299 Tpa Jobs - Page 5

About the Company Loop Health is India s first Health Assurance company, founded in 2018, that combines group health insurance with unlimited primary care, preventive healthcare, and wellness services. Serving over 750,000 members across 1,000+ companies, Loop leverages technology and an in-house medical team to deliver holistic, people-centric healthcare. Job Summary The Endorsement and Enrolment Executive will be responsible for timely and accurate processing of enrolments, endorsements, and related policy servicing tasks for health insurance clients. The role requires coordination with insurers, internal teams, and clients to ensure policy records are up-to-date and compliant with regulatory norms. Key Responsibilities Enrolment: Process member enrolments (additions, deletions, changes) in GMC/GPA/GTL policies as per client and insurer requirements. Review and validate enrolment data received from clients or internal stakeholders. Upload and maintain accurate records in internal systems and insurer portals. Maintain the active roster and CD statements for the customers Endorsement: Handle policy endorsements such as member updates, change in coverage, corrections in personal details, etc. Coordinate with insurers for endorsement issuance and follow up for endorsement letters/certificates. Ensure timely communication of endorsements to clients with updated documentation. Documentation & Reporting: Maintain and update accurate records and trackers for all enrolment and endorsement activities. Prepare periodic MIS reports and dashboards for internal use and client reporting. Stakeholder Management: Coordinate with clients, TPA (Third Party Administrators), insurers, and internal sales/service teams to resolve queries or discrepancies. Provide support during policy renewal, including reconciliation of member lists and premium calculations. Key Requirements Education: Graduate in any discipline (preferably in Commerce, Business Administration, or related fields). Experience: 1 - 5 years of relevant experience in health insurance enrolments/endorsements or policy servicing at a broker Skills Strong attention to detail and accuracy Proficiency in MS Excel and data handling Good communication and coordination skills Knowledge of health insurance processes and terminology Ability to work under deadlines and handle multiple tasks Preferred Qualifications Prior experience using insurer portals or broker management software Understanding of group health insurance schemes and endorsements Basic understanding of insurance compliance and documentation norms What We Offer Opportunity to work in a growing and dynamic industry Learning and development support Collaborative and supportive team culture Competitive salary and benefits

To manage insurance portfolio of all types of insurance policies & ensure adequate risk coverage at optimum costs and claims management. To procure various insurance policies with adequate coverage at optimum cost, ensure timely renewal of the insurance policies, and to ensure internal customer expectations for deliverables in terms of time, cost and service quality are met in line with business objectives. Proficient in managing insurance claims especially PDBI claims Good technical knowledge about insurance products, coverage features and claims process Coordination with cross functional teams within the Company, Subsidiaries, insurers, surveyors etc. Implement best practices as per company s guidelines. Ensure compliance of various processes and demonstrate through conduct of internal as well as external audit. Obtaining and compiling relevant information from various departments on insurance requirements. Understand various risks, suggest appropriate clauses / wordings in the insurance policies to mitigate the risks and get the desired insurance coverage. Review the performance of Insurers and TPA s and ensure prompt settlement of insurance claims within a stipulated time frame. Promptly address queries & concerns on Insurance matters. Conduct Knowledge sharing sessions to colleagues from other departments on the coverage under important insurance policies & the claims process. To manage insurance portfolio of all types of insurance policies & ensure adequate risk coverage at optimum costs and claims management. To procure various insurance policies with adequate coverage at optimum cost, ensure timely renewal of the insurance policies, and to ensure internal customer expectations for deliverables in terms of time, cost and service quality are met in line with business objectives. Proficient in managing insurance claims especially PDBI claims Good technical knowledge about insurance products, coverage features and claims process Coordination with cross functional teams within the Company, Subsidiaries, insurers, surveyors etc. Implement best practices as per company s guidelines. Ensure compliance of various processes and demonstrate through conduct of internal as well as external audit. Obtaining and compiling relevant information from various departments on insurance requirements. Understand various risks, suggest appropriate clauses / wordings in the insurance policies to mitigate the risks and get the desired insurance coverage. Review the performance of Insurers and TPA s and ensure prompt settlement of insurance claims within a stipulated time frame. Promptly address queries & concerns on Insurance matters. Conduct Knowledge sharing sessions to colleagues from other departments on the coverage under important insurance policies & the claims process. Graduate with Associate or Fellow from Insurance Institute of India, or MBA/PGDBA with insurance specialization, or BE with additional qualification specialized in insurance

