Get alerts for new jobs matching your selected skills, preferred locations, and experience range.
2.0 - 5.0 years
4 - 7 Lacs
Vadodara
Work from Office
1. Claims Administration and Management Coordinate with branches in resolving the claims within the set SLAs / TATs; resolve any issue / concern Review the claim settlement status daily; guide team in addressing claims which exceed TAT; seek clarifications and resolve issues to ensure that the claims are processed at the earliest Conduct reviews (OFR / CFR) to identify problems within claims settlement and propose solutions; discuss the same with the superior and seek feedback / assistance in the same 2. TPA Management Connect with the TPA vendors and invite quotes; assess information like loss ratio/ service expectations, etc. ; Negotiate with the TPAs on different aspects; assess loss ratio and drive action to arrest the same by seeking assistance from underwriting team on premium / risk assessment, etc. Share policy details, benefits and nuances; train them on the specifics of the policy and how to administer the payment / claim processing 3. Report Generation (MIS) Generate MIS on set frequency and apprise relevant stakeholder of the claim status within the team Provide clarifications / reasons in case of delayed claim settlement 4. Team Training Lead training efforts for upskilling of team to better deliver in terms of claims administration, settlement, issue resolution, etc. Provide directions in planning and coordination of training efforts for team Motivate and retain key talent in the team 5. Process Improvement Collaborate with technology teams internally to drive implementation of tech-based platforms for claims processing, etc. Support different internal teams to come up with innovations / process improvement and drive its implementation for effective claims management 6. Team Development and Engagement Establish location wise performance expectations and evaluation metrics, and regularly review location wise performance Share information regarding business and key developments with the team proactively; guide them in utilizing their skills in the best possible manner Understand team grievances and guide for their effective resolution Identify and create development opportunities for team members to enhance functional knowledge
Posted 1 week ago
5.0 - 8.0 years
8 - 12 Lacs
Noida
Work from Office
Job Profile: Background of having experience of dealing with insurance companies to settle the claims and working upon taking insurance policies at optimum cost preferably in group of companies. Person should have minimum 5-7 years of experience handling end to end process of managing all types of insurance instruments. Ability to prepare and present- Allocate MIS or related work. Commercial background and working on SAP. Good knowledge of Excel and reasonable communication/liasoning skills.
Posted 1 week ago
3.0 - 7.0 years
2 - 5 Lacs
Siliguri, Katihar
Work from Office
Handling TPA related all process from billing to co-ordinate with TPA companies. Maintaining & uploading patient's files on the portal. Handling billing Department, Implants bill updating & reconciliation.
Posted 2 weeks ago
0.0 - 1.0 years
3 - 3 Lacs
Bengaluru
Work from Office
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 disha.raman@mediassist.in or WhatsApp on 8904968911
Posted 2 weeks ago
1.0 - 5.0 years
1 - 4 Lacs
Rajkot
Work from Office
Job description: Counsels patients on the reports given by the doctor. Co-ordination with Consultant / Centre Head on daily basis based on surgery advice and conversion. Maintain checklist as per the instruction given by the management. (Like Cataract, FFA, etc.,) Explain the tariff of the concern procedures / investigations to patients in detail. Maintain Counselor report on daily basis (Advise, Conversion and Patient wise details). Co-ordinating with TPA / Insurance Dept (Sending Pre-authorization, Getting Approval, Billing). Cross verifying all the relevant documents related to Credit billing before surgery. Maintaining Counselor Summary for all counseled patients. Doing Tele Calling and maintaining report for the same. Preparing Surgery list and handing over the same to concern doctor and centre head, one day before the surgery. Follow up with patients at all stages. Explain the tariff of the concern procedures / investigations to patients in detail. For More details contact HR - drop your cv on mariya.a@dragarwal.com or WhatsApp on 9712687709
Posted 2 weeks ago
4.0 - 8.0 years
4 - 4 Lacs
Manesar
Work from Office
Preferred candidate profile : Graduate with Minimum 4+ Years experience as Dispatch Executive in Hospital For inquiries, kindly reach out to - Mr. Hament, at 7011324972 or via email at hament.gautam@fortishealthcare.com
Posted 2 weeks ago
0.0 - 5.0 years
0 - 3 Lacs
Noida
Work from Office
Roles and Responsibilities Improvement in overall TAT of preauthorization/ query/ discharge Minimal denials for admission, not justified/ prior information of suspected denials/ Timely information to all the stake holders for denials Audit of all TPA bills before uploading for cashless approvals Required corrections in summary , bill, OT sheets, etc. Regular maintenance of outstanding data/ follow up with TPA for enhancements/ counselling/patient for SI MIS: Maintain and generate process related data as and when required by the HOD Update patients and doctors about status of authorization Uphold basic standards of cleanliness of work place area as well as self-grooming, and demonstrate use of standard phrases and telephone etiquette during all points of customer interface .
