1024 Tpa Jobs - Page 8

About Job Claims Management Specialist is responsible for processing and managing cashless insurance claims efficiently and accurately, ensuring timely closure to policyholders and seamless coordination with insurance providers. The job purpose of a Claims Management Specialist is to process and manage cashless claims for employees. This includes verifying policy coverage, reviewing medical records, coordinating with Insurers, and ensuring that claims are processed accurately and efficiently. The processor may also be responsible for communicating with employees or dependants to provide updates on the status of their claims and to address any questions or concerns. Overall, the job purpose i...

Role & responsibilities - Acts as an interface between the TPA, Insurance Company and the hospital. - Responsible for investigation of suspicious claims on calls & Emails. - 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) Preferred candidate profile Qualification - B Pharmacy / M Pharmacy Experience - 6 Months to 2 Years.

Designation Team Leader /Assistant Manager- Training Qualification BUMS/BAMS/BHMS/BDS/BSc Nursing/BPT Experience - 0-5 years in Claims Training or Claims Operations (Fresher are most welcome) Location - Noida, Bangalore and Mumbai Reporting to - Head L&D Responsibilities Deliver training sessions to new recruits and existing employees on Insurance, Health Insurance Fundamentals, Claims and Claims Processing, Matrix, On-Job Training Workshops, Audit Errors, refresher programs , etc. Conduct post-training quizzes, capture and maintain attendance, training duration, and assessment scores. Maintain and publish training reports on a Weekly, Monthly, and Yearly basis . Create presentations on new ...

Job Summary: The Doctor will be responsible for diagnosing and treating patients, managing medical cases, maintaining patient records, and working collaboratively with other healthcare professionals. The ideal candidate must have a strong clinical background, excellent communication skills, and a patient-first attitude. Key Responsibilities: Conduct physical examinations, take medical histories, and assess patient conditions. Diagnose illnesses and prescribe appropriate treatments, medications, or therapies. Provide follow-up care and monitor patients' progress. Maintain accurate and up-to-date patient records and medical documentation. Refer patients to specialists or other medical professi...

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...

Roles and Responsibilities: Check the medical admissibility of a claim by confirming the diagnosis and treatment details. Scrutinize the claims, as per the terms and conditions of the insurance policy. Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiation of open billing and package etc. Understand the process difference between PA and an RI claim and verify the necessary details accordingly. Verify the required documents for processing claims and raise an IR in case of an insufficiency. Coordinate with the LCM team in case of higher billing and with the provider team in case of non-availability of tariff. Approve or d...

Role & responsibilities Coordinate with patients, TPAs, and insurance companies for pre-authorization, approval, and final claim settlements. Prepare and submit claim documents and bills to TPAs/insurance companies in the prescribed format. Follow up regularly with TPAs for claim status, pending queries, and settlement updates. Verify patient insurance details, coverage, and eligibility before admission and discharge. Maintain accurate and up-to-date records of all claims submitted and settled. Handle rejections, discrepancies, and short settlements by coordinating with relevant departments and TPAs. Ensure compliance with hospital policies and TPA/insurance requirements. Generate periodic r...

Role & responsibilities Asst. Billing Manager works under supervision of Head of Accounts & Finance Guide and mentor team Maintains billing controls by preparing and recommending policies and procedures. Maintains financial security by following internal controls. Prepares refunds by verifying documentation, and requesting refunds. Maintains customer confidence and protects operations by keeping financial information confidential. Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies. Accomplishes the result by performing the duty. Supervise, guide, train,...

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...

Role Summary: Responsible for end-to-end management of Group Personal Accident (GPA) claims within the health claims vertically. This is a non-medico role focused on operational excellence, stakeholder coordination. Please share resume at aparna@aceconsultants.in

Bams Doctor/BHMS Doctor -female for Hospitals Location-Saharsa, Bihar

Role: Senior Executive - Account Management 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. Non voice coordinator 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. NOTE: Must have TPA or Insurance work experience for min 1-2 yrs

Roles and Responsibilities Department: Cashless & TPA Designation: Executive-Cashless & TPA JOB RESPONSIBILITY 1. Need to reach Hospital on Time and cross check the cleanliness of Cashless & TPA room, need to check proper working condition of internet, PC, Printers, Telephone Lines. 2. Should have an updated list of all TPA & Govt PSU on panel with updated MOU & Rate list as per agreed tariff, Email ID with Contact Number of costumer care and TPA Coordinator. 3. Should have proper knowledge of all the documents required for cashless approval, Preauthorization form, claim form and process like RSBY, BSBY, ECSH, CGHS. 4. Should handle entire billing part and documentation. 5. Should fill the a...

