1031 Tpa Jobs - Page 27

Job Description Acts as an interface between the TPA, Insurance Company and the hospital. Responsible for investigation of suspicious claims. Effective usage of Fraud control measures. Act as a backend support to the TPA. Responsible for data mining and analytics related to Fraud and Investigation (IFD) Field visit for investigation purpose. Open to travel. Desired Candidates Profile Qualification Any Graduate Experience Fresher - 2 Years Exp. Profile Executive If interested kindly share your resume to recruitment1@mdindia.com

This position is responsible for providing administrative support to colleagues in the Talent & Culture function to ensure the timely and accurate delivery of Talent & Culture initiatives and projects. Process day-to-day Talent & Culture administration in an accurate and timely manner Conduct regular file audit for candidate files. Prepare new ambassador s personal files including all necessary forms, document and information. End to End process of Pre-Employment Medicals/Food Handlers renewal test and report administration Ensure that Health and safety policies of ESIC, Group Medical Coverage, Group Personal Accident and Group Term Life Insurance are periodically reviewed and renewed Assist...

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

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 skills including but no...

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 skills including but no...

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TPA Executive - Hospital or insurance

Role & responsibilities 1) 1-3 years working experience in health insurance/health insurance TPA at Hospital handling/audit 2) Candidate must have excellent knowledge of health insurance / Health TPA domain. 3) Candidate must have excellent bill/medical negotiation skills & customer handling skills. 4) Good communication skills in Hindi/English and regional language of the state/region. 5) Ready to relocate himself/herself at location within India as may be required according to the job requirement . 6)Candidate must own vehicle to travel in various hospital assigned to him 7) MS Office and excel Preferred candidate profile Proficient in handling complex situations and customers. Candidate m...

Role & responsibilities Serve as a point of contact for Insurance related inquiries Create a consistent, positive work atmosphere through the communication Close interaction with respective department at hospital To interact with hospital insurance patients. Interact with Hospital Management, Doctors, Medical and non-medical staff at the hospital To create awareness about insurance claims (reimbursement and cashless claims, pre & post hospitalization claims etc.) Collecting claim support documents from the patients / hospitals & coordinate with backend team to ensure smooth transfer of data to the TPA/Insurance Company. Send the pre auth request and follow up on cashless approval form insura...

Key Result Areas Supporting Actions To build an ecosystem that would assess/ recommend/ decision the viability of credit lending proposals based on institutionalized processes and dynamic market information The role needs to mitigate the title risk in retail loan proposals/facilitate the approving authority to take decision on the proposal. To be responsible for ensuring the legal assessment, approval and recommendation of all retail/ prime/affordable/CF proposals. Reviewing of PDD/ escrow, maintaining MIS and monitoring of exceptions. Formulation of product/policy/procedures by interacting with internal/external stakeholders in the field of legal due diligence during the entire life-cycle o...

Job Description 1 Graduate Medical background, MR (B pharma), BHMS, BAMS/ MBA in Hospital Adminstration 2 2+ Years working experience in health insurance/health insurance TPA at Hospital handling/audit 3 Candidate must have excellent knowledge of health insurance / Health TPA domain. 4 Candidate must have excellent bill/medical negotiation skills & customer handling skills. 5 Good communication skills in Hindi/English and regional language of the state/region. 6 Ready to relocate himself/herself at location within India as may be required according to the job requirement 7 Candidate must own vehicle to travel in various hospital assigned to him 8 Candidate must be computer literate and shall...

• 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 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...

Roles and Responsibilities Handle claims from receipt to settlement, ensuring timely and accurate processing. Verify claim documents, including medical records, bills, and reports. Coordinate with hospitals, doctors, and other stakeholders for necessary documentation. Conduct thorough investigations into complex cases to resolve disputes efficiently. Ensure compliance with regulatory requirements and company policies.

Job Description: We are looking for a dynamic and detail-oriented Medical Operations Executive to join our team. You will be responsible for coordinating and executing medical services for clients, ensuring smooth communication between doctors and patients, and maintaining proper documentation. Responsibilities: Coordinate end-to-end medical services for corporate clients and patients. Maintain a high level of accuracy in medical data entry and operational documentation. Liaise between doctors, patients, diagnostic partners, and internal teams. Support virtual consultations, second opinions, and medical report collection. Ensure timely scheduling of health check-ups, teleconsultations, and f...

