1031 Tpa Jobs - Page 32

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years Language - Ability: English(Domestic) - Intermediate 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...

Key Responsibilities: Handle end-to-end reimbursement and cashless claims for corporate clients' employees and dependents. Scrutinize claim documents for completeness, medical validity, and compliance with policy terms. Coordinate with empaneled hospitals, insured members, and insurance companies for claim clarification, queries, and approvals. Maintain TAT and SLA commitments for smooth and timely processing. Ensure compliance with IRDAI guidelines and internal company SOPs. Update and manage claims data in the internal system accurately. Prepare and share MIS reports with internal stakeholders and corporate clients. Manage escalated and high-value claims with detailed attention and resolut...

We are seeking a dedicated and detail-oriented Patient Finance Counsellor to join our hospitals administrative team. This critical role involves guiding patients and their families through the financial aspects of their treatment, ensuring transparency and understanding regarding costs, insurance, and payment options. The successful candidate will excel in admission counselling related to finance, demonstrate strong coordination skills with various departments, and possess an unwavering commitment to compassionate patient care while managing all finance -related inquiries. If you have a background in healthcare finance or counselling and are passionate about supporting patients through their...

MBA/MHA Hospital and Healthcare management with 1 to 3 years of experience or any graduate with experience in hospital billing department with 3 to 4 years of experience. Experience : Minimum 2 years of Clinical experience with one year of experience working in Hospital billing department or 2-4 years of experience in Hospital Management. 3-year fixed term contract Roles and Responsibilities: Planning of the teaching programme including an orientation programme in consultation with the HOD Academics. Planning for students Practical experience, ward assignments and trainings in consultation with the HOD Academics. Planning of curriculum with the cooperation and collaboration of the HOD Academ...

Job Description Acts as an interface between the TPA, Insurance Company and the hospital. Responsible for investigation of suspicious claims. Effective usage of Fraud control measures. Act as a backend support to the TPA. Responsible for data mining and analytics related to Fraud and Investigation (IFD) Field visit for investigation purpose. Open to travel. Desired Candidates Profile Qualification Any Graduate Experience Fresher - 2 Years Exp. Profile – Executive If interested kindly share your resume to recruitment1@mdindia.com

To co-ordinate with cashless patients, Insurance companies and corporate for smooth functioning of cashless treatment provided to the patient. To send the pre-authorization forms to the concerned TPAs and to follow-up till receipt of initial approval

About Us: Medi Assist is Indias 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 admissibili...

Key Responsibilities: *Knowledge in TPA, Insurance Company, UTI TSL , Hospital Sector Understanding of the product and provide training and product demo to new and existing clients Team management/ handing team of Medical officers / quality analysts Handling operations of the accounts Meeting and understanding of the customer requirements, plan implementation Travel to the customer's site as and when required for training and implementing Ensure service levels are maintained at hospitals Establish objectives and operational criteria for accounts managed. Understand the requirements of Clients regularly and implement the process at hospitals. Motivating / retaining the team members. Develop a...

Skill required: Retirement Solutions - Customer Service Designation: Customer Service Associate Qualifications: Any Graduation Years of Experience: 1 to 3 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 1+ years of experience in US Retirement Services domain Defined Cont...

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

Job Description: Skills Required: Strong leadership, team management skills with Excellent communication and interpersonal skills Comprehensive understanding of hospital admission processes and billing systems Customer service oriented with problem-solving capabilities Ensuring accurate billing for services provided to inpatient (hospitalized) patients, including room charges, medical procedures, medications, and consultations. Leading and managing the team responsible for processing and generating bills for inpatient services. Collaborating with other departments like clinical, pharmacy, and insurance for timely and accurate billing. Overseeing day-to-day administration, directing and contr...

Inpatient/Outpatient Billing. Overseas/Corporate/Insured/TPA billing. Payment Tracking. Bed Management. TPA files follow-up and closure. Tracking of discounts/Cancelled bills/refunds/free bills/posting of packages. Service Recovery in the billing Area. Training of the HIS modules in billing with the power users.

