1031 Tpa Jobs - Page 28

Minimum 1 year of Medical Coding Experience. Strong Knowledge on coding appropriate ICD s, CPT s and HCPC Codes. Strong Knowledge to ensure in assign codes based on coding and customer guidelines. Hands - on Knowledge in CCI edits, LCD, NCD coverage determination etc Strong Knowledge in Medical terminology, Human Anatomy and Physiology Knowledge of coding all CPT s related to Simple Procedures - Both Pro/ Fac Laceration repair Incision and Drainage Foreign body removal Splint Fracture reduction Nail Procedures Epistaxis Cerumen Impaction removal Moderate Sedation Procedure Blood Transfusion Foley/ Straight Cath Placement Bladder Scan Fracture Care Intraosseous Line Placement TPA for Stroke P...

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 ...

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/Bangalore 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 th...

Urgent requirement of Senior Executive (Recovery) - TPA@ Amrita Hospital Faridabad Experience - 2 to 5Yr Qualification - UG & PG Interested Candidates Can Contact - Rahul Chauhan - 9911892435 Email ID - rahul.chauhan@fbd.amrita.edu

Urgent requirement of Senior Executive (Recovery) - TPA@ Amrita Hospital Faridabad Experience - 2 to 5Yr Qualification - UG & PG Interested Candidates Can Contact - Rahul Chauhan - 9911892435 Email ID - rahul.chauhan@fbd.amrita.edu

Urgent requirement of Senior Executive (Recovery) - TPA@ Amrita Hospital Faridabad Experience - 2 to 5Yr Qualification - UG & PG Interested Candidates Can Contact - Rahul Chauhan - 9911892435 Email ID - rahul.chauhan@fbd.amrita.edu

Urgent requirement of Senior Executive (Recovery) - TPA@ Amrita Hospital Faridabad Experience - 2 to 5Yr Qualification - UG & PG Interested Candidates Can Contact - Rahul Chauhan - 9911892435 Email ID - rahul.chauhan@fbd.amrita.edu

Role & responsibilities: Outline the day-to-day responsibilities for this role. Preferred candidate profile: Specify required role expertise, previous job experience, or relevant certifications.

Join our dynamic international business team across Bangalore and Hyderabad Job Description Claims Service Support (CSS) - AM/Manager Summary: We at Prudent Insurance Brokers, are seeking an experienced Employee Benefit-Claims Service Support professional for our International Business (IB) vertical. Employee Benefits Practice at Prudent is a strategic business unit dedicated to strengthening Prudent’s global brand in the international market. The individual will be responsible to Serve as primary point of contact for all employee claim queries etc. We are committed to delivering bespoke Benefit & Total Reward Solutions with high standards of service excellence, world-class advisory and cons...

Select how often (in days) to receive an alert: Select how often (in days) to receive an alert: Jun 3, 2025 Bangalore, India, 560064 Who we are The opportunity Responsible for General Ledger, Intercompany including but not limited to General Ledger transactions, Support Balance sheet review, Intercompany reconciliations preparation, Billing and compliance with internal and business controls. Communication and (internal) stakeholder management with higher management levels within the Global Teva organization is required in this process. How you ll spend your day Technical/functional knowledge in Intercompany Accounting, Closing and reporting process area Handle various types of intercompany t...

Greetings from Vidal Health Insurance TPA Pvt Ltd., Openings For District Medical Officer!!! - Non Clinical Role,Immediate Joiners Preferred Qualification -MBBS(FMG - Non MCI)/BDS Experience - 0 to 1 Year Job Location - Chennai Roles and Responsibilities Involved in analyzing medical reports and do medical Audit at the Hospitals. Should have medical knowledge. Providing quality services. Updating the new medical terms and conditions as per the policy. Should be good knowledge in Academics. Resolving Claims related queries and discrepancies, Following up and responding to queries of customers. Approving and Rejection of Payments to the Customers with all verification. Updating the Status of t...

About Us: Medi Assist is India's leading Health Tech and Insure Tech company focused on administering health benefits across employers, retail members, and public health schemes. We consistently strive to drive innovation and participate in such initiatives, to lower health care costs. Our Health Benefits: Administration model is designed to deliver the tools necessary for a health plan to succeed, whether its our modular claims management system, our technology that unveils data to make important decisions, or our service solutions built around the voice of the customer. In short, our goal is to link our success to that of our members Roles and Responsibilities: Check the medical admissibil...

I am hiring for this position for one of our Life Insurance clients. Role & responsibilities Prudent claim Assessment and management of end-to-end claim settlement /repudiations, including Life, Group claims Coordinate with Reinsurers /sales/customers for closure of claims within the regulatory framework and timelines Direct and oversee the maintenance of complete and accurate claim management records. Managing the claim teams on day-to-day claims transactions, guidance on claims philosophy, regulatory, and audit procedures Ensuring daily claim deliverables are met and claims decisions within prescribed SLA with quality Ensure customer centric approach while delivering sensitive area of deat...