About the Company Loop Health is India s first Health Assurance company, founded in 2018, that combines group health insurance with unlimited primary care, preventive healthcare, and wellness services. Serving over 750,000 members across 1,000+ companies, Loop leverages technology and an in-house medical team to deliver holistic, people-centric healthcare. Job Summary The Endorsement and Enrolment Executive will be responsible for timely and accurate processing of enrolments, endorsements, and related policy servicing tasks for health insurance clients. The role requires coordination with insurers, internal teams, and clients to ensure policy records are up-to-date and compliant with regulatory norms. Key Responsibilities Enrolment: Process member enrolments (additions, deletions, changes) in GMC/GPA/GTL policies as per client and insurer requirements. Review and validate enrolment data received from clients or internal stakeholders. Upload and maintain accurate records in internal systems and insurer portals. Maintain the active roster and CD statements for the customers Endorsement: Handle policy endorsements such as member updates, change in coverage, corrections in personal details, etc. Coordinate with insurers for endorsement issuance and follow up for endorsement letters/certificates. Ensure timely communication of endorsements to clients with updated documentation. Documentation & Reporting: Maintain and update accurate records and trackers for all enrolment and endorsement activities. Prepare periodic MIS reports and dashboards for internal use and client reporting. Stakeholder Management: Coordinate with clients, TPA (Third Party Administrators), insurers, and internal sales/service teams to resolve queries or discrepancies. Provide support during policy renewal, including reconciliation of member lists and premium calculations. Key Requirements Education: Graduate in any discipline (preferably in Commerce, Business Administration, or related fields). Experience: 1 - 5 years of relevant experience in health insurance enrolments/endorsements or policy servicing at a broker Skills Strong attention to detail and accuracy Proficiency in MS Excel and data handling Good communication and coordination skills Knowledge of health insurance processes and terminology Ability to work under deadlines and handle multiple tasks Preferred Qualifications Prior experience using insurer portals or broker management software Understanding of group health insurance schemes and endorsements Basic understanding of insurance compliance and documentation norms What We Offer Opportunity to work in a growing and dynamic industry Learning and development support Collaborative and supportive team culture Competitive salary and benefits

About the Company Loop Health is India s first Health Assurance company, founded in 2018, that combines group health insurance with unlimited primary care, preventive healthcare, and wellness services. Serving over 750,000 members across 1,000+ companies, Loop leverages technology and an in-house medical team to deliver holistic, people-centric healthcare. Job Summary The Endorsement and Enrolment Executive will be responsible for timely and accurate processing of enrolments, endorsements, and related policy servicing tasks for health insurance clients. The role requires coordination with insurers, internal teams, and clients to ensure policy records are up-to-date and compliant with regulatory norms. Key Responsibilities Enrolment: Process member enrolments (additions, deletions, changes) in GMC/GPA/GTL policies as per client and insurer requirements. Review and validate enrolment data received from clients or internal stakeholders. Upload and maintain accurate records in internal systems and insurer portals. Maintain the active roster and CD statements for the customers Endorsement: Handle policy endorsements such as member updates, change in coverage, corrections in personal details, etc. Coordinate with insurers for endorsement issuance and follow up for endorsement letters/certificates. Ensure timely communication of endorsements to clients with updated documentation. Documentation & Reporting: Maintain and update accurate records and trackers for all enrolment and endorsement activities. Prepare periodic MIS reports and dashboards for internal use and client reporting. Stakeholder Management: Coordinate with clients, TPA (Third Party Administrators), insurers, and internal sales/service teams to resolve queries or discrepancies. Provide support during policy renewal, including reconciliation of member lists and premium calculations. Key Requirements Education: Graduate in any discipline (preferably in Commerce, Business Administration, or related fields). Experience: 1 - 5 years of relevant experience in health insurance enrolments/endorsements or policy servicing at a broker Skills Strong attention to detail and accuracy Proficiency in MS Excel and data handling Good communication and coordination skills Knowledge of health insurance processes and terminology Ability to work under deadlines and handle multiple tasks Preferred Qualifications Prior experience using insurer portals or broker management software Understanding of group health insurance schemes and endorsements Basic understanding of insurance compliance and documentation norms What We Offer Opportunity to work in a growing and dynamic industry Learning and development support Collaborative and supportive team culture Competitive salary and benefits

