1031 Tpa Jobs - Page 29

Role & responsibilities Claims adjudication, claims approval, TAT, accuracy, productivity, claims cost, fraud and leakage control, client/provider feedback, team training and retention Preferred candidate profile Processing claims, quality check and adherence to TAT, fraud triggers, fraud risk assessment, computer skills. Candidate should be open to work in 24X7X365 environment Microsoft office proficiency Knowledge of Indian Health Care and prior experience in Health Insurance Claim Processing, Good Clinical Acumen Minimum 1-3 Years Preferred Industry Health Insurance/TPA/Hospital / Clinical Practice/heath care/ wellness etc.. Minimum- Medical Graduate (BDS/BAMS/ BHMS/BPT/ BUMS) Preferred L...

Designation-Executive/Team Lead in CRM for Client Servicing for Big Corporate. Job Location: Vadodara (Implant/Helpdesk) Industry-TPA Company or Health Insurance will only be preferred Job Description: Key Responsibilities: 1 . Management and Retention of Top corporate for the region along with Team as a L1 Level. 2. Reports on top corporate/insurance companies/brokers to be reviewed with Leadership Team and proactively act on issues before escalations. 3. Fulfilment of SLAs. 4. Oversee timely submission of MIS reports to Insurance Companies/Corporate etc.. 5.. Oversee department functions like the Customer Care, Claims, Preauth and related functions. 6.Claims and Cashless settlement 7. Coor...

Key Responsibilities: Conduct induction training for new joiners across all departments. Design and deliver process-specific training modules for Claims Processing, Claims Coordination, and Support Teams. Train internal and external staff on insurance processes, and TPA/Hospital workflows. Monitor and assess trainees performance during and after training; recommend improvements. Maintain accurate training records and prepare training reports for management. Support knowledge sharing, performance improvement, and continuous learning culture across the company. Requirements: Bachelors degree in any discipline (preferred: Healthcare, Management, or related fields). Minimum 2–4 years of experien...

Designation-Team Lead/Assistant Manager in CRM for Client Servicing Job Location: Gurgaon Industry-TPA Company or Health Insurance will only be preferred If you are interested, please you can visit to Office between 11AM to 1PM Monday-Friday Vidal Health TPA | 531-532 | Udyog Vihar | Phase V | Gurgaon | Haryana 122 016 Contact Number-9971006988 Job Description: Key Responsibilities: 1 . Management and Retention of Top corporate for the region alont with Team as a L1 Level. 2. Reports on top corporate/insurance companies/brokers to be reviewed with Leadership Team and proactively act on issues before escalations. 3. Fulfilment of SLAs. 4. Oversee timely submission of MIS reports to Insurance ...

The Clinton Health Access Initiative, Inc. (CHAI) is a global health organization committed to our mission of saving lives and reducing the burden of disease in low-and middle-income countries. We work at the invitation of governments to support them and the private sector to create and sustain high-quality health systems. At CHAI, our people are our greatest asset, and none of this work would be possible without their talent, time, dedication and passion for our mission and values. We are a highly diverse team of enthusiastic individuals across 40 countries with a broad range of skillsets and life experiences. CHAI is deeply grounded in the countries we work in, with the majority of our sta...

We are seeking a dynamic and result-oriented Marketing & Sales Specialist for our 200 bedded NABH accrediated hospital.The candidate will be responsible for driving referral sales, managing relationships with empaneled organizations. Required Candidate profile To achieve monthly and annual revenue targets. To devise monthly and yearly plans & review the progress. To develop good relationships with senior corporate contacts to drive business growth.

Identify, approach, & onboard hospitals & clinics for cashless treatment & financing solutions Promote Medical Loans (0% EMI) and Advance Against Mediclaim to hospital partner Coordinate with internal teams for smooth activation & issue resolution Required Candidate profile Hospital onboarding, TPA coordination, healthcare sales, or medical loans HealthTech, NBFC, insurance, or hospital B2B sales Self-starter, target-oriented, and willing to travel locally

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...

Role & Responsibilities Handling TPA related all process from billing to co-ordinate with TPA companies. Responsible for counseling patient's family & pre-Auth process. Maintaining & uploading patient's files on the portal. Couriering the hard copy of patient's medical file to the Insurance companies. Responsible for all co-ordination activities from patient's admission to discharge. Handling billing Department, Implants bill updating & reconciliation. Daily co-ordination with the patient and Hospital staff. Outstanding follow-up with TPA. To obtain and review referrals and authorizations for treatments. Must be aware of norms of the insurance sector. Daily follow up with Insurance companies...

POSITION: MEDICAL OFFICER 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 the medical a...

POSITION: MEDICAL OFFICER 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 Medical Officer Claims PA/RI Approver Reporting to Location Assistant Manager Claims Noida Educational Qualification BHMS, , BAMS Shift 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 admissibility of a claim by confirming the diagnosis and treatment d...