Posted 2 weeks ago
0.0 - 1.0 years
1 - 5 Lacs
Bengaluru
Work from Office
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 Accenture is a global professional services company with leading capabilities in digital, cloud and security.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. We embrace the power of change to create value and shared success for our clients, people, shareholders, partners and communities.Visit us at www.accenture.com What would you do We help insurers redefine their customer experience while accelerating their innovation agenda to drive sustainable growth by transforming to an intelligent operating model. Intelligent Insurance Operations combines our advisory, technology, and operations expertise, global scale, and robust ecosystem with our insurance transformation capabilities. It is structured to address the scope and complexity of the ever-changing insurance environment and offers a flexible operating model that can meet the unique needs of each market segment.Claim processing team collects end-end data dataDevelop and deliver business solutions that support the claims process across its lifecycle, including first notice of loss, claims investigation, payment administration or adjudication, provider reimbursement (health care), subrogation and recovery. What are we looking for Ability to establish strong client relationshipAbility to handle disputesAbility to manage multiple stakeholdersAbility to meet deadlinesAbility to perform under pressure- Roles and Responsibilities: In this role you are required to solve routine problems, largely through precedent and referral to general guidelines Your primary interaction is within your own team and your direct supervisor In this role you will be given detailed instructions on all tasks The decisions that you make impact your own work and are closely supervised You will be an individual contributor as a part of a team with a predetermined, narrow scope of work Please note that this role may require you to work in rotational shifts Qualification Any Graduation
Posted 2 weeks ago
3.0 - 4.0 years
5 - 6 Lacs
Gurugram
Work from Office
About the Role The Sr BA role is part of the Territory Planning & Analytics (TP&A) team in GSSO. The TP&A team is focused on designing the optimal territory investment, design and alignment strategy to maximize Sales (and Services) productivity. This is an internal consulting team that partners with Gartner s sales leaders to determine where, when, and how the company should direct its substantial investment in incremental sales professionals. The individual in this role will collaborate with sales leaders to guide strategic investment and go-to-market decisions at regional and global levels. What you will do: Stakeholder Management & Collaboration Partner with Gartner s sales leaders to define growth needs and design optimal teams that align with corporate sales strategy to achieve business growth. Independently and fully support one of the sales regions within Gartner Monitor performance / status vs. plan, and proactively manage expectations of internal and external stakeholders re: risks, delivery, etc. Lead preparation and development of executive-level meeting material and presentations. Territory Operations Analyze internal and external data to identify trends and characterize market opportunity at various levels (e.g., region, industry, local area, company). Own and execute medium complexity analytical projects to analyse internal and external client, prospect, and market data to provide senior sales leaders information and advice to maximize sales revenue. Drive ad hoc analysis to facilitate decision-making for Gartner s sales leaders and C-level executives. Leads development and execution of workplan, including key steps, milestones, resource requirements, KPIs, etc. Consistently presents data/information in a way that audience can relate to; is independently able to efficiently present several different arguments in clear support of a position that has a strong effect. What you will need: 3-4 years of management consulting experience required. Exceptional analytical skills, including high proficiency with Microsoft Excel, data analysis, etc. Experience of working with non-conforming data sets and generating analytical insights. Exceptionally strong written and verbal communication skills to enable direct and frequent conversations with senior leaders in Gartner. Demonstrated ability to form relationships with and influence senior leaders. Ability to deal with ambiguity and independently own a project from start to finish Ability to see past the numbers , adapt to change, and effectively explain concepts to audiences with varying levels of experience/understanding What you will get: Competitive salary, generous paid time off policy, charity match program, Group Medical Insurance, Parental Leave, Employee Assistance Program (EAP) and more! Collaborative, team-oriented culture that embraces diversity Professional development and unlimited growth opportunities
Posted 2 weeks ago
4.0 - 7.0 years
3 - 7 Lacs
Mumbai
Work from Office
