), BHMS, BAMS/ MBA in Hospital Administration. 2+ Years working experience in health insurance/health insurance TPA at Hospital handling/audit Candidate must have excellent knowledge of health insurance / Health TPA domain. Candidate must have excellent bill/medical negotiation skills & customer handling skills.Good communication skills in Hindi/English and regional language of the state/region .Ready to relocate himself/herself at location within India as may be required according to the job requirement. Candidate must ow...

Candidates with experience in Life/Annuity Insurance product conversion from one admin system to another is very helpful An ideal candidate will require working knowledge to expertise on many of the following: Working daily reconciliation reports and performing root cause analysis for life products (traditional life, universal life, ISWL, Indexed UL). Thorough understanding and experience working with the following product elements: Market Value Adjustment (MVA) Bailout/Caps/Floor rates Free Withdrawal Minimum Gtd Cash Value Premium based bonus (additional X bps credited assuming Prem Paid > Set limit) Account Value based bonus (additional Y bps credited assuming Account Value > Set Limit) M...

Proven experience in leading and delivering life insurance policy conversion projects or similar initiatives. Oversee the entire data conversion lifecycle, from planning and design to execution, testing, and go-live, ensuring projects stay on track and within budget. Work closely with client stakeholders to understand their data requirements, facilitate design sessions, and address their concerns throughout the project lifecycle. Possess a strong understanding of data conversion processes, data structures, and mapping techniques used in life insurance. Manage and mentor a team of data conversion consultants, providing technical guidance, coaching, and performance management. Implement and ma...

Cashless Executive, TPA Executive, Insurance Executive Responsibilities: Patient Eligibility Verification: Claim Processing: Pre-authorization and Approvals: Coordination: Status Tracking and Follow-up: Cashless Admission Facilitation:

Vidal is hiring for claim Processor Designation: Executive-Claims Location: Gurgaon, Key Responsibilities: Review and validate claim documents submitted by hospitals or insured members Scrutinize medical records and bills for completeness and accuracy Apply policy terms, conditions, and exclusions to adjudicate claims Perform ICD and procedure coding as per ailment and treatment Coordinate with medical officers for clinical opinion when required Maintain claim logs and update CRM systems with claim status Ensure adherence to defined SLAs and minimize processing errors Flag suspicious or potentially fraudulent claims for investigation Communicate with stakeholders for clarifications or missin...

Department: Account Management Designation: Account Executive - Team Lead We are hiring an Executive Account Management to build, maintain, and strengthen long-term relationships with clients by understanding their needs, providing tailored solutions, and ensuring high levels of customer satisfaction by acting as the primary point of contact between the client and the organization, ensuring seamless communication, service delivery, and overall account success. Key Responsibility: Respond to employee/corporate customer queries via e-mail/ phone in a timely and professional manner. Coordinate with respective stake holders for cashless claim settlement and resolution . Explain claim decisions, ...

Key Roles : Ensure accurate documentation and timely claim settlement Follow up with TPA and Govt. bodies for approvals/payments Strong knowledge of Govt. healthcare panels (ECHS, CGHS, ESIC, etc.) Experience in hospital billing & claim processing Annual bonus Provident fund Health insurance

Managing CGHS, ECHS, CAPF and Ayushman Bharat Government Portals: Claim Processing Audit Uploading Query Management Reconciliation and Recovery Management. Annual bonus Provident fund Health insurance

TPA Executive to manage pre-authorizations, insurance claims & coordination with TPAs and government health scheme. The role requires accurate documentation, timely claim submissions, & effective communication with internal departments and insurers. Required Candidate profile Graduate with 1–3 years of hospital TPA experience. Proficient in handling CGHS, ECHS, PMJAY claims, insurance coordination, billing & documentation. Strong communication, MS Office & software skills.

Key Responsibilities: TPA & Insurance Networking Build and maintain relationships with TPAs, insurance companies, and corporate health clients. Ensure diagnostic centre is empanelled with major TPAs and insurers. Act as a liaison between the diagnostic lab and insurance companies for service coordination. Sales & Revenue Growth: Drive revenue through insurance-related health check-ups, cashless diagnostic services, and wellness packages. Identify opportunities to increase patient volume through insurance-tied programs. Develop new business from TPAs and corporate clients. Empanelment & Contract Management: Ensure timely renewal and compliance of contracts with insurance companies and TPAs. H...

Greetingd from Niva Bupa! Key Roles & Responsibilities: Answer incoming customer calls in a professional and timely manner. Assist customers with inquiries including medical claims and rejections. Provide accurate and detailed information about claim procedures, documentation requirements, and coverage. Investigate and resolve customer concerns, ensuring high levels of customer satisfaction. Collaborate with internal departments, such as claims processing to address and resolve complex issues. Maintain thorough and up-to-date knowledge of products, medical billing codes, and claim processes. Document customer interactions and update customer records accurately in the system. Identify and esc...

Responsible to ensure quality of service given is equivalent to the set standards. Responsible to maintain payable status at its minimum; close follow up on critical issues. Random checking of bills in terms of their accuracy and make sure the corporate bills are prepared as per the agreements and prompt dispatch of the same with the help of credit cell. Responsible to record department MIS reports and submission of the same to higher authority Responsible to monitor the surgical package limits in terms of material consumption and professional charges. Systems & Procedures: Responsible to design, implement and refine systems to manage processes and to optimize performance. Responsible to dev...

