1031 Tpa Jobs - Page 31

Job Description (IFD) Communicating with clients and understanding the investigation requirements. • Meeting with clients to discuss the nature of the investigation. • Conducting field investigations on appointed cases, insurance claims, or client requests. • Conducting in-depth research on various appointed cases. • Decide the extent and validity of a claim, and in so doing, prevent fraudulent claims by determining the claim's authenticity. • Gathering and analyzing evidence reports. • Conducting photographic and audio surveillance to gather evidence • Reviewing and solving cases by authenticating insurance claims. • Coordinating with agents to understand insurance claims matters. • Answeri...

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

Fortis Hospital Mohali is hiring for following vacancies; 1. OPD 2. IPD 3. TPA 4. Counsellor interested candidates can come directly for the interview as per schedule or share resume at baljinder.singh@fortishealthcare.com

TATA AIG General Insurance Company Limited is looking for Senior Manager - Health Claims to join our dynamic team and embark on a rewarding career journey Analysis for the current business practice. Find out the different operational strategies. Work on developing the current operational strategy applied to the company with the most recent technology. Coordinate with the operations manager to take the required steps after brainstorming and research. Optimize the operations in the company. Put the suitable operational strategy to fit with the companys culture. Implement the operational strategy in the different departments of the company. Supervise the strategy, and make sure that all the emp...

Urgent requirement for BHMS/BAMS/BDS Mumbai(Fort) candidate with TPA experience required. Interested candidates can call on 9371762436 or share their updated resumes to career@mdindia.com Job Description: 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. Required Candidate profile: BAMS / BHMS / BDS graduate. Male candidate prefer. Good Medical & basic computer knowledge Should have completed internship (Permanent Registration number is mandatory) Minimum 1 Year TPA Expereince Candi...

Responsibilities: * Ensure accurate Hospital Billing of cash/insurance patients. * Manage TPA claims from submission to settlement * Collaborate with insurance companies on claim resolution and settlement. Please contact 9326009595

The selected candidate willbe responsible for managing the approval and rejection processes for cashlessclaims under TPA and MJPJAY schemes. This will involve close coordination withhospital doctors, wards, the billing team, and insurance companies. Key Responsibilities: Handle approval and rejection of cases within the TPA department. Coordinate with hospital doctors and wards to ensure the availability of cashless facilities for patients. Manage pre-authorizations, patient admissions, and discharges, especially in the absence of the respective TPA/MJPJAY team member. Collaborate with the in-house ward, ICU, IPCU, and billing team to ensure final cashless approval for patients. Resolve issu...

About Rentokil PCI Rentokil PCI is the leading pest control service provider in India. A Rentokil Initial brand, Rentokil PCI was formed in 2017 through a joint venture (JV) between Pest Control India, the number one pest control company in India, and Rentokil, the world s leading pest control brand. Rentokil PCI aims to set new standards for customer service having operations across 300 locations in India. About the Role: OE / Sr. OE shall be owner of his / her assigned service areas within the Branch in terms of operations related actions as given in job responsibilities, and shall be responsible for providing qualified Technicians for execution of services. Responsible for Resi, SA, SMEs....

The role involves verifying insurance eligibility and benefits for patients, and coordinating with internal and client teams to ensure timely and accurate claim processing.

Ensure the smooth operations of all departments within the hospital Ensure the smooth flow of all patient services and facilities Ensure efficient operations of hospitals accounting and budgeting systems Protect the reputation of the hospital and its employees Advise the board of directors and hospital administration Provide leadership and management to hospitals staff Informed decision-making ability Effective communication skills High level of interpersonal skills Good knowledge of healthcare.

Urgent requirement for MBBS-Chennai( Kilpauk ) Freshers. Interested candidates can call on 9371762436 or share their updated resumes to career@mdindia.com Job Description: 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. Required Candidate profile: MBBS graduate. MBBS Candidate Should be MCI Registered Male candidate prefer. Good Medical & basic computer knowledge Should have completed internship (Permanent Registration number is mandatory) Freshers can also apply. Work from office...

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- 8951865563 Whatsapp CV mail id -sarika.pallap@mediassist.in

Designation: Medical Officer Location: Ghaziabad JD: History taking and documentation, assessment of vitals. Discussing patients history and findings with treating consultant for formulation of a care plan. Transcribing any medication or other orders given by the treating consultant into the medical record. Clarifying any doubts, the patient/ family may have about treatment/ procedure/ processes at the hospital/ investigation results. Liaison between patients and treating doctor or administrative staff for any patient queries. Transcription of discharge summaries on treating consultants directions. Entering data and maintaining all documentation in hard & Soft copy for all possible records a...

