1024 Tpa Jobs - Page 4

Role: Back End Operations -US Health Insurance Work Location: 2-15+ years' work experience in back-office US Health Insurance/Retirement pension domain /BFSI can apply Location: Wipro Elcot SEZ, Survey No. 602/03, Elcot Sez, Shollinganallur, Chennai, Tamil Nadu Shift Timing- 5.30pm to 3am Cab Facility- One way drop Work from Office: From Day 2 Onwards (Work from office ) Permanent work profile with Wipro Education - B.com, BA, BBA, Any B.sc (graduates only)/ NO BE/B TECH will be eligible for this hiring Job Summary Strong understanding of client plan provisions/product & processing guidelines and SLA metrics Able to manually perform Benefit processes and complex tasks/calculations that requi...

Role & responsibilities Conduct timely follow-up on outstanding payments with customers, corporates, insurance companies, and third-party administrators (TPAs). Manage part-payment and short-payment reconciliations, ensuring accurate tracking and proper accounting entries. Prepare and maintain outstanding reports (daily, weekly, and monthly) for management review. Monitor aging analysis and escalate long-pending dues for resolution. Coordinate with billing, finance, and customer service teams to ensure smooth payment flow and dispute resolution. Maintain accurate documentation and communication records related to payment follow-ups. Assist in month-end closing activities, ensuring proper pos...

Designation: Senior Medical Officer Function: Claims PA/RI Approver Reporting to: Assistant Manager/Manager Location: Andheri East, Mumbai Educational Qualification: BAMS, BHMS, BPT, MBBS, BSc. Nursing Additional Qualification: None Specialization: General Medicine Related courses attended: None Management Level: Junior Management Level Industry Type: Hospital/TPA/Healthcare/Insurance Roles and Responsibilities : Check the medical admissibility of a High Value claim, scrutinize and process it as per terms & conditions of insurance policy. Handle escalations, customer queries and responding to mails accordingly Effectively manage the team so that the targets are met while reducing the no. of ...

POSITION: MEDICAL OFFICER/CONSULTANT PA/RI APPROVER PURPOSE OF ROLE: To scrutinize and process the claims within the agreed TAT by having an understanding of the policy terms & conditions while applying their domain medical knowledge. Designation : Medical Officer/Consultant Function : Claims PA/RI Approver Reporting to : Assistant Manager Claims Location : Pune Educational Qualification : BHMS, Bsc Nursing , BAMS, BPT, BDS, B. Pharma Shift : Rotational Shift (for female employee shift ends at 8:30 PM) Week offs : 6 rotational week offs Provided per month Management Level : Junior Management Level Industry Type : Hospital/TPA/Healthcare/Insurance Roles and Responsibilities : Check the medica...

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...

Role & responsibilities Prepare, verify, and submit TPA and insurance bills accurately and on time. Coordinate with TPA coordinators and insurance representatives for claim approvals and settlements. Handle pre-authorization requests and maintain all relevant documentation. Track claim status and follow up for pending or rejected claims. Reconcile TPA accounts and maintain updated records of claims, payments, and rejections. Assist in preparing MIS reports related to TPA billing and collections. Ensure compliance with hospital billing policies and TPA/insurance guidelines. Coordinate with the finance and accounts teams for payment postings and reconciliations. Address patient and TPA queries...

Roles and Responsibilities Handle health claims from receipt to settlement, ensuring timely processing and quality service delivery. Conduct thorough audits on insurance claims, identifying areas for improvement and implementing corrective actions. Prepare accurate and detailed audit reports, highlighting key findings and recommendations. Manage email communication with clients, agents, and internal stakeholders regarding claim status updates and queries. Utilize MS Office skills to maintain efficient records management systems. Salary- 25k/month + other benefits Work Location-Gurgaon work from Office only Timings: 9:30am to 5:30pm (Monday-Saturday) Contact No-9971006988 through whats app ch...

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 dona.antony@mediassist.in Thanks & Regards Contact No-9632777628

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 dona.antony@mediassist.in Thanks & Regards Contact No-9632777628

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...

JOB DESCRIPTION POSITION: TEAM LEADER / ACCOUNT MANAGEMENT / RELATIONSHIP PERSONNEL PURPOSE OF ROLE: Ensure smooth claims processing for customers. Lead a team of helpdesk personnel including implants, semi-implants, account management and document pickup team. Designation Function Team Leader Roles and Responsibilities: 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 members to understand their concerns and help simplify the process. Review the claims dump along with front end...

COMPREHENSIVE JOB DESCRIPTION TEMPLATE A. POSITION BACKGROUND ORGANIZATION / Medi Assist Insurance TPA Private Limited DIVISION SUMMARY DEPARTMENT SUMMARY To serve the customers well by delivering a high standard, efficient customer service and to represent the organization in the possible best way. B. POSITION DETAILS DIVISION / Customer Relationship Management DEPARTMENT DESIGNATION GRADE (BAND) Executive / Senior Executive REPORTING TO LEVEL A3/A4 LOCATION Bangalore C. POSITION REQUIREMENTS Education Minimum: Graduate Other Requirements Qualification: Any graduate Experience Minimum: 0 5 Industry: Healthcare D. Job Description/Key Roles & Responsibility • • • • Receive and check claim doc...

a. Responsibilities : * To ensure that bills are prepared for in-patients and out patients and ensure that the bills are paid on time. * Provide training for the billing team whenever necessary. * Assist the team members in using Insta (H.I.S.). * Supervise the team b. Out Patient Billing : * Collect cash from the out patients. * Update orders from lab, pharmacy, radiology etc. * Refund amount if necessary after approval from the consultant / Directors. c. Inpatient Billing : * Taking the details of the inpatient for registration. * Update the activities undertaken. * Observe the discharge summary and finalize the bill amount. * Issue discount if necessary with approval. * Updating of surger...

