406 Tpa Jobs - Page 3

Role: Executive - Account Management (CRM) Receive and check claim documents for completeness and advice employees regarding pending documents, if any. Track and control documents to ensure TAT of claims/cards as per SLA. Feedback from Insurers and Corporates. Additional revenue opportunities from existing Corporates. Non voice coordinator Respond to queries from the employees of the corporate through e-mails. Maintain weekly reports on claims and queries and the TAT of the same Escalate issues as per the escalation matrix. To attend to any other assignments assigned to you from time to time. Interested candidates share Cv on ronojoy.bagchi@mediassist.in

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 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 as per the terms and conditions within the TAT. Handle escalations and responding to mails accordingly. Work from Office only Pune address: C-Wing, First Floor, Manikchand Icon, Balkrishna Sakharam Dhole Patil Rd, Sangamvadi, Pune, Maharashtra 411001 Mumbai address: 4th floor, AARPEE Chambers, Off Andheri-Kurla Road Industrail Estate Marol, Andheri East, , Marol Cooperative Next To Times Square, Shagbaug, Gamdevi, Marol, Mumbai, Maharashtra 400059 Interested candidates can share their resumes to WhatsApp to 9632777628

Responsibilities and Duties. 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 insurance company. Efficiently and effectively handle grievance / issue raised by hospital staff & patients, escalate issue to the team leader, as when necessary. Follow-up and Updates to be given to the clients

KEY 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. ACADEMIC & PROFESSIONAL QUALIFICATIONS • BHMS/BAMS/BDS HR 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

Role & responsibilities Review the performance of all the key Pan India accounts and address the possible areas of improvement to enhance stakeholder satisfaction. Be a team player and leader by periodically reviewing the team's performance, setting goals and targets, and encouraging upskilling for efficient client management. Prepare interim performance reports for these accounts for both the internal and external stakeholders. Organize employee engagement sessions and upskilling for team members through training, coaching and any relevant mentoring sessions. Handle escalations and associated documentation if any. Managing the key stakeholders of the assigned accounts and ensuring their employees have a seamless claims experience by making sure the services provided are per the agreed SLA Essential Qualification: Any graduate degree from a recognized Indian University Recommended Experience: Having 5+ years of experience working with TPAs and Brokers in General Insurance, Life Insurance, or Health Insurance Experienced in managing large accounts and a team members in either a TPA/Broker/Insurance/hospital Excels in market analytics while thriving in a customer-oriented role Comfortable working in an environment that fosters inter-departmental coordination and contribution Interested candidate can share their resume to varsha.kumari@mediassist.in

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 have mill finish, anodized, powder coated, fabricated products manufactured under one roof. The profiles developed and manufactured are highly complex in nature, having critical die designs, challenging operations, involve highly skilled technicians, special machinery, and processes. This unit has two 8-inch press with a capacity of 16, 000 TPA, anodizing 2500 TPA, powder coating 3200 TPA along with various fabrication machinery like manual & robotic welding, CNC cutting & machining centers, Flaring & collaring, assembly lines serving for Building & Construction (25%), Industrial (40%), Exports (25%) Automotive (7%), and Solar segments (3%). The unit is increasing its business in automated warehouse system, premium anodizing finish products (exports), Solar energy and automotive (domestic) segments by increasing utilization of existing facility with additional shifts for continuous operation, setting up new fabrication facility, additional anodizing tanks and a brand-new extrusion press Job Challenges: Arranging service person within 24 hours if any machine breakdown. Ensure all spares are order on time & get on time, to be needed in case of breakdown. After Market handling service team is quite challenging. Packaging cost inflation is a big challenge. Import spares offer and getting material within short lead time through CHA. Key Result Areas KRA (Accountabilities) (Max 1325 Characters) Supporting Actions (Max 1325 Characters) KRA1 Material Availability To ensure the 100% availability of Materials to meet the Monthly Product dispatches as per customer requirements. To ensure 100% availability of right Quality & Quantity of Raw Materials as per planned & unplanned requirements. To priorities the procurement in accordance with the requirement & usages. KRA2 Material Cost Benching all materials to validate right cost procurement To ensure proper bid evaluation are made with competitive cost comparison. To keep a watch on price volatility of key inputs. Creating the competitive with suppliers. No Scrappage of Materials due to wrong ordering. Packaging materials cost saving by YOY compared to existing purchase price. Freight terms change without any price Impact. Consolidating export shipments for reducing freight cost KRA3 Supplier capability development To improve their capabilities and competitiveness in the areas of cost, quality, time, and technology as per our requirements to meet customer requirements. KRA4 Customer Centricity (Internal & External) 1. IR VS PO VS Receipt tracking - to ensure receipt of material on time for meeting customer requirement 2. Conversion IR to order within 5 days other than special and Capex. 3. AMC Renewals on time - to maintain PMs intact to avoid breakdowns to meet customer production. 4. To Achieve OTIF target (Incoming Materials) of 100%. 5. Dual source for all high value/volume packaging materials for avoid interruption in supply 6. On time Import Clearance within 5 Days. 7. Supplier delivery performance monitoring 8. Pending order status follow-up with supplier to alert their pending for supply to us. 9. Service jobs sending material to supplier and getting back follow-up done for tracking. KRA5 Capital Goods Procurement To ensure Capital goods purchase within the sanctioned amount. To conduct multiple technical and commercial negotiations, to procure the best equipment at most competitive rate with right time. KRA6 Working Capital Management To obtain increased Credit period and try to restrict advance payment. To co-ordinate with Accounts dept for timely payment & if any issues. Supplier Credit terms increase Split delivery for High Value Materials to improve cash flow. Advance Payment supplier convert to Credit terms minimum 5 Supplier. Inventory reduction by 5% YOY Periodic reconciliation of suppliers

