1024 Tpa Jobs - Page 5

Manager / Assistant Manager Account Management - MediAssist Job Title: Manager / Assistant Manager Account Management Company: Medi Assist Location: Bangalore CTC: 7 to 8 LPA Experience: 4 to 8 years Industry: Health Insurance / TPA / Healthcare Key Responsibilities:- Client Relationship & Strategy: Build and maintain long-term partnerships with insurers, corporate clients, and healthcare providers. Lead high-level review meetings and ensure strong relationship governance. Operations & Service Delivery: Oversee end-to-end account operations including claims, customer service, and issue resolution. Ensure compliance with TATs and SLAs. Performance Analysis & Reporting: Monitor KPIs, analyze c...

About The Role Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years 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 ...

We are seeking an experienced and detail-oriented Billing & Insurance Manager to oversee hospital billing operations, ensure accurate claims processing, coordinate with insurance providers, and streamline revenue cycle management. The ideal candidate will have a strong understanding of medical billing procedures, TPA coordination, and hospital insurance practices. Key Responsibilities Oversee end-to-end billing operations for IP, OP, and corporate clients. Manage claim submission, follow-up, and settlement with TPAs and insurance companies. Verify insurance eligibility, pre-authorizations, and final bill approvals. Review and audit billing reports to ensure accuracy and compliance. Coordinat...

Key Roles & Responsibility : Planning and supervising changes and managing the daily operations of customer service. Setting up and meeting performance goals and targets. Maintaining current knowledge of industry new developments, productions, and involvement in network. Recording statistics, performance levels and feedback of clients and preparing the reports. Motivating, coaching, and retaining staff as well as coordinating reward, bonus, and incentive scheme. Reviewing the staffs performance, determining training needs and scheduling training sessions. Responsible for the efficient functioning of CRM by ensuring that the Team attends to customer calls & Networking with the concerned depar...

JD Account Management- Executive Job Responsibilities: Client Servicing Receive and check claim documents for completeness and advice employees regarding pending documents, if any. Track and control documents to ensure TAT of claims/cards as per SLA. Feedback from Insurers and Corporates. Additional revenue opportunities from existing Corporates. Respond to queries from the employees of the corporate through e-mails. Maintain weekly reports on claims and queries and the TAT of the same Escalate issues as per the escalation matrix. To attend to any other assignments assigned to you from time to time. Respond to queries from the employees of the corporate over Phone Maintain weekly reports on ...

Role Overview: You will be responsible for hands-on experience working with CISCO ACI, including Leaf & Spine Architecture, configurations, and troubleshooting skills on Nexus 9K switches. Additionally, you will work in Data Centers with ACI fabric and integrate with Firewall, TPA, Load balancers, and configure BGP on IPN. You should have a good understanding of routing protocols such as IS-IS, OSPF, BGP, MPLS, OOB/Inbound network routing, Segment Routing, PBR, Route Redistribution, QoS, IGP. Moreover, you will provide inputs for various connectivity requirements, implement network changes, and troubleshoot integration issues with platform owners. Understanding network design, LLDs, communic...

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 company€™s culture. Implement the operational strategy in the different departments of the company. Supervise the strategy, and make sure that all the e...

OE shall be owner of his / her service area in terms of all operations related actions and shall Execute daily service operations with a team of assigned Technicians within a given service areas Ensure quality of service delivery by effective supervision on technicians - on the job as per company SOPs Ensure technicians carry out treatment within a given Time on Site (ToS) in a competent manner. (OE to engage technician via route riding, training on the job). Plan & execute 02 TPAs (Technicians Performance Assessment) per assigned technician with 2 development programs per year. Coach & train assigned technicians in order to improve the service quality Convey special instructions, if any, to...

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 primary job purpose of an Executive Reimburseme...

Role & responsibilities Act as the primary liaison between the employees and insurance providers related to claims, escalations, queries related to insurance policies. Support employee queries related to insurance policies, benefits, and claim status. Maintain and update insurance databases accurately and in a timely manner. Preparing claims data related to reimbursement claims, cashless claims, claims settlement timelines etc. Preparing Microsoft presentations for various data. Preferred candidate profile Bachelors degree in any discipline; MBA HR is a plus. Good Proficiency in Microsoft Excel skills: VLOOKUP, Pivot Tables, COUNTIF, IF statements, data validation, etc and MS Presentation. G...

Greetings from Sagility . Sagility has huge openings for BDS/ MDS graduates in US healthcare organization Job Description: Interpret all types of Medical records Must have worked in Health care TPA/ must have worked a medical officer in any recognized TPA CPT & ICD 9 & 10 Coding Interpret medical necessity in contrast to clinical policies / guidelines Interpret medical data and provide accurate clinical review Identify Cost Savings within Medical Claims Itemized bill review (IBR) for Institutional claims Qualification & Skills: BDS/ MDS Graduation with Internship Interested Candidates can share the CV's to Yuva Indira. K @ 7200012804/ Share their CV's through mail yuvaindira.k@sagilityhealth...