About the Company Loop Health is India s first Health Assurance company, founded in 2018, that combines group health insurance with unlimited primary care, preventive healthcare, and wellness services. Serving over 750,000 members across 1,000+ companies, Loop leverages technology and an in-house medical team to deliver holistic, people-centric healthcare. Job Summary The Endorsement and Enrolment Executive will be responsible for timely and accurate processing of enrolments, endorsements, and related policy servicing tasks for health insurance clients. The role requires coordination with insurers, internal teams, and clients to ensure policy records are up-to-date and compliant with regulatory norms. Key Responsibilities Enrolment: Process member enrolments (additions, deletions, changes) in GMC/GPA/GTL policies as per client and insurer requirements. Review and validate enrolment data received from clients or internal stakeholders. Upload and maintain accurate records in internal systems and insurer portals. Maintain the active roster and CD statements for the customers Endorsement: Handle policy endorsements such as member updates, change in coverage, corrections in personal details, etc. Coordinate with insurers for endorsement issuance and follow up for endorsement letters/certificates. Ensure timely communication of endorsements to clients with updated documentation. Documentation & Reporting: Maintain and update accurate records and trackers for all enrolment and endorsement activities. Prepare periodic MIS reports and dashboards for internal use and client reporting. Stakeholder Management: Coordinate with clients, TPA (Third Party Administrators), insurers, and internal sales/service teams to resolve queries or discrepancies. Provide support during policy renewal, including reconciliation of member lists and premium calculations. Key Requirements Education: Graduate in any discipline (preferably in Commerce, Business Administration, or related fields). Experience: 1 - 5 years of relevant experience in health insurance enrolments/endorsements or policy servicing at a broker Skills Strong attention to detail and accuracy Proficiency in MS Excel and data handling Good communication and coordination skills Knowledge of health insurance processes and terminology Ability to work under deadlines and handle multiple tasks Preferred Qualifications Prior experience using insurer portals or broker management software Understanding of group health insurance schemes and endorsements Basic understanding of insurance compliance and documentation norms What We Offer Opportunity to work in a growing and dynamic industry Learning and development support Collaborative and supportive team culture Competitive salary and benefits

About the Company Loop Health is India s first Health Assurance company, founded in 2018, that combines group health insurance with unlimited primary care, preventive healthcare, and wellness services. Serving over 750,000 members across 1,000+ companies, Loop leverages technology and an in-house medical team to deliver holistic, people-centric healthcare. Job Summary The Endorsement and Enrolment Executive will be responsible for timely and accurate processing of enrolments, endorsements, and related policy servicing tasks for health insurance clients. The role requires coordination with insurers, internal teams, and clients to ensure policy records are up-to-date and compliant with regulatory norms. Key Responsibilities Enrolment: Process member enrolments (additions, deletions, changes) in GMC/GPA/GTL policies as per client and insurer requirements. Review and validate enrolment data received from clients or internal stakeholders. Upload and maintain accurate records in internal systems and insurer portals. Maintain the active roster and CD statements for the customers Endorsement: Handle policy endorsements such as member updates, change in coverage, corrections in personal details, etc. Coordinate with insurers for endorsement issuance and follow up for endorsement letters/certificates. Ensure timely communication of endorsements to clients with updated documentation. Documentation & Reporting: Maintain and update accurate records and trackers for all enrolment and endorsement activities. Prepare periodic MIS reports and dashboards for internal use and client reporting. Stakeholder Management: Coordinate with clients, TPA (Third Party Administrators), insurers, and internal sales/service teams to resolve queries or discrepancies. Provide support during policy renewal, including reconciliation of member lists and premium calculations. Key Requirements Education: Graduate in any discipline (preferably in Commerce, Business Administration, or related fields). Experience: 1 - 5 years of relevant experience in health insurance enrolments/endorsements or policy servicing at a broker Skills Strong attention to detail and accuracy Proficiency in MS Excel and data handling Good communication and coordination skills Knowledge of health insurance processes and terminology Ability to work under deadlines and handle multiple tasks Preferred Qualifications Prior experience using insurer portals or broker management software Understanding of group health insurance schemes and endorsements Basic understanding of insurance compliance and documentation norms What We Offer Opportunity to work in a growing and dynamic industry Learning and development support Collaborative and supportive team culture Competitive salary and benefits