Prudential s purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured, for our people, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and we support our people s career ambitions. We pledge to make Prudential a place where you can Connect, Grow, and Succeed. Prudential (UK) in partnership with the HCL group plans to set-up a standalone Indian health insurance company to address the growing healthcare needs of the Indian consumer. This joint venture will combine Prudentials global expertise in insurance and financial services with HCL Group s experience in technology and healthcare solutions. Prudential, with its longstanding presence in India, already operates two leading businesses in life insurance and asset management with the ICICI Group. Prudential was also the proud sponsor of the 1983 Cricket World Cup, India s first World Cup Victory! Prudential Health India is a Zero to One team undertaking a no-legacy, greenfield health insurance deployment in India, building journeys that truly empathize with the customer and offer a differentiated experience. o To partner with us in this mission, we are looking for a talented Specialist - Grievance Desk Escalations to join our Customer Service team in Mumbai. Your typical week might include the following: Ensuring timely, fair, and effective handling of grievances received across PHI escalation touchpoints. Handling complaints received via social media, regulatory portals (Bima Bharosa, NCH, etc), as per the defined turn-around-time. Ensure timely handing of Ombudsman and legal cases as well. Act as a voice of customer for PHI by raising timely red flags which shall be instrumental in fixing gaps and enhancing service experience. Work collaboratively with internal and external teams like Distribution, Branch, Claims, Underwriting, Legal, Medical services TPA etc. to expedite complaint resolution. Be aware of all compliance related requirements. Participate in closure of process enhancement recommendations, risk identifications along with a future fix. Participate and drive service recovery initiatives to ensure enhanced customer experience and re-instil customer trust in PHI. You could be the right candidate if you: Have 6-7 years of experience with 4-5 years of complaints handling experience health insurance, general insurance or financial services industry. Hae strong knowledge of IRDA guidelines, compliance protocols and insurance related grievance mechanisms. Have ability to manage diverse teams and stakeholders, regulatory bodies and ensure cross-functional collaboration. Possess excellent communication and negotiation skills. Have a Bachelor s degree from a recognized University Are a highly driven individual who goes that extra mile to deliver an outstanding product to the business team and end users/customers. Have demonstrated the ability to work in a fast paced and hyper-growth environment using agile methodologies where Customer and Distributor expectations can be changing This could be the gig for you if you Are passionate about bringing truly consumer centric ideas and products into reality and have an attentive ear listen to new ideas. Thrive in environments that celebrate co-creation and collaboration. Are passionate about leveraging new age digital tools and technologies to transform customer experience. Like to work in a culture where everyone can see what others are doing Take help from others when stuck and encourage others when there are setbacks Take full responsibility for your team s contribution output while thinking wing to wing across the organization; to solve for the customer. What can make you extra special if you Have walked extra mile in solving business problems by adopting offbeat path Proven track record of exceeding Service level expectations from stakeholders. Demonstrate visible leadership supporting colleagues in a diverse, inclusive, and collaborative team environment. Be a team player who is goal orientated, committed, and an advocate and early adopter of change. A proven track record working in complex business environments executing and delivering initiatives across multiple domains, stakeholder groups and technology solutions. We are keen to listen to your story; doesn t matter if you tell these stories with a sigh or with excitement. We respect both versions. Truly. If you think this is the one for you, drop in a line with your story at careers@prudentialhealth.in . We are eager to catch-up! Prudential is an equal opportunity employer. We provide equality of opportunity of benefits for all who apply and who perform work for our organisation irrespective of sex, race, age, ethnic origin, educational, social and cultural background, marital status, pregnancy and maternity, religion or belief, disability or part-time / fixed-term work, or any other status protected by applicable law. We encourage the same standards from our recruitment and third-party suppliers taking into account the context of grade, job and location. We also allow for reasonable adjustments to support people with individual physical or mental health requirements.