Overview Hi Team, I am currently working at CTS Speciality Hospital in the Insurance Department, where I have been for the past year. In total, I have over three years of experience in the health insurance sector, handling various responsibilities related to medical claims, policy coordination, and patient insurance support. I am confident that my experience and skills in health insurance operations make me a valuable asset for roles in this field. Tagged as: insurance Before applying for this position you need to submit your online resume . Click the button below to continue. Related Jobs Financial Advisor AGEAS FEDERAL GROUP Bangalore Freelance 2025-03-14 RELATIONSHIP OFFICER IN BANK Bank ...

Overview Roles & Responsibilities: 1) Candidates Should have worked in hospital Insurance desk 2) Provide Medical opinion for health Insurance claims 3) Processing of cashless requests & Health Insurance claims document 4) Proficient with medical terms & system 5) Understanding of policy terms & system. 6) Understanding of Claims adjudication/ Claims Processing Tagged as: insurance Before applying for this position you need to submit your online resume . Click the button below to continue. Related Jobs RELATIONSHIP OFFICER IN BANK Bank Jorhat Full Time 2024-01-19

Medical Typist Location : Greater Noida Designation : Medical Typist Department : TPA Qualification : Any Graduate Experience : 1-3 years experience in Pathology/ Radiology/ Report Typing Job Description : Pathology/ Radiology/ Report Typing Skill Required : Relevant Notes : Full Time Job Submit

Qualification: Any Graduate Experience: 8-10Years Must have worked for TPA / Corporate/ PSU/Referral Marketing Contact: HR Department Email : www.umkalhospital.com Mo. : 8860077509,7988561761

We are hiring TPA Manager for very reputed hospital in Delhi location. Need min 10 years experience & well versed with the following:- TPA Empanelment (visit in TPA and Insurance companies) Co-ordination with OPD/IPD Department (Admission & Discharge of cashless patient) Processing all the co-ordination activities from cashless patient's admission to discharge. Counselling the patient's family to explaining the pre-auth process. Maintaining & uploading patient's files on the portal. Handling all TPA Portals. Maintaining separate file for every patient with highlight co-payment and authorization letter. Telephonic follow up to the insurance company for conveniently claim settled. Maintaining ...

Manage end-to-end claims process for corporate insurance policies (GMC, GPA, WC, Fire, etc). Coordinate with clients, insurers, and TPAs to ensure timely documentation and settlement . Track claim status and provide regular updates to clients. Analyze claim patterns and support clients with insights and loss mitigation strategies. Ensure service level agreements (SLAs) are met and maintain claim MIS reports. Assist clients during audits or investigations, where required. Requirements: Minimum 2 years of experience in corporate insurance claims handling. Strong understanding of Group Mediclaim , GPA , and WC policies. Excellent communication and client coordination skills. Organized, detail-o...

Job Title: Sr Manager Health Insurance Claims Location: Bangalore (Hybrid) Company: Pazcare Type: Full-time About Pazcare Pazcare is transforming employee healthcare and wellness for 2000+ companies including Mamaearth, Chaayos, Mindtickle, and more. We simplify health insurance and wellness benefits, giving HR teams superpowers through real-time claim tracking, analytics, and stellar employee experiences. Role Overview As a Claims Manager, you will be the frontline owner of ensuring claims are settled within the agreed turnaround time (TAT) across TPAs. You will play a critical role in driving TPA performance, resolving escalations, and advocating on behalf of our clients to ensure no valid...

Roles and Responsibilities Manage team performance, ensuring timely completion of tasks and projects. Conduct audits, rate analysis, package management, policy issuance, and negotiations with clients. Develop strong coordination skills to ensure effective communication among team members. Identify areas for improvement and implement process enhancements to increase efficiency. Collaborate with cross-functional teams to achieve business objectives. TPA EXperience will be preffered.

Job Title : CRM Manager TPA Industry 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 Data Management - Ensure accurate and secure client data entry and maintenance - Mo...

Designation-Executive/Team Lead in CRM for Client Servicing for Big Corporate. Location: Ludhiana, Punjab Industry-TPA Company or Health Insurance will only be preferred Job Description: Key Responsibilities Functional Area Responsibilities Client Management & Retention - Lead the retention and engagement strategy for top corporate clients in the region - Work closely with the servicing team to ensure consistent delivery and relationship strengthening Leadership Reporting - Review reports on corporate clients, insurance companies, and brokers with senior leadership - Identify potential service gaps and resolve proactively before escalation SLA Fulfillment - Monitor and ensure adherence to ag...

Responsibilities: Ensure timely claim settlements within policy limits. Manage health claims from intake to payment. Process mediclaim & TPA claims with accuracy. Collaborate with insurers on claim resolution. Health insurance Annual bonus