Hurry up Authentic Healthcare is hiring Medical officers Non clinical job AT Noida, HYD , Bangalore Location Role/Position: Permanent Experience: 1 to 2 yrs in TPA or clinical Education: BPT, MPT,BDS, BAMS, BHMS Shifts: Day shift work from office

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...

Adani Hospitals is looking for Medical Officer to join our dynamic team and embark on a rewarding career journey Diagnosing and treating patients' illnesses and injuries Creating and maintaining patient medical records Prescribing medication and therapies Ordering and interpreting diagnostic tests Referring patients to specialists as needed Developing and implementing treatment plans Educating patients about their health conditions and treatment options Working closely with patients and their families, as well as other healthcare professionals Clinical Medical Officer MBBS

We are currently hiring Medical Officers to handle the processing of cashless requests and health insurance claims for TPAs/Insurance companies and Manage volumes effectively & efficiently to maintain Turnaround time of processing cases.

Role & responsibilities Responsible for entire branch management, handling complete operational activities, client/corporate servicing, and branch administration. Branch business retention & new business acquisition. Liasoning with Insurance Companies, Brokers, etc. Attending meetings of Corporates, Clients, Insurance Companies, etc. Build and maintain effective and influential relationships with the officials of Corporates, Clients, ICs, etc. Drafting forecasts and business plans. Managing budgets, allocating branch funds & petty cash mgt. Coordinating with various department of HO & Branches. Involvement in new projects planning and execution. Maintenance of the database of clients and cor...

We are looking for a motivated and detail-oriented Customer Service Associate to support client servicing operations for group health insurance. This is a junior-level position suitable for candidates with prior experience handling TPA operations and servicing large corporate accounts (50+ clients). The role involves supporting claims, endorsements, and other service tasks as assigned, while also contributing to business development through referrals and account references. Key Responsibilities: Handle client service tasks including: Claims coordination and follow-ups with TPA/insurer. Policy endorsements (additions/deletions/changes). Documentation and query resolution. Maintain strong work...

Urgent requirement for BHMS/BAMS/BDS -Chennai(Annasalai) Freshers/candidate with clinical or TPA experience. 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) Freshers can als...

Responsibilities: * Provide medical services to patients , do Medical examination , * Conduct stress tests, ECGs, TPAs, and other diagnostics. * Manage Staff Increasing footfall at centres

Responsibilities: * Lead claims settlements and operations on-site * Ensure compliance with HIPAA & insurance ops standards * Manage health claims of our patients from start to finish * Collaborate with stakeholders on claim resolution

Process cashless and reimbursment claims (Should have knowledge of processing retail policies of National/United/New India/Oriental insurance companies.

Role & responsibilities Ensure team members are visiting the customers place as per the schedule Monitor the team members activity in terms of volumes (documents collected) Review the queries received from the customer and the responses from the team members Help team members in resolving escalationsfrom customers Review the reports sent by the team members and take necessary actions (issues with respect to claim registrations) based on the report. Coordinate with front end team and help in getting the claims registered Conduct weekly/monthly one on one review with the team membersto understand their concerns and help simplify the process Review the claims dump along with front end team and ...

Job Title: Insurance Desk Executive TPA Coordination / Claims Specialist Location Options: KIMS Hospital, Nashik Survey No. 571/1A/1, Plot No. 63, Mumbai Agra Highway, Nashik, Maharashtra – 422001 KIMS Hospital, Thane West – Queens St, near Brentford Cooperative Society, Hiranandani Estate, Thane West, Maharashtra – 400615 Organization: Ayu Health Hospitals Experience Required: 0–2 years (Freshers are welcome to apply) Preferred Gender: Male Candidates Preferred Location: Candidates residing near hospital locations will be given preference About Ayu Health: Ayu Health is one of India’s fastest-growing healthcare networks, dedicated to making high-quality healthcare accessible and affordable ...

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