Posted 2 weeks ago
4.0 - 7.0 years
4 - 8 Lacs
Mumbai
Work from Office
Prudential s purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured, for our people, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and we support our people s career ambitions. We pledge to make Prudential a place where you can Connect, Grow, and Succeed. Prudential (UK) in partnership with the HCL group plans to set-up a standalone Indian health insurance company to address the growing healthcare needs of the Indian consumer. This joint venture will combine Prudentials global expertise in insurance and financial services with HCL Group s experience in technology and healthcare solutions. Prudential, with its longstanding presence in India, already operates two leading businesses in life insurance and asset management with the ICICI Group. Prudential was also the proud sponsor of the 1983 Cricket World Cup, India s first World Cup Victory! Prudential Health India is a Zero to One team undertaking a no-legacy, greenfield health insurance deployment in India, building journeys that truly empathize with the customer and offer a differentiated experience. o To partner with us in this mission, we are looking for a talented Specialist - Social Media Escalations to join our Customer Service team in Mumbai. Your typical week might include the following: Ensuring timely, fair, and effective handling of grievances received across social media platforms. Handing grievances received via internal escalation touchpoints, , regulatory portals (Bima Bharosa, NCH, etc), as per the defined turn-around-time. Ensure timely handing of Ombudsman and legal cases as well. Act as a voice of customer for PHI by raising timely red flags which shall be instrumental in fixing gaps and enhancing service experience. Work collaboratively with internal and external teams like Distribution, Branch, Claims, Underwriting, Legal, Medical services TPA etc. to expedite complaint resolution. Be aware of all compliance related requirements. Participate in closure of process enhancement recommendations, risk identifications along with a future fix. Participate and drive service recovery initiatives to ensure enhanced customer experience and re-instil customer trust in PHI. You could be the right candidate if you: Have 6-7 years of experience with 4-5 years of complaints handling experience health insurance, general insurance or financial services industry. Have strong knowledge of IRDA guidelines, compliance protocols and insurance related grievance mechanisms. Have ability to manage diverse teams and stakeholders, regulatory bodies and ensure cross-functional collaboration. Possess excellent communication and negotiation skills. Have a Bachelor s degree from a recognized University Are a highly driven individual who goes that extra mile to deliver an outstanding product to the business team and end users/customers. Have demonstrated the ability to work in a fast paced and hyper-growth environment using agile methodologies where Customer and Distributor expectations can be changing This could be the gig for you if you Are passionate about bringing truly consumer centric ideas and products into reality and have an attentive ear listen to new ideas. Thrive in environments that celebrate co-creation and collaboration. Are passionate about leveraging new age digital tools and technologies to transform customer experience. Like to work in a culture where everyone can see what others are doing Take help from others when stuck and encourage others when there are setbacks Take full responsibility for your team s contribution output while thinking wing to wing across the organization; to solve for the customer. What can make you extra special if you Have walked extra mile in solving business problems by adopting offbeat path Proven track record of exceeding Service level expectations from stakeholders. Demonstrate visible leadership supporting colleagues in a diverse, inclusive, and collaborative team environment. Be a team player who is goal orientated, committed, and an advocate and early adopter of change. A proven track record working in complex business environments executing and delivering initiatives across multiple domains, stakeholder groups and technology solutions. We are keen to listen to your story; doesn t matter if you tell these stories with a sigh or with excitement. We respect both versions. Truly. If you think this is the one for you, drop in a line with your story at careers@prudentialhealth.in . We are eager to catch-up! Prudential is an equal opportunity employer. We provide equality of opportunity of benefits for all who apply and who perform work for our organisation irrespective of sex, race, age, ethnic origin, educational, social and cultural background, marital status, pregnancy and maternity, religion or belief, disability or part-time / fixed-term work, or any other status protected by applicable law. We encourage the same standards from our recruitment and third-party suppliers taking into account the context of grade, job and location. We also allow for reasonable adjustments to support people with individual physical or mental health requirements.