Role & responsibilities 1) Relationship & communication with local Insurance Companys officials / agents. 2) Business development. 3) Overall operational process supervision. 4) Empanelment of Diagnostic Centres & Hospitals. 5) Willing to travel across states for Empanelment. 6) Team management. 7) Close coordination with PIMS HO team Preference would be given to candidates with prior experience in relevant field. Interested candidates can share their resume on jobs@mdindia.com Also can contact on 77091 89897

Education Mandatory : Any Graduate (BSC/BCOM/BA) Desirable : Nil Experience Minimum 6 Months eligibility/enrolment experience (preferred) Technical Competencies : (Job related) Exceptional data entry skills with high attention to detail, strong organization skills and ability to multi-task Should have working knowledge of MS-Office: (Teams, Outlook, Excel, Word, OneNote) Soft Skills : (Job related) Effective verbal and written communication skills and excellent interpersonal skills Ability to work effectively with team members, employees/members, providers, and clients and vendors Ability to use common sense understanding to carry out instructions furnished in oral, written or diagram form F...

Will be responsible for leading & managing the overall operations & business development activities. This role requires strong leadership, operational excellence & client relationship skills to ensure smooth service delivery & business growth. Required Candidate profile Candidate MUST have experience in TPA *Operations Management *Business Development *Team Leadership *Compliance & Reporting *Client Relationship Management *Networking & Negotiation Skills

As a Domain Trainee/ Management Trainee - Treasury at Genpact, you will play a crucial role in cash management by reviewing legal entities and all accounts for fund management. Your responsibilities will include working on open items, collaborating with other Finance departments to resolve issues, ensuring open items are clarified through follow-up escalation matrix, and maintaining the hygiene of Reconciliations by keeping a tab on open items. Key Responsibilities: - Review legal entities and all accounts for fund management - Work on open items and collaborate with other Finance departments to resolve issues - Follow up escalation matrix to ensure open items are clarified - Maintain the hy...

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...

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. For more details: https://www.rentokil-pestcontrolindia.com Our Family Of Businesses Rentokil Pest Control is the world's leading commercial pest control company, operating in 70 countries and ranked in the top 3 in 65 of those countries. Ranking in the top 3 in 38 of the 44 countries we ...

Medical Officer (MBBS/BAMS/BHMS) at Good Health Insurance TPA. Responsible for cashless request processing, claim review, ICD coding, and policy adherence. Freshers can apply. Strong medical knowledge and computer skills required. 91212 46809

JOB DESCRIPTION FOR ASSISTANT MANAGER - BILLING POSITION : - ASSISTANT MANAGER DEPARTMENT : - BILLING REPORTING TO : - HEAD - FINANCE & ACCOUNTS QUALIFICATION : - GRADUATE /B.COM PREFFERED EXPERIENCE : - MINIMUM 5 TO 8 YEARS OF EXPERIENCE IN HOSPITAL BILLING JOB RESPONSIBILITIES : - The Billing Staff is responsible for managing all aspects of billing related to CGHS, MJPJAY patients, TPA & OTHER billing related work in the hospital. This includes verifying patient details, ensuring the correct application of health scheme policies, preparing and processing bills, as per agreed tariffs and maintaining records for these specific patient categories. Job Description: 1. CGHS & MJPJAY Billing: - ...

POSITION : - OFFICER DEPARTMENT : - BILLING REPORTING TO : - HEAD - FINANCE & ACCOUNTS QUALIFICATION : - GRADUATE /B.COM PREFFERED EXPERIENCE : - MINIMUM