Designation-Team Lead/Assistant Manager/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 In...

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...

JOB DESCRIPTION : HOSPITAL RELATIONS MANAGER Department: Hospital Relations Location: Hyderabad,Warangal,Nizamabad,Vijaywada,Visakhapatnam Job Type: Full-Time Job Summary: The Hospital Relations Manager will be responsible for managing and optimizing the relationship between the organization and hospital partners. This role involves overseeing pricing strategies, negotiating claims, resolving pending issues, and ensuring smooth coordination with internal stakeholders. The position also requires meticulous documentation related to training, meetings with internal and external stakeholders and updates to facilitate effective communication and decision-making. Key Responsibilities: 1. Hospital ...

RESPONSIBILITIES *Responding to Customers' Needs. ~Keeping an Eye on Trends and Monitoring Competition. *Communicating work and brand values with Marketing Team. *Developing a Growth Strategy.

Job Summary: We're seeking an experienced Risk and Compliance Executive responsible for vendor management, risk mitigation, business continuity planning, and client-related compliance activities . The ideal candidate will have a strong background in risk management, compliance, and contract administration within a corporate environment. Key Responsibilities: Audits and Risk Management : Plan and execute internal and external audits to ensure compliance with regulations and company policies. Manage and maintain comprehensive risk registers, and develop and implement robust risk mitigation strategies. Business Continuity Planning (BCP) : Assist in maintaining and testing BCP documentation, ens...

Role & responsibilities To greet incoming patients or their representatives and to record complete information required for processing cashless facility. To hand over Pre-Auth form to patient and explain the procedure in detail. To process Initial approval, interim bill and final enhancement and co-ordinate with billing. To answer questions and to provide information directly to the person or on the telephone. For eg.Explaning Policy terms and conditions and hospital Policy regarding payment of bills. To prepare and maintain data of patients availing cashless facility and status, check payable report. To explain hospital regulations to patients, concerning Insurance process and discharge for...

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...

Vadamalayan Hospitals is looking for Claims Executive to join our dynamic team and embark on a rewarding career journey As a Claims Executive, you will be responsible for processing insurance claims and ensuring timely and accurate claim settlements Receiving and reviewing insurance claims from policyholdersVerifying policy coverage and investigating the claim to determine its validityKnowledge of insurance policies and regulationsStrong analytical and problem-solving skillsExcellent communication and interpersonal skills

Role & responsibilities To supervise all billing transactions on a day to day basis, monitor the correct processing of bill to patients and resolve/convince patients for any queries related to billing process or department. Reconciliation of cash and cheque transactions Receiving the outstanding payment report and following it up with concern departments and stakeholders Analysis of refund cases and giving necessary approvals Team meeting with IP billing and emergency on a daily basis Making floor visits along with Medical Transcriptionist. Handling grievances of patients and resolving them in a timely manner Imparting software training to team and new joiner. Attending to queries and grieva...

Objective / Purpose NA About Us NA Roles & Responsibilities Underwriting grievances/ queries to be resolved in co-ordination with TPA Branch queries/Sales queries to be resolved pertaining to medicals Follow up with CMO for decision and pushing cases to resolve bucket Stop/Cancellation data maintenance on daily basis and send mail to TPA accordingly Follow up with TPA for additional medicals fixing Ensure timely and accurate billing of TPAs / Data maintenance for the same. Medical quality control/ Mystery shopping & checks Educational Qualification Any Graduate Experience 5 to 8 Years Competencies Skills Minimum 3 years of Underwriting experience. Thorough Knowledge of Underwriting principle...

Objective / Purpose NA About Us NA Roles & Responsibilities Underwriting grievances/ queries to be resolved in co-ordination with TPA Branch queries/Sales queries to be resolved pertaining to medicals Follow up with CMO for decision and pushing cases to resolve bucket Stop/Cancellation data maintenance on daily basis and send mail to TPA accordingly Follow up with TPA for additional medicals fixing Ensure timely and accurate billing of TPAs / Data maintenance for the same. Medical quality control/ Mystery shopping & checks Educational Qualification Any Graduate Experience 8 to 10 Years Competencies Skills Minimum 4 years of Underwriting experience. Thorough Knowledge of Underwriting principl...

Responsibilities: * Manage claims from intake to settlement. * Adjudicate medical necessity & settle claims fairly. * Ensure timely claim payment & employer satisfaction. * Process mediclaim & health insurance claims accurately.