Posted 2 weeks ago
6.0 - 7.0 years
2 - 6 Lacs
Mumbai
Work from Office
Prudential s purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured, for our people, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and we support our people s career ambitions. We pledge to make Prudential a place where you can Connect, Grow, and Succeed. Prudential (UK) in partnership with the HCL group plans to set-up a standalone Indian health insurance company to address the growing healthcare needs of the Indian consumer. This joint venture will combine Prudentials global expertise in insurance and financial services with HCL Group s experience in technology and healthcare solutions. Prudential, with its longstanding presence in India, already operates two leading businesses in life insurance and asset management with the ICICI Group. Prudential was also the proud sponsor of the 1983 Cricket World Cup, India s first World Cup Victory! Prudential Health India is a Zero to One team undertaking a no-legacy, greenfield health insurance deployment in India, building journeys that truly empathize with the customer and offer a differentiated experience. o To partner with us in this mission, we are looking for a talented Specialist - Grievance Desk Escalations to join our Customer Service team in Mumbai. Your typical week might include the following: Ensuring timely, fair, and effective handling of grievances received across PHI escalation touchpoints. Handling complaints received via social media, regulatory portals (Bima Bharosa, NCH, etc), as per the defined turn-around-time. Ensure timely handing of Ombudsman and legal cases as well. Act as a voice of customer for PHI by raising timely red flags which shall be instrumental in fixing gaps and enhancing service experience. Work collaboratively with internal and external teams like Distribution, Branch, Claims, Underwriting, Legal, Medical services TPA etc. to expedite complaint resolution. Be aware of all compliance related requirements. Participate in closure of process enhancement recommendations, risk identifications along with a future fix. Participate and drive service recovery initiatives to ensure enhanced customer experience and re-instil customer trust in PHI. You could be the right candidate if you: Have 6-7 years of experience with 4-5 years of complaints handling experience health insurance, general insurance or financial services industry. Hae strong knowledge of IRDA guidelines, compliance protocols and insurance related grievance mechanisms. Have ability to manage diverse teams and stakeholders, regulatory bodies and ensure cross-functional collaboration. Possess excellent communication and negotiation skills. Have a Bachelor s degree from a recognized University Are a highly driven individual who goes that extra mile to deliver an outstanding product to the business team and end users/customers. Have demonstrated the ability to work in a fast paced and hyper-growth environment using agile methodologies where Customer and Distributor expectations can be changing This could be the gig for you if you Are passionate about bringing truly consumer centric ideas and products into reality and have an attentive ear listen to new ideas. Thrive in environments that celebrate co-creation and collaboration. Are passionate about leveraging new age digital tools and technologies to transform customer experience. Like to work in a culture where everyone can see what others are doing Take help from others when stuck and encourage others when there are setbacks Take full responsibility for your team s contribution output while thinking wing to wing across the organization; to solve for the customer. What can make you extra special if you Have walked extra mile in solving business problems by adopting offbeat path Proven track record of exceeding Service level expectations from stakeholders. Demonstrate visible leadership supporting colleagues in a diverse, inclusive, and collaborative team environment. Be a team player who is goal orientated, committed, and an advocate and early adopter of change. A proven track record working in complex business environments executing and delivering initiatives across multiple domains, stakeholder groups and technology solutions. We are keen to listen to your story; doesn t matter if you tell these stories with a sigh or with excitement. We respect both versions. Truly. If you think this is the one for . We are eager to catch-up!