Company Profile At Edify Insurance Brokers Pvt Ltd, our Client Service team is the engine that drives our customer satisfaction and query solutions. We are seeking a qualified Client service - manager to help our clients in claims and any other query solution through their own skills. Our ideal CS manager has to have indepth 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 Objective of this Role One stop solution for all client queries and requirements Represent our company, wi...

* Processing of Cashless Requests & Health Insurance Claims for TPA / Insurance company * Process and Provide Medical opinion for Health Insurance Claims * Understanding of Claims adjudication / Claims Processing

TATA AIG General Insurance Company Limited is looking for Manager - Health Claims to join our dynamic team and embark on a rewarding career journey Collaborate with cross-functional teams to achieve strategic outcomes Apply subject expertise to support operations, planning, and decision-making Utilize tools, analytics, or platforms relevant to the job domain Ensure compliance with policies while improving efficiency and outcomes

Role & responsibilities Conduct timely follow-up on outstanding payments with customers, corporates, insurance companies, and third-party administrators (TPAs). Manage part-payment and short-payment reconciliations, ensuring accurate tracking and proper accounting entries. Prepare and maintain outstanding reports (daily, weekly, and monthly) for management review. Monitor aging analysis and escalate long-pending dues for resolution. Coordinate with billing, finance, and customer service teams to ensure smooth payment flow and dispute resolution. Maintain accurate documentation and communication records related to payment follow-ups. Assist in month-end closing activities, ensuring proper pos...

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 sarika.pallap@mediassist.in Thanks & Regards dona.antony@mediassist.in Contact No-9632777628

Vidal Health Insurance TPA is hiring for an AVP CRM -Client Servicing role for large corporate accounts Job Location: Gurgaon Interested candidates can send their resumes on tiju.jose@vidalhealth.com Key Responsibilities: 1. Management and Retention of Top corporate for the region. 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 of top stakeholders for the respective region. 4. Oversee timely submission of MIS reports to Insurance Companies/Corporate etc. 5. Relationship with HO of Insurance Companies, Brokers etc... 6. Service fees collection for the region. 7. Oversee departm...

Greetings from Vidal Health Insurance TPA Pvt Ltd.,Openings For Medical Officer!!! - Non Clinical RoleQualification -MBBS-MCI RegExperience - 0 to 1 YearJob Location - Bangalore(Whitefiled) Roles and Responsibilities Involved in analyzing medical reports and do medical Audit at the Hospitals. Should have medical knowledge. Providing quality services. Updating the new medical terms and conditions as per the policy. Should be good knowledge in Academics. Resolving Claims related queries and discrepancies, Following up and responding to queries of customers. Approving and Rejection of Payments to the Customers with all verification. Updating the Status of the Customers about the respective Clai...

Job Summary A Neurologist is needed to diagnose and treat conditions affecting the brain, spinal cord, nerves, and muscles. The role requires expertise in identifying and managing a wide range of neurological disorders. Key Responsibilities Diagnose and treat neurological conditions, including stroke, epilepsy, migraines, and Parkinson's disease.Conduct neurological examinations and interpret diagnostic tests like MRIs and CT scans.Develop and manage treatment plans, including medication and physical therapy.Collaborate with neurosurgeons and other medical professionals as needed. Requirements MBBS degree and a postgraduate degree (MD/DNB) in Neurology.Valid medical license and registration.

Role & responsibility District medical officer - Field auditing and investigation Preferred candidate profile BHMS,BAMS,BDS & MBBS

Perform routine payroll tax profile audits of existing clients to ensure accuracy Processes payroll corrections to prepare for amendments and communicates summaries of the corrections to clients Completes monthly New Hire Reporting to state agencies Assists in monthly, quarterly and annual tax filing audits Communicates with clients regarding missing or invalid account information Maintain individual performance to meet established team goals and OKRs Obtain accurate tax jurisdiction account information to ensure timely filing and payment of payroll tax obligations Participate in various processes and initiatives to ensure accurate payments and filings of client taxes Do you have the right i...

Job Summary: We are seeking a Domain Specialist to join our team in Chennai. The ideal candidate will have expertise in one or more domains such as SaaS, HRTECH, EDTECH, MANUFACTURING, FINANCE, or IT. This role will involve providing specialized knowledge and support within the specified domain. Key Responsibilities: Provide expert domain knowledge and support to internal teams and clients. Conduct market research and analysis to identify industry trends and opportunities. Develop and deliver training programs and presentations on domain-specific topics. Collaborate with cross-functional teams to develop and implement domain-specific solutions. Stay up-to-date with industry best practices an...

About Plum Plum is an employee insurance and health benefits platform focused on making health insurance simple, accessible and inclusive for modern organizations. Healthcare in India is seeing a phenomenal shift with inflation in healthcare costs 3x that of general inflation. A majority of Indians are unable to afford health insurance on their own; and so as many as 600mn Indians will likely have to depend on employer-sponsored insurance. Plum is on a mission to provide the highest quality insurance and healthcare to 10 million lives by FY2030, through companies that care. Plum is backed by Tiger Global and Peak XV Partners. About the Role The Strategic Accounts Servicing Team is responsibl...