Urgent Opening for IPD Billing at Fortis Hospital Kalyan Qualification - Any Graduate Experience - 8 to 12 Yrs of Experience Knowledge of IPD Billing, GIPSA, TPA Billing, CGHS, Looking for Hospital Experience Candidate I nterested candidate can call on 7977763787 or Email - kln.hr@fortishealthcare.com Note - Sunday Not Working

Role & responsibilities Perform audit reviews of adjudicated health / hospital / medical claims to verify correctness, completeness, and adherence to policy guidelines, contractual terms, and regulatory norms. Use sampling and systematic review techniques (random audits, targeted audits, high-value claims audits) to ensure quality coverage across volumes. Check for proper documentation, coding (ICD / CPT / procedure / diagnosis codes), member eligibility, policy coverage, benefit limits, copayments, exclusions, etc. Validate whether preauthorization, referrals, or supporting documentation was appropriately obtained / processed. Identify and flag discrepancies, overpayments, underpayments, du...

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 escalations from 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 members to understand their concerns and help simplify the process Review the claims dump along with front end team an...

Job Description: 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 IRs raised. Ensure that the claims are approved or denied as per the terms and conditions within the TAT. Provide supportive and positive experience to the new joiners and train them. Gather inputs from various sources and keep up-to-date on the new policies or changes in existing policies and intimate the Configuration team and the CRM team Manage a group of claim processors, guide and coach them...

Role & responsibilities : Manage the performance of the key accounts in the branches Set goals and targets for the teams. Monitor and review the performance of the team periodically. Preparation of reports which will be shared with other teams. Understand the training needs of team members, develop them through training, coaching and mentoring sessions. Handle escalations and associated documentation if any. Preferred candidate profile : Education: Min Graduation completion. Experience: 7+ years of experience with broker or hospital or insurance background preferred. Managed large accounts in a TPA/insurance/hospital background with ability to handle 10-20 team members. Location: Bangalore- ...

About The Role Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years 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 mod...

Role & responsibilities Claims Processing & Coordination Facilitate the Green Channel process to ensure zero waiting time for patient admissions and discharges. Support the end-to-end processing of cashless and reimbursement claims efficiently. Liaise with the Head Office to resolve claim-related issues promptly. Address and resolve patient grievances related to claims processing, escalating unresolved issues when necessary Collaborate with hospital staff to ensure seamless admission and discharge procedures for insured patients. Adhere to strict protocols to prevent fraudulent activities in claims processing. Enhance customer satisfaction by reducing waiting time for admissions, claims, and...

JD Account Management- Senior Executive Job Responsibilities: Client Servicing Receive and check claim documents for completeness and advice employees regarding pending documents, if any. Track and control documents to ensure TAT of claims/cards as per SLA. Feedback from Insurers and Corporates. Additional revenue opportunities from existing Corporates. Respond to queries from the employees of the corporate through e-mails. Maintain weekly reports on claims and queries and the TAT of the same Escalate issues as per the escalation matrix. To attend to any other assignments assigned to you from time to time. Respond to queries from the employees of the corporate over Phone Maintain weekly repo...

Job Purpose To plan, maintain and co-ordinate the HR activities such as Training (Technical and Behavioural) for employees, Administration, Employee Engagement activities, Event Management. Job Context & Major Challenges Job Context: The Taloja sheet rolling plant is located in the Raigad district of Maharashtra. The capacity of plant is 79,200 TPA. Taloja has a team of around 500 people. Aluminium Sheets & Coils, Lithographic sheets, Finstock, Foil stock, Closure stock, Lamp caps are the main products of Taloja. Hindalco Industries Limited, Taloja has been designing and implementing various HR / IR initiatives for the last few years, which has resulted in improving overall efficiency, teamw...

Rentokil Initial Rentokil Initial is an international business services company employing over 35,000 colleagues across 70 countries. We strive to protect people and enhance lives, for example by controlling pests, improving hygiene and improving interior spaces with plants and scenting. We are experts in the fields we operate in, investing in training, science, innovation and technology. Listening and acting on feedback is part of our culture to support colleagues and our customers. Rentokil Initial regards equality and fairness as a fundamental right of all of its colleagues. We live our values of Service, Relationships and Teamwork which were identified by our colleagues across the world....

The Associate Field Biologist/Field Biologist/Sr. Field Biologist shall be responsible for Pest Audits of Branch Large / HD Customers (having Third-party Audits- USFDA, AIB, BRC, FSSC, SQF, LEED, etc), Key national customers in various segments - Food & Pharma Mfg, w/h, Large food retailers (excluding QSRs, Fast food chains), Large ITES & MA s, etc The incumbent will report administratively to the DM & functionally to Opex QA and work as a part of the multi-functional team involving collaboration with the internal & external stakeholders. Job Responsibilities: Carry out Pest Audits of Global accounts, Key designated NK accounts- Food & Pharma units, Food & Pharma warehouses, Large food retai...

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...

Hiring CRM for Health Insurance Servicing. Location - Mumbai/Hyderabad/Ahmedabad. Candidate must have prior experience in TPA industry. Kindly share resume on 8291886837.

Hiring CRM for Health Insurance Servicing. Location - Mumbai/Hyderabad/Ahmedabad. Candidate must have prior experience in TPA industry. Kindly share resume on 8291886837.