Posted 2 weeks ago
6.0 - 7.0 years
3 - 7 Lacs
Mumbai
Work from Office
Prudential s purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured, for our people, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and we support our people s career ambitions. We pledge to make Prudential a place where you can Connect, Grow, and Succeed. Prudential (UK) in partnership with the HCL group plans to set-up a standalone Indian health insurance company to address the growing healthcare needs of the Indian consumer. This joint venture will combine Prudentials global expertise in insurance and financial services with HCL Group s experience in technology and healthcare solutions. Prudential, with its longstanding presence in India, already operates two leading businesses in life insurance and asset management with the ICICI Group. Prudential was also the proud sponsor of the 1983 Cricket World Cup, India s first World Cup Victory! Prudential Health India is a Zero to One team undertaking a no-legacy, greenfield health insurance deployment in India, building journeys that truly empathize with the customer and offer a differentiated experience. o To partner with us in this mission, we are looking for a talented Specialist - Social Media Escalations to join our Customer Service team in Mumbai. Your typical week might include the following: Ensuring timely, fair, and effective handling of grievances received across social media platforms. Handing grievances received via internal escalation touchpoints, , regulatory portals (Bima Bharosa, NCH, etc), as per the defined turn-around-time. Ensure timely handing of Ombudsman and legal cases as well. Act as a voice of customer for PHI by raising timely red flags which shall be instrumental in fixing gaps and enhancing service experience. Work collaboratively with internal and external teams like Distribution, Branch, Claims, Underwriting, Legal, Medical services TPA etc. to expedite complaint resolution. Be aware of all compliance related requirements. Participate in closure of process enhancement recommendations, risk identifications along with a future fix. Participate and drive service recovery initiatives to ensure enhanced customer experience and re-instil customer trust in PHI. You could be the right candidate if you: Have 6-7 years of experience with 4-5 years of complaints handling experience health insurance, general insurance or financial services industry. Have strong knowledge of IRDA guidelines, compliance protocols and insurance related grievance mechanisms. Have ability to manage diverse teams and stakeholders, regulatory bodies and ensure cross-functional collaboration. Possess excellent communication and negotiation skills. Have a Bachelor s degree from a recognized University Are a highly driven individual who goes that extra mile to deliver an outstanding product to the business team and end users/customers. Have demonstrated the ability to work in a fast paced and hyper-growth environment using agile methodologies where Customer and Distributor expectations can be changing This could be the gig for you if you Are passionate about bringing truly consumer centric ideas and products into reality and have an attentive ear listen to new ideas. Thrive in environments that celebrate co-creation and collaboration. Are passionate about leveraging new age digital tools and technologies to transform customer experience. Like to work in a culture where everyone can see what others are doing Take help from others when stuck and encourage others when there are setbacks Take full responsibility for your team s contribution output while thinking wing to wing across the organization; to solve for the customer. What can make you extra special if you Have walked extra mile in solving business problems by adopting offbeat path Proven track record of exceeding Service level expectations from stakeholders. Demonstrate visible leadership supporting colleagues in a diverse, inclusive, and collaborative team environment. Be a team player who is goal orientated, committed, and an advocate and early adopter of change. A proven track record working in complex business environments executing and delivering initiatives across multiple domains, stakeholder groups and technology solutions. We are keen to listen to your story; doesn t matter if you tell these stories with a sigh or with excitement. We respect both versions. Truly. If you think this is the one for . We are eager to catch-up!
Posted 2 weeks ago
2.0 - 3.0 years
5 - 6 Lacs
Mumbai
Work from Office
Role & responsibilities Sending Monthly Reports to insurance co (new additions, deletions etc) He/she will be a SPOC for all employees with reference to handling queries regarding their medical benefits/hospitalizations To close Service tickets pertaining to medical matters within a specified TAT Managing emergency support to employees Liasing closely with the insurance company for faster processing of claims Monitoring CD balance and replenishing the same in co-ordination with the accounts team
Posted 2 weeks ago
5.0 - 8.0 years
4 - 6 Lacs
Hyderabad
Work from Office
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 under tight deadlines. Excellent communication skills for effective interaction with customers (patients), providers (hospitals), and insurers. Perks and benefits As per industry
Posted 2 weeks ago
2.0 - 4.0 years
1 - 2 Lacs
Jaipur
Work from Office
Responsibilities: Process customer orders accurately and efficiently Maintain accurate records and reports on billing activities Prepare and send out invoices promptly Manage credit accounts and collections RGHS/Ayushman Bharat billing
Posted 2 weeks ago
0.0 - 5.0 years
3 - 4 Lacs
Noida
Work from Office
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 If candidates are interested please drop your update resume/CV on my Mail ID - varsha.kumari@mediassist.in Thanks & Regards Varsha Kumari Email - varsha.kumari@mediassist.in
Posted 2 weeks ago
0.0 - 5.0 years
0 - 2 Lacs
Pune
Work from Office
Hiring Executive CRM (Corporate and Client Relationship) Company - MD India Health Insurance TPA Job Description Responsible for managing client relationships with key decision makers Subject matter expert for partners and internal staff for the assigned product Addresses the gaps identified between client requirement & the service provided Ensure that the service is delivered in accordance with the agreed service level agreement Act as a point of contact for any escalation or feedback from clients Collaborate with the other functional Group to evaluate the product performance and to recommend Refinements and improvements in service performance Establish and maintain on-going partner relationships and anticipate and resolve potential problems of the client Announcements of new updates and upcoming events/meetings Manage account renewal, customer support escalation Ensure smooth support during renewal of account Excellent Communication Skills Good knowledge of MS Office Open to travel
Posted 2 weeks ago
0.0 - 3.0 years
2 - 3 Lacs
Mumbai, Mumbai Suburban
Work from Office
Position Medical Officer Location Mumbai (Andheri East, Saki Naka) Basic Responsibilities Call prospective customer of insurer for taking medical history through structured tele medical interview. Ask reflex questions in case of any medical adversity. Take complete details of investigation and treatment completed by customer. The doctors need to work from office for 8 hrs. Qualification BAMS/ BHMS/ BDS/ BUMS/ BEMS/BSMS Shift Timing: 8 hrs day shift Skills Fresher doctors are welcome or some prior exposure or sound understanding of Tele/Video MER process. Permanent or provisional registration number is a MUST. Excellent written and verbal communication skills You have Eye for details, Good Communication skills and Ability to Identify Gaps. Interested applicants can share their resume on snehal.salvi@healthassure.in or connect with me on 8356947469.