Job Title: Medical Underwriter (On-site) Location: Gurgaon Duration: Contractual Salary: 60,000 - 75,000 per month Joining: Immediate Job Overview: We are hiring experienced Medical Underwriters for Gurgaon . The ideal candidates will be responsible for evaluating medical risks, reviewing applications, and making underwriting decisions based on medical history and policy guidelines. Key Responsibilities: Assess and underwrite medical insurance applications based on industry standards and company guidelines. Analyze medical reports, diagnostic tests, and case histories to determine risk exposure. Make underwriting decisions based on pre-existing diseases (PED), medical conditions, and other risk factors. Work closely with medical professionals and internal teams for case discussions. Ensure compliance with underwriting policies and regulatory guidelines. Document underwriting decisions and provide clear justifications for approvals, rejections, or modifications in coverage. Requirements: Experience: Minimum 3+ years in Medical Underwriting (Health or Life Insurance). Qualifications: MBBS, BHMS, BAMS, BDS Skills: Strong knowledge of medical underwriting principles and risk assessment. Ability to analyze and interpret medical reports. Excellent decision-making and communication skills. Understanding of regulatory and compliance requirements. Proficiency in underwriting tools and software. Work Schedule: Days: Monday to Saturday Hours: 10 AM 7 PM (or as per company requirements) CTC- 4.5 LPA To 8 LPA

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 a 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 as per the terms and conditions within the TAT. Handle escalations and respond to mails accordingly. Interested Candidates can share their resumes to kishan.dwivedi@mediassist.in or WhatsApp on 9795919025

Sr. Executive IPD Billing (Night) Kailash Hospital, Jewar KAILASH HOSPITAL, JEWAR (A Unit of Kailash Healthcare Limited) PLOT NO. Manage and oversee end-to-end IPD (In-Patient Department) billing processes, including patient admission, discharge, and final bill generation. Ensure accuracy in billing by verifying patient treatment records, doctor consultations, procedures, investigations, and room charges. Coordinate with clinical and non-clinical departments to collect necessary documents for smooth billing operations. Handle queries related to insurance approvals, TPA documentation, and ensure timely submission and follow-up for payments. Reconcile daily billing transactions and ensure proper recording in the hospital’s billing system.

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 own vehicle to travel in various hospital assigned to him Candidate must be computer literate and shall possess skills including but not limited to Microsoft Office Suite and navigating through internet Portals. Candidate will be mapped with minimum 20 hospitals for physical visit based on the location and city. Additionally, 20-25 Hospitals for Case Audit and Management Proficient in handling complex situations and customers. Candidate must possess clinical knowledge for evaluation of medical files Sound knowledge of surgical procedures and disease cure management Interested candidates can share their CV on priyanka.shrivatsa@icicilombard.com or contact on 9664261933.

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 own vehicle to travel in various hospital assigned to him Candidate must be computer literate and shall possess skills including but not limited to Microsoft Office Suite and navigating through internet Portals. Candidate will be mapped with minimum 20 hospitals for physical visit based on the location and city. Additionally, 20-25 Hospitals for Case Audit and Management Proficient in handling complex situations and customers. Candidate must possess clinical knowledge for evaluation of medical files Sound knowledge of surgical procedures and disease cure management Interested candidates can share their CV on priyanka.shrivatsa@icicilombard.com or contact on 9664261933.