About the Company Loop Health is India s first Health Assurance company, founded in 2018, that combines group health insurance with unlimited primary care, preventive healthcare, and wellness services. Serving over 750,000 members across 1,000+ companies, Loop leverages technology and an in-house medical team to deliver holistic, people-centric healthcare. Job Summary The Endorsement and Enrolment Executive will be responsible for timely and accurate processing of enrolments, endorsements, and related policy servicing tasks for health insurance clients. The role requires coordination with insurers, internal teams, and clients to ensure policy records are up-to-date and compliant with regulatory norms. Key Responsibilities Enrolment: Process member enrolments (additions, deletions, changes) in GMC/GPA/GTL policies as per client and insurer requirements. Review and validate enrolment data received from clients or internal stakeholders. Upload and maintain accurate records in internal systems and insurer portals. Maintain the active roster and CD statements for the customers Endorsement: Handle policy endorsements such as member updates, change in coverage, corrections in personal details, etc. Coordinate with insurers for endorsement issuance and follow up for endorsement letters/certificates. Ensure timely communication of endorsements to clients with updated documentation. Documentation & Reporting: Maintain and update accurate records and trackers for all enrolment and endorsement activities. Prepare periodic MIS reports and dashboards for internal use and client reporting. Stakeholder Management: Coordinate with clients, TPA (Third Party Administrators), insurers, and internal sales/service teams to resolve queries or discrepancies. Provide support during policy renewal, including reconciliation of member lists and premium calculations. Key Requirements Education: Graduate in any discipline (preferably in Commerce, Business Administration, or related fields). Experience: 1 - 5 years of relevant experience in health insurance enrolments/endorsements or policy servicing at a broker Skills Strong attention to detail and accuracy Proficiency in MS Excel and data handling Good communication and coordination skills Knowledge of health insurance processes and terminology Ability to work under deadlines and handle multiple tasks Preferred Qualifications Prior experience using insurer portals or broker management software Understanding of group health insurance schemes and endorsements Basic understanding of insurance compliance and documentation norms What We Offer Opportunity to work in a growing and dynamic industry Learning and development support Collaborative and supportive team culture Competitive salary and benefits

Adhere billing process guidelines Review claims, Verify coverage Assist with inquiries Prepare claim forms & documents & timely claim processing Record Keeping & upload files on the portal Assist pre-authorizations Resolve billing issues/escalation Required Candidate profile Any graduation or BBA/BHA min. 1 year Billing Experience is preferred Please Email your resume at hr@jimsh.org

About the role : We are looking for a Dedicated Claims Specialist with a strong background in medical and health insurance, particularly in group medical corporate policies . The ideal candidate should have 2-4 years of experience in claims processing or CRM roles. Key Responsibilities: Handle end-to-end processing of reimbursement claims for group medical corporate policies. Provide excellent customer service by addressing claims-related queries via Freshchat, Ozontel, and Freshdesk. Analyze medical documentation, policy terms, and conditions to ensure accurate claim assessment and processing. Liaise with internal teams, insurers, TPA s, and hospitals to ensure seamless claims settlement and timely resolutions. Manage claims escalations, ensuring prompt resolution while maintaining a customer-centric approach. Required Skills: In-depth knowledge of corporate group medical insurance policies and claims processing. Ability to understand medical terminology, treatment procedures, and health-related documentation. Proficient in Ozontel, Freshdesk, or similar customer support and claims management tools. Strong communication and problem-solving skills to manage customer relationships and resolve issues effectively. Attention to detail to ensure accuracy in claim processing and documentation review. Ability to collaborate effectively with cross-functional teams, including insurance partners and hospital networks. Qualifications: Bachelor s degree in healthcare, insurance, or related field preferred. 2-4 years of experience in claims processing, CRM role preferably within group medical corporate policies.