Posted 2 weeks ago
1.0 - 4.0 years
2 - 3 Lacs
Pune
Work from Office
Role & 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. 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 Visit us @ www.mdindiaonline.com
Posted 2 weeks ago
1.0 - 3.0 years
1 - 2 Lacs
Ahmedabad
Work from Office
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 with be mention Details Total Experience Current City Current Company Home Town Current Salary Expected Salary Notice Period
Posted 2 weeks ago
3.0 - 6.0 years
4 - 6 Lacs
Bengaluru
Work from Office
Claims Executive- EB website Link: www.dishainsurance.com Job Summary: We are seeking a qualified Claims executive to help our clients in claims and any other query solution through their own skills. Our ideal Claims executive has to have in-depth knowledge of and experience with the Claim process, Policy terms and conditions, relationship building and MIS management. We are seeking a quick learner with strong communication skills, and someone with a track record of success who can inspire the same in others Roles & Responsibilities: One stop solution for all client queries and requirements Represent our company, with a comprehensive understanding of our services in the area of claim process and policy terms and conditions. Providing the timely help to clients in claim settlements in both cashless and reimbursements claims. Co-ordinating with Insurance Company in updating endorsements, CD Balance and claims reports. Co-ordinating with TPA in claim settlements, in solving the issues due to any calculation error and any data error with the MIS reports. Co-ordinating with clients, HR Head and Finance Head in resolving any issues. Maintaining MIS reports. Co-ordinating with the Retention team. Visiting clients to understand if they have any concerns and help them in fixing the issues. Visiting the TPA and Insurance Company to maintain good relationship with the customer relation team. Desired Profile/ Who should join: Should have 3 to 6 years of experience in a general insurance company/ insurance broker / surveyor Proficient in Microsoft Excel and MS office Fair knowledge about the Insurance processes Good communication skills Problem solving attitude Flexibility with calls and mails
Posted 2 weeks ago
8.0 - 10.0 years
3 - 7 Lacs
Patna
Work from Office
Role & responsibilities Checking bill as MOA Deduction analysis Knowledge of TPA norms,AL and portal Knowledge of NHA and ECHS portal Preferred candidate profile
Posted 2 weeks ago
4.0 - 9.0 years
4 - 6 Lacs
Gurugram
Work from Office
Hiring TPA Incharge/Officer for a hospital in Gurgaon. Min 4 yrs exp in TPA desk. Must handle claims, pre-auths, billing, discharges & patient queries. Strong communication & TPA workflow knowledge required. Send cv on-82808 33507
Posted 2 weeks ago
2.0 - 7.0 years
3 - 8 Lacs
Mohali
Work from Office
Hiring Clinical Investigator for Mohali location ! Eligibility Criteria: Education BHMS,BAMS,MBBS,BPT Candidates with prior US Healthcare or Clinical experience will be preferred. Noncertified Physicians can apply however should be ready to complete the same within specified timeline. (CPC/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. Job Location - Mohali Interested candidates can share resume - Jitendra.pandey@cotiviti.com Regards, Jitendra 7350534498
Posted 2 weeks ago
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