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 Chennai Educational Qualification Shift BHMS, , BAMS , BDS, B.Sc Nursing. Rotational Shift (for female employee shift ends at 7:30 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 admissibility ...

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...

We are hiring medical officers for cashless claims processing. Ideal candidates have 0-2 years in TPA/insurance with BAMS/BHMS. Strong medical knowledge and understanding of health policy terms are required.

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 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 120 countries. Visit us at www.accenture.com What would you do We help insurers redefine their customer expe...

Greeting from Medi assist TPA Pvt ltd. Hiring Medical officer for Insurance Claim processing Profile Location- Mumbai -Andheri East. Role - Medical officer Exp : 0-8 years Job description : * 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 Interested candidate can drop there resume in my Mail ID : varsha.kumari@mediassist.in We are looking for fresher or exp candidates BAMS, BHMS, B.sc Nursing, BPT mail id - varsha.kumari@mediassist.in Thanks & Regards Email: varsha.kumari@mediassist.in

Greeting from Medi assist TPA Pvt ltd. Hiring Medical officer for Insurance Claim processing Profile Location- Mumbai -Andheri East. Role - Medical officer Exp : 0-8 years Job description : * 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 Interested candidate can drop there resume in my Mail ID : varsha.kumari@mediassist.in We are looking for fresher or exp candidates BAMS, BHMS, B.sc Nursing, BPT mail id - varsha.kumari@mediassist.in Thanks & Regards Email: varsha.kumari@mediassist.in

Handling all debtor receivables, Solving all querieswhich are related to bill. Checking all IP files before dispatch. Checking the reasons of cancellation of billfree billdiscount billrefund bill. Making the changes of packages rates/tests rates as per the Company Agreement. Maintaining the Debtors aging report for OP & IP Communicate with the companies and TPA s for follow-up on the payments of bills. Interaction with the patients for payments of the dueswhich are not made by the TPA or company. Check the bottlenecks that arise in the payments and solve the problems regarding the bills Decisions making regarding payments high amount bills to reduce the outstanding of the company.

Process health insurance claims. Should have knowledge of cashless and reimbursement. Location - Chembur. Should have knowledge of excel. Graduation mandatory. Call or send your resumes on 8097516521. TPA experience Mandatory

Responsibilities: * Manage patient care in emergencies * Conduct claim investigations * Process health claims * Adjudicate claims fairly * Collaborate with TPAs on case resolution

Walk-in Drive || Clinical Doctors || Cotiviti Pune || IPDRG || Fresher & Experienced || Walk-in Date : 12th Jul 25 Walk-in Time : 10 AM to 2 PM Job Location : Pune Venue : COTIVITI INDIA PRIVATE LIMITED - Plot C Binarius Building 190 / 192 Plot C, Deepak Complex, National Games Road Off Golf Course, Shastrinagar, Yerawada, Pune, Maharashtra 411006 Eligibility : Fresher Eligibility Criteria : Medical Degree (MBBS or BAMS or BHMS or BPT) with Clinical experience or US Healthcare experience Strong analytical, critical thinking and problem solving skills Should have general knowledge on Medical Procedures, Conditions, illness & Treatment Practices Excellent verbal and written communication skill...

Job Description Coordinate with patients, insurance companies, and internal departments for smooth processing of cashless claims. Facilitate timely pre-authorization approvals and ensure all required documents are submitted. Maintain records of all TPA communications and claim documents. Handle queries from patients and their attendants regarding insurance claims. Follow up with TPAs/insurance companies for pending approvals and payments. Reconcile TPA receivables and ensure timely payment posting and recovery. Assist the billing team in preparing final bills for insured patients. Ensure compliance with hospital policies and insurance guidelines. Regularly update TPA software and internal MI...

Clients: 1. Relationship Management 2. Maintain TAT for all assignments 3. Maintain healthy relationship with insurance companies and TPA 4. Ensure Proper and Systematic documentation (folder management) 5. Claims Management (GPA and GTL claims Tracker, GMC Outstanding claims tracker) 100% adherence to the service design for clients as per the service design identified as below:-. Renewal activity (Intimation+calendar, Plan design + QCR etc., policy placement Monthly activity report to clients + Claims MIS + Claims UR + Health & Wellness letters + HR Connect Maintaining strong vendor relationships - Client, Insurer & TPA Client meetings with MOM being mandatory, (Monthly meetings compulsory ...

Manager-Segment Incharge The role is responsible for all tasks related to Processing and Settlement of claims, Monitoring TPA performance for the assigned business. The role includes managing the assigned specialized business handling of any one or more of the following activities: Settlement of Claims, Monitoring TPA performance based on defined KPI, System, Development, UAT, Portfolio Analysis, MIS/Compliance. If this is you, we are looking for you! Key Responsibilities Managing end-to-end claims. Requisitioning detailed information on all reported and settled Claims and monitoring performance of TPAs, evaluating performance of all TPA based on parameters of SLA with Regular Review of defi...

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...