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) Minimum Premium functionality (Prem that will keep policy active even if cash value is below threshold) h. UL product calculations: COI, Monthly Load, Per Thousand Load, Policy Fee, Payment Fee 7702/7702A - basic understanding of tax limits on premiums paid Working with/coordinating resources helping with the conversion projects/task related activities (not an active project manager, but will require coordination/following up with people in various areas) Working with recon forms, reports, and processes in Access DB and Excel. Experience using VBA with Excel reporting Compiling progress and reporting on status of recon activities Independently working to complete a task with little direction (after understanding the objective and path froward) JIRA experience Need to analyze complex data, identify patterns, and develop solutions. Able to analyze the calculation differences between 2 Admin systems for compare and solution to match them. Must be able to explain technical concepts clearly and concisely to both technical and non-technical audiences Need to be able to evaluate information from various sources and analyze the problem to find solution. Experience / Skills 15+ years work experience in successful delivery of complex policy conversion projects end to end Strong understanding of data conversion processes, data structures, data mapping Life Annuity Insurance domain knowledge in a TPA environment is a must. Knowledge and experience with project management methodologies (Agile/Waterfall). Excellent written and verbal communication skills, including the ability to effectively communicate with both technical and non-technical audiences. Ability to identify and resolve business issues and challenges related to data conversion Strong understanding of data quality principles and best practices. Familiarity with life insurance systems, regulations, and industry standards

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 maintain data quality controls and validation processes to ensure the accuracy and completeness of converted data. Effectively communicate project status, risks, and issues to stakeholders, both internally and externally. Identify and resolve technical issues and challenges related to data conversion. Manage risks, blockers, and challenges proactively, ensuring timely delivery on commitments and maintaining full stakeholder transparency Identify and implement process improvements to enhance efficiency and effectiveness of data conversion projects. Identifies process and procedure enhancements to drive efficiency and improve customer satisfaction. Experience in configuring new product launches in Life and Annuity Domain, enhancing existing products. Eagerness to learn new digital technologies and cloud platform; suggest better way of doing things in the platform. Experience in SDLC methodologies. Experience / Skills 15+ years work experience in successful delivery of complex policy conversion projects end to end Strong understanding of data conversion processes, data structures, data mapping, ETL tools, and database management systems. Life Annuity Insurance domain knowledge in a TPA environment is a must. Knowledge and experience with project management methodologies (Agile/Waterfall). Excellent written and verbal communication skills, including the ability to effectively communicate with both technical and non-technical audiences. Ability to identify and resolve technical issues and challenges related to data conversion Strong understanding of data quality principles and best practices. Familiarity with life insurance systems, regulations, and industry standards Experience with project management methodologies and tools.

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 missing documents Support audit and compliance teams with documentation and reports Shortfalls & Queries Required Skills & Competencies: Strong understanding of health insurance policies and TPA workflows Familiarity with medical terminology and coding (ICD, CPT) Attention to detail and analytical thinking Proficiency in claims processing software and MS Office tools Good written and verbal communication skills Ability to manage high volumes under pressure Commitment to confidentiality and data protection norms Qualifications & Experience: Graduate in any discipline (preferably life sciences or healthcare) 1-3 years of experience in claims processing within a TPA or insurer

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, deductions and provide status updates clearly to customers and agents. Escalate unresolved issues following the defined escalation matrix to get quicker resolutions & communicate the same to the customers. Receive and verify the completeness of claim documents; advise on any pending or missing documents. Coordinate with the inward team for claim registration and ensure proper documentation flow. Allocate claims to the processing team for timely action. Liaise with the enrollment team to ensure policy registration for both cashless and reimbursement claims. Allocate claims to the processing team for timely action. Liaise with the enrollment team to ensure policy registration for both cashless and reimbursement claims. Monitor and follow up on all queries using claim numbers until full resolution. Maintain weekly reports detailing claims, queries, and their respective TATs. Key Qualifications and Skills : Any graduate - B Com/BBA/BCA/BA/B Sc. Strong interpersonal and communication skills (both verbal and written) Problem solving & escalation handling Teamwork & adaptability Interested candidates can share their CVs to sanjukta.agarwal@mediassist.in

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. Handle documentation for empanelment and assist in negotiation of service rates. Operations Coordination: Coordinate with internal teams to ensure smooth patient processing for insured customers. Monitor billing, claim submissions, and dispute resolutions with TPAs. Client Servicing: Manage service-level expectations with TPAs and clients. Address queries and complaints related to insurance processes or coverage. Target Achievement: Meet monthly/quarterly sales targets from TPA and insurance channel. Monitor and report key performance metrics (e.g., number of empanelled insurers, TPA-driven footfall). Awareness & Promotion: Conduct sessions/workshops with TPAs or HR teams of corporates to promote diagnostic services. Assist marketing team in promoting health packages tailored for insured customers. Compliance & Reporting: Ensure adherence to IRDAI regulations and internal policies. Maintain MIS reports related to insurance billing, TPA revenue, and client performance. Qualifications: 1. Bachelor's degree in any discipline (MBA Sales & Marketing) 2. Insurance industry experience (TPA, health insurance, or related field) preferred 3. Understanding of life insurance regulations (IRDAI) and TPA operations Skills: 1. Experience in the healthcare or insurance industry 2. Knowledge of diagnostic services and TPA operations 3. Strong communication and relationship-building skills 4. Sales and business development skills 5. Negotiation and contract management skills 6. Analytical and problem-solving skills 7. Ability to work independently and manage multiple stakeholders 8. Knowledge of diagnostic services and healthcare industry 9. Familiarity with MIS reporting and data analysis Role & responsibilities