About the role : We are looking for a Dedicated Claims Specialist with a strong background in medical and health insurance, particularly in group medical corporate policies . The ideal candidate should have 2-4 years of experience in claims processing or CRM roles. Key Responsibilities: Handle end-to-end processing of reimbursement claims for group medical corporate policies. Provide excellent customer service by addressing claims-related queries via Freshchat, Ozontel, and Freshdesk. Analyze medical documentation, policy terms, and conditions to ensure accurate claim assessment and processing. Liaise with internal teams, insurers, TPA s, and hospitals to ensure seamless claims settlement and timely resolutions. Manage claims escalations, ensuring prompt resolution while maintaining a customer-centric approach. Required Skills: In-depth knowledge of corporate group medical insurance policies and claims processing. Ability to understand medical terminology, treatment procedures, and health-related documentation. Proficient in Ozontel, Freshdesk, or similar customer support and claims management tools. Strong communication and problem-solving skills to manage customer relationships and resolve issues effectively. Attention to detail to ensure accuracy in claim processing and documentation review. Ability to collaborate effectively with cross-functional teams, including insurance partners and hospital networks. Qualifications: Bachelor s degree in healthcare, insurance, or related field preferred. 2-4 years of experience in claims processing, CRM role preferably within group medical corporate policies.

About the role : We are looking for a Dedicated Claims Specialist with a strong background in medical and health insurance, particularly in group medical corporate policies . The ideal candidate should have 2-4 years of experience in claims processing or CRM roles. Key Responsibilities: Handle end-to-end processing of reimbursement claims for group medical corporate policies. Provide excellent customer service by addressing claims-related queries via Freshchat, Ozontel, and Freshdesk. Analyze medical documentation, policy terms, and conditions to ensure accurate claim assessment and processing. Liaise with internal teams, insurers, TPA s, and hospitals to ensure seamless claims settlement and timely resolutions. Manage claims escalations, ensuring prompt resolution while maintaining a customer-centric approach. Required Skills: In-depth knowledge of corporate group medical insurance policies and claims processing. Ability to understand medical terminology, treatment procedures, and health-related documentation. Proficient in Ozontel, Freshdesk, or similar customer support and claims management tools. Strong communication and problem-solving skills to manage customer relationships and resolve issues effectively. Attention to detail to ensure accuracy in claim processing and documentation review. Ability to collaborate effectively with cross-functional teams, including insurance partners and hospital networks. Qualifications: Bachelor s degree in healthcare, insurance, or related field preferred. 2-4 years of experience in claims processing, CRM role preferably within group medical corporate policies.

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 WhatsApp no - 8951865563 Thanks & Regards Sarika Email - sarika.pallap@mediassist.in

Basic Function Initiating Broker/GA/TPA, Add/Change/Remove request submitted by the group customer, sales service team and resolving the related queries/escalations for assigned brokers/GA/TPA of varying complexity. Meets quality and customer service expectation levels set by the organization guidelines. The key deliverables of the role will include but will not be restricted to the details below: Essential Functions Review of the request and form for acceptability Partnering with different stakeholders and resolve broker compensation related queries/escalations received from various departments/stakeholders through emails & calls. Updating systems with broker/GA/TPA details, commission rate and send external confirmation communication email. Implement corrective actions, as needed, to ensure correct comp release for brokers/GA/TPA Assisting vintage team members, supervisor and/ or management in developing or providing process related information, required solutions and responses

Jaslok Hospital & Research Centre is now a private, full-fledged multi-specialty hospital with 350 beds, out of which 75 are ICU beds.It is also one of the biggest research centers in India, conducting regular research and clinical trials in various fields, often in collaboration with other institutions in India & abroad. Role: Senior Billing Executive Location: Mumbai (Peddar Road) What You'll Do: Bill Follow-up: Follow up with individual patients and corporate clients to recover pending payments. Coordinate with internal departments (e.g., discharge, TPA, front office) for smooth billing closure. Data Collection & Reporting: Collect, compile, and maintain accurate billing data daily. Generate daily, weekly, and monthly reports related to outstanding bills. Maintain logs of communication with patients/corporates regarding billing issues. CSR Patient Analysis: Track and analyse bills related to Corporate Social Responsibility (CSR) supported patients. Prepare summaries for management and audit purposes. Billing Data Analysis: Perform regular data analysis to identify trends, delays, and discrepancies in billing and collections. Provide insights to support operational decisions and reduce outstanding payments. Assist in preparing MIS reports for the Billing Head and senior management. What We Are Looking For: Bachelors degree in Commerce, Finance, Healthcare Administration, or related field Minimum 23 years of experience in a hospital billing department or similar healthcare setting What We Offer: Competitive salary and benefits package Opportunities for professional development and career growth A collaborative and inclusive work environment