Walkin : Mon to Sat between 11am to 3pm - Siruseri Unit Job Title: Insurance Co-ordinator Role & responsibilities: List out the total Number Of credit patients (All Insurance). To send the Pre- Authorization form to the concern insurance company. Explain the Admission & Discharge procedure to the patient & attenders also. All data's and activities should be computerized. Watch the approval status and query reply to be update shortly. To Proper communication about the patient Admission, Approval, Enhancement procedure, Discharge, Payment, and cancellation process. The most common job duties for a health unit coordinator are clerical tasks like answering phones and processing paperwork, includ...

Hiring Clinical Doctors for Medical coding role in Mohali !! Job Location - Mohali Role : Auditor I (IPDRG) 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. (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. Interested candidates can share resume - abdul.rahuman@cotiviti.com Regards, Abdul Rahuman 9080276...

Samved e-Care Pvt Ltd is a prominent healthcare claim and TPA service provider in India, offering hospitals advanced claim processing solutions. We are currently seeking a diligent and detail-oriented TPA Assistant to become part of our team in Ahmedabad. The ideal candidate will have the opportunity to thrive in the healthcare administration sector and contribute to optimizing cashless claim procedures for our affiliated hospitals. As a TPA Assistant, your primary responsibilities will include supporting cashless claim processing and documentation, ensuring timely submission and approval of claims by collaborating with hospitals, patients, and insurance TPAs. You will be responsible for dat...

Role & responsibilities Preferred candidate profile

About the Role: The Associate Field Biologist/Field Biologist/Sr. Field Biologist shall be responsible for Pest Audits of Branch Large / HD Customers (having Third-party Audits- USFDA, AIB, BRC, FSSC, SQF, LEED, etc), Key national customers in various segments - Food & Pharma Mfg, w/h, Large food retailers (excluding QSRs, Fast food chains), Large ITES & MA s, etc. The incumbent will report administratively to the DM & functionally to Opex QA and work as a part of the multi-functional team involving collaboration with the internal & external stakeholders. Job Responsibilities: Carry out Pest Audits of Global accounts, Key designated NK accounts- Food & Pharma units, Food & Pharma warehouses,...

Management of master fees files. Management & control of fees booking entries in accounting software Tally. Controlling billing/invoicing across the country. Arrangements of TPA Service Charge Reports. Coordination with all outstation offices. Fees collection follow-up for early release of payment. Resolving queries from Insurance Companies regarding fees. Resolving system issues at Insurance Companies. Lower TPA fees rate confirmations & follow-ups with Insurance Companies and inter-departments. Liaising with officials of Insurance Companies for early settlement of fees and other queries. Reconciliation of pending fees in books of accounts. Fees MIS management required by Insurance Companie...

Hiring for Assistant Manager for Vidal Health Insurance TPA Pvt Ltd Job Title : CRM Assistant Manager Location: Gurgaon Industry : Health Insurance / Third Party Administration Role Objective To lead and optimize the organizations CRM strategy, ensuring seamless client interactions, data integrity, and service delivery across health insurance workflows. The CRM Manager acts as a bridge between technology, client servicing, and operational teams to enhance customer satisfaction and retention. Key Responsibilities Functional Area RM Strategy & Execution - Design and implement CRM strategies aligned with business goals - Drive customer engagement, retention, and satisfaction initiatives Client ...

Urgent requirement for Assistant MIS Manager (Pune) TPA experience. Interested candidates can call on 9371762436 or share their updated resumes to career@mdindia.com Job Description: Roles and Responsibilities Manage MIS operations, ensuring accurate and timely reporting of health insurance claims data. Develop and maintain advanced Excel models for data analysis, including pivot tables, HLOOKUPs, and VLOOKUPs. Create management reports using TPA's software to track key performance indicators (KPIs) such as claim processing times, denial rates, etc. Collaborate with internal stakeholders to identify business requirements and develop solutions that meet their needs. Ensure compliance with reg...

POSITION: MEDICAL OFFICER/CONSULTANT PA/RI APPROVER PURPOSE OF ROLE: To scrutinize and process the claims within the agreed TAT by having an understanding of the policy terms & conditions while applying their domain medical knowledge. Designation Function Medical Officer/Consultant Claims PA/RI Approver Reporting to Location Assistant Manager Claims Mumbai Educational Qualification Shift BHMS, , BAMS, MBBS(Indian registration Required) Rotational Shift (for female employee shift ends at 8:30 PM) 6 rotational week offs Provided per month Week offs Related courses attended None Management Level Junior Management Level Industry Type Hospital/TPA/Healthcare/Insurance Roles and Check the medical ...

As a diligent individual within the role, you will be responsible for verifying TPA documents before submission. It will be essential to maintain accurate records of all TPA cases, including approvals and rejections, to facilitate audits and follow-up procedures effectively. Effective communication with insurance companies and TPA coordinators will be crucial in addressing queries and ensuring all necessary information is provided. Furthermore, you will play a key role in preparing and submitting final discharge summaries, bills, and other essential documents required for claim settlement. Monitoring the approval status and handling enhancement requests will also be part of your responsibili...

Manage insurer & client coordination, handle policies, endorsements, and claims, resolve escalations, build strong broker/client relations, lead servicing team, ensure seamless delivery & represent company in insurer meetings. Provident fund

Role & responsibilities Graduate Medical background, MR (B pharma), BHMS, BAMS/ MBA in Hospital Adminstration 2+ Years working experience in health insurance/health insurance TPA at Hospital handling/audit Candidate must have excellent knowledge of health insurance / Health TPA domain. Candidate must have excellent bill/medical negotiation skills & customer handling skills. Good communication skills in Hindi/English and regional language of the state/region. Ready to relocate himself/herself at location within India as may be required according to the job requirement Candidate must own vehicle to travel in various hospital assigned to him Candidate must be computer literate and shall possess...