Roles and Responsibilities 01. Involves Processing of Claims ( Preauthorization / Reimbursement claims) 02. Validating and processing these claims within TAT 03. With good communication and medical Knowledge 04. TPA Experience is an added advantage Financial : To see to that there is no financial implication for the organization while settlement of claims Role : Medical Officer Required Knowledge /Skill : Clinical / TPA /Medical knowledge with insurance background Education : MBBS Working timing: Morning Shift / General Shift / Afternoon Shift / Evening Shift Job Location : IBC Knowledge Park, 4th Floor, D Block, Dairy Circle, Bannerghatta Road, Bangalore Note : This position is for Working ...

The candidate must have completed BHMS, BAMS, or BUMS from a reputed university." Experience : 0 to 2 years Locations : Bangalore, Chennai and Mumbai / Pune 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 control...

Job Title: Billing Incharge - Hospital Billing & Claims Location: Moradabad Department: Billing Reports To: Hospital Administrator / Finance Manager About Hospital: The Siddh Multispeciality Hospital is established by Dr. Anurag Mehrotra, MD, DM, FACC, FESC a renowned figure in the field of cardiology for last twenty years. We have been able to achieve NABH (Complete) & ISQUA (For International Patients) Accreditations in short span of time. Hospital also got accreditation with NBEMS for DNB courses. Siddh Hospital is tertiary Care hospital known for its cardiac & intensive care. Hospital also excess in equipped departments like gastro surgery, minimal invasive surgery, ortho & neurosurgery,...

The SOC professional will be responsible for the preparation of third party attestation reports, including Service Organization Control (SOC) 1, SOC 2, and WebTrust for CAs, as well as HITRUST, and ISO, applying most areas of the governing standard as necessary and documenting, validating, testing and assessing various control systems. This position may also be involved in other business process or IS assurance related engagements, including SOX, IT general control testing for private company financial audit engagements, and agreed-upon procedure engagements. Job Duties Control Environment Applies knowledge and understanding of the collective effect of various factors on establishing or enha...

About the role : We are looking for a Dedicated Claims Specialist with a strong background in medical and health insurance, particularly in group medical corporate policies . The ideal candidate should have 2-4 years of experience in claims processing or CRM roles. Key Responsibilities: Handle end-to-end processing of reimbursement claims for group medical corporate policies. Provide excellent customer service by addressing claims-related queries via Freshchat, Ozontel, and Freshdesk. Analyze medical documentation, policy terms, and conditions to ensure accurate claim assessment and processing. Liaise with internal teams, insurers, TPA s, and hospitals to ensure seamless claims settlement an...

About the role : We are looking for a Dedicated Claims Specialist with a strong background in medical and health insurance, particularly in group medical corporate policies . The ideal candidate should have 2-4 years of experience in claims processing or CRM roles. Key Responsibilities: Handle end-to-end processing of reimbursement claims for group medical corporate policies. Provide excellent customer service by addressing claims-related queries via Freshchat, Ozontel, and Freshdesk. Analyze medical documentation, policy terms, and conditions to ensure accurate claim assessment and processing. Liaise with internal teams, insurers, TPA s, and hospitals to ensure seamless claims settlement an...

Key Roles & Responsibility : Planning and supervising changes and managing the daily operations of customer service. Setting up and meeting performance goals and targets. Maintaining current knowledge of industry new developments, productions, and involvement in network. Recording statistics, performance levels and feedback of clients and preparing the reports. Motivating, coaching, and retaining staff as well as coordinating reward, bonus, and incentive scheme. Reviewing the staffs performance, determining training needs and scheduling training sessions. Responsible for the efficient functioning of CRM by ensuring that the Team attends to customer calls & Networking with the concerned depar...

You will be responsible for guiding patients and attendants to various health services provided by the hospital. Your role will involve ensuring that the correct billing is conducted based on the type of service required by the patient. Additionally, you will be assisting patients and attendants by resolving their problems and addressing any queries they may have regarding their case. Your duties will also include directing patients to the appropriate departments within the hospital, maintaining Management Information System (MIS) records, and adhering to Turnaround Time (TAT) requirements. You will be required to escalate any grievances to the designated officer and deliver reports to the p...

Looking for doctors who have experience in processing Cashless And Reimbursment Claims (Group or Retail) Experience - 2+ years in claim processing

Prepare final bill when cash/TPA/corporate/fund cards come for discharge. In the case of TPA credit patients, if the bill exceeds the approval final bill with discharge summary is send it to the insurance dept for the final approval. If there is any collection to be done from patient it is done (E.g. co-payment, room restriction, non applicable charges etc). Every day morning all the previous day discharged cards are to be cross checked whether they have paid the bill and show discharge in the HIS. In case of cash patient if they have not paid who has given permission should give a letter which should be attached with the card & it is filed in the billing dept. In case of credit bills after ...

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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 (Claimant, Treating...