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 escalate critical or unresolved issues to the appropriate department or supervisor. • Adhere to company policies, procedures, and compliance guidelines. Key Requirements A minimum of 1-3 years of experience in a call center environment, preferably in a healthcare or medical insurance setting. Strong knowledge of medical terminology, insurance claim procedures, and billing codes. Ability to contribute to revenue basis cross sell. • Excellent verbal and written communication skills. Ability to handle high call volumes and prioritize customer needs effectively. Strong problem-solving and decision-making abilities. Attention to detail and accuracy in data entry and documentation. Exceptional customer service skills with a friendly and professional demeanor. Proficiency in using computer systems, including customer relationship management (CRM) software and Microsoft Office Suite. • Ability to work effectively in a team-oriented environment. • Flexibility to work shifts as per business requirements. Key Requirements Education & Certificates • Any Life science, Paramedical, Medical Graduates and Postgraduates (Pharmacy, Physiotherapy, Nursing, Health education) or equivalent degree Interested candidates can walkin for the interview directly in the office Second floor, Logix Infotech Park, Sector-59, Noida from Monday to Friday from 11 am to 1:30 PM

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 develop innovative ideas break through advancements and innovative solutions to problems Should be aware of all the Corporate Tariffs as agreed and ensure an error free billing from our end Should be able to prepare a complete billing kit and transfer the same to the submissions department as per the TAT Liaisoning Responsible to have regular interaction with consultants in regard to the bills and their payments. Responsible to coordinate and maintain good relations with corporate clients, patients, doctors, and public. Feedback to the Management Responsible for providing feedback to the management on customer/ patient requirements/expectations by maintaining constant relation with patients, visiting operational environment; conducting surveys etc.

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, including discharge, transfer, and admittance forms. Health unit coordinators also often act as a liaison between patients, nurses, doctors, and different departments within the hospital or care facility. Other tasks can include scheduling procedures like tests and x-rays, transcribing doctors' orders, and ordering medical and office supplies. Health unit coordinators are a part of a broader medical team, and are expected to keep pace with the potentially hurried and stressful environments in which they work. Heath care coordinators work closely with patients on a one-on-one basis. They provide guidance, support, and advice to patients dealing with complex medical issues. These professionals can help their clients navigate through a medical care scenario that may involve a variety of different doctors and treatment methods. Duties can include scheduling appointments, assisting with major decisions, helping patients understand complex medical information, evaluating care quality, and working with other health care professionals to ensure that the correct path is being taken. To Properly Intimate the consultants about credit limits. To make sure the Surgery details, Summary follow ups with consultants. To maintain the good rapport with consultants. Follow ups for consultant Payments. Reporting to Head of the department. Job Title: Executive - Credit Recovery Role & responsibilities: Marking Despatch details & updating claim details in KMH Internals Combinedly doing OS reconciliations as required with TPA/Corporates Sending out monthly OS statements / letters to TPA. / Corporates as may be agreed from timeline Marking Despatch details & updating claim details in KMH Internals Delivering Doctor's cheque with in time line Receiving acknowledgements for cheques submission from doctor & closing the entry in KMH DERN Collecting our Hospital other unit bills & submitting at agreed corporates. Follow up with TPA/Corporates for refund of collectible disallowance Regular follow up for renewing for MOU with TPA/Corporates Submitting Hospital Revised Tariff list to TPA / Insurance Reporting to Senior Officer - Credit Recovery Preferred candidate profile: Any Degree Holder (UG/PG Arts & Science) A minimum of 2 to 10 years of experience in Insurance. Working knowledge of Insurance standards Proficient in Microsoft Office. Strong attention to details. Perks and benefits: ESI, EPF Gratuity Contact person: Naveenkumar - HR - omrhr@drkmh.com

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 9080276094

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 data entry, verification, and maintaining accurate patient records, as well as following up on pending approvals and addressing any discrepancies. Additionally, you will assist in client communication and backend claim management while ensuring adherence to internal and regulatory protocols. The qualifications for this role include a minimum of 1 year of experience in any field (preferably TPA/Insurance/Healthcare background), along with a graduation or 12+3 diploma. Strong communication and organizational skills are essential, as well as proficiency in basic computer applications and data entry processes. If you are ready to take on this challenging yet rewarding role in our dynamic organization, we welcome you to apply and be a part of our dedicated team in Ahmedabad.,