CRM Executive / Health Insurance Claims Executive / TPA - Helpdesk / TPA - Executive / TPA - Senior Executive Handling day-to-day servicing requirements of clients in a timely basis to ensure complete customer satisfaction Effectively coordinating between client / insurers for any document collection / handover Effectively coordinating with the TPA for daily service requirements Ensuring that all operational requirements / processes are met as per Company defined TAT Communicating with internal & external stakeholders as needed based on business requirements Accountable for deliverables pertaining to the areas assigned and responsible for results Basic knowledge of insurance / insurance products (EB at the minimum) Good communication skills Good interpersonal skills Proactive attitude for handling customer needs Multi-tasking & prioritizing Attention to detail Time management Willingness to learn Minimum 1 year in handling client relations / Helpdesk Activity in TPA or Insurance Broking Company

Greetings from Vidal Health Insurance TPA Pvt Ltd., Openings For District Medical Officer!!! - Non Clinical Role Qualification -MBBS-MCI Reg Experience - 0 to 1 Year Job Location - Chennai 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 Claim/Preauth. Play as an intermediate role between the Insurance co., and the Customer. Handling Customer queries and giving a prompt reply to the customers through email. Preparing the Weekly consolidated reports of the team and updating to the Management. Assigning and Resolving Customer Queries through email. Raising Shortfall whenever it is necessary. Approving and Rejecting of Claim/Preauth after all necessary checks I nterested Candidates can Whatsapp(no calls please ) your resume to Udaya Kumar R - 9940138034 or Apply in Naukri Itself. Regards Udaya Kumar R 9940138034

We are Hiring Doctors for claim processing (Medical Officer ) ACADEMIC & PROFESSIONAL QUALIFICATIONS • BHMS/BAMS/BDS Interested candidates can call on 9371762436 ADDITIONAL SKILLS • Good communication • Familiarity with Computers and interest in learning on the job. 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 Only male candidate required

Managing CGHS, ECHS, CAPF and ESIC and All Government Portals: Medical file Audit Claim Processing Uploading Query Management Required Candidate profile Mandatory practical experience of government empanelment such as CGHS ECHS ESIC CAPF etc. and medical file audit and processing for Railways, CGHS, ECHS and other govt empanelment's.

Role and Responsibilities: - Managing underwriting for group health - Responsible for review of group health products' RFQs received from partner - Correct pricing of risk in accordance with Underwriting guidelines and principles.

Walkin : Mon to Sat between 11am to 3pm - Siruseri Unit 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

Job Title : Medical Officer (Claim Processing) Location: Chennai T-Nagar Type: Full-Time Skills and Qualifications : Medical Knowledge : Strong understanding of medical terminology, treatments, and procedures. Analytical Skills : Ability to assess medical records and evaluate claims based on necessity and policy guidelines. Attention to Detail : High accuracy in reviewing claims and supporting documentation. Communication Skills : Effective in liaising with healthcare providers, patients, and colleagues. Regulatory Knowledge : Familiarity with healthcare regulations and billing codes. Problem-Solving : Ability to resolve claim disputes and issues efficiently. Technical Skills : Proficiency in claim processing software and medical management tools. Educational and Professional Requirements : Education : Medical degree (MBBS, MD, or equivalent). Experience : Experience in healthcare or insurance claims processing is preferred.

Urgent requirement for BHMS/BAMS/BDS/MBBS-Pune (Vadgaonsheri) Freshers/candidate with clinical or TPA experience Interested candidates can call on 7391042258 (Sneha- HR department) or share their updated resumes to recruitment@mdindia.com Roles and 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. Required Candidate profile: BAMS / BHMS / BDS/ MBBS graduate. Good Medical & basic computer knowledge Should have completed internship (Provisional /Permanent Registration number is mandatory) Freshers can also apply. Work from office . Interview Timings-11am To 5pm(Monday To Saturday) Venue Details: MDIndia Health Insurance TPA Pvt. Ltd. S. No. 46/1, E-space, A-2 Building, 4th floor, Pune Nagar Road, Vadgaonsheri, Pune 411014

We are hiring for Network Manager Job Title: Network Manager (West Zone) Location: Mumbai - Sakinaka Working Days: Monday to Saturday (Any 2 Saturdays off in a month) Shift Timings: 10:00 AM to 7:00 PM or 10:30 AM to 7:30 PM Job Summary: We are looking for a high-energy, mature individual who excels in Business Development , Relationship Building , and is process-oriented to independently handle the West Zone . The ideal candidate should be capable of driving sales, managing relationships, and overseeing process integration with medical providers. This role also involves working closely with Operations/IT teams to ensure smooth integration after contracts are signed with medical providers. ts. Key Responsibilities: Drive network empanelment with hospitals, diagnostic centers, and wellness networks in the West Zone. Build and maintain strong relationships with medical providers. Lead negotiations and finalize service agreements. Maintain and update the Medical Network database. Manage network empanelment for corporate and retail healthcare services. Occasional travel within the West Zone. Preferred Skills & Qualifications: Experience in business development within healthcare or similar sectors. Strong relationship-building and negotiation skills. Technically proficient with IT systems. Willing to travel as needed. Why Join Us? Work with a dynamic and growing team in the healthcare sector. Opportunity to independently manage the West Zone and have a direct impact on business growth. Competitive compensation package with opportunities for growth. Education: Any Graduate or Postgraduate Email your CV at naina@mumbairozgaar.com Call me at 7039628121

Interested candidate can share their CV at Hr82@miracleshealth.com or call at 9911652651

The associate will be responsible for leading and managing independently Operational Services to Sales Leaders and help drive NCVI (Net Contract Value Increase) by executing key processes and improving Territory Strategy for a Pod. Independently drive and partner with TPA Stakeholders to help Sales Leaders take informed decisions in incremental Sales force and building optimal territories. Clients Service: Provide support to Gartner Sales Leaders Engage verbally and in writing with assigned Sales regions to provide timely and accurate resolution Work on ad-hoc and regular operational projects with minimal guidance Manage and resolve support requests from internal clients within service level agreements. Engage with Sales Leaders and partners with members across functions to deliver value Partner within and across teams to Identify gaps, problem solve and improve Seller productivity and experience Conduct data analysis and support reporting needs Ensure data integrity by identifying discrepancies and updating datasets regularly. Manage data tools and internal applications including Anaplan, Excel, Power BI, CRM, etc. Successfully drive high complexity projects with minimal guidance Gain strong understanding of internal systems and processes such as Account Moves Process guidelines and Rules of Engagement (RoE) Mentor and train other team members on processes/tools Execute on business-critical sales operations & provide service support for core TP&A processes which include: Correct account alignment: Ensuring right Salesperson is assigned to correct accounts Efficient new hire intake process: Ensuring new to role sales associates have a robust territory as soon as they become quota eligible. Personnel changes: Ensuring our internal processes and systems are set up when we have critical changes in our sale personnel. E.g., when sales associate join or depart the firm, when they have changes in their territories, etc. Assist with transition and implementation of new processes. Own and drive execution of assigned workstreams independently. What you ll need: Bachelors degree, preferably in STEM discipline with 3 years of relevant experience in client service and/or service operations/delivery role Strong Microsoft office skills, especially Excel and Power Point, knowledge of VBA/Macros and Power BI is a plus. Experience in working with multiple stakeholders across geographies with changing requirements. Problem-Solving ability breaks down problems and considers solutions, comfortable with quantitative analysis. Good Communication skills with a strong sense of ownership and is seen as trusted business advisor by stakeholders Thoughtful, coachable & driven individual, respectfully challenges the status quo and quickly absorbs feedback Stakeholder Management - works effectively with stakeholders/partners/teams; builds / maintains good relationships. High sense of urgency and attention to detail Ability to analyze and improve operational processes and services. Good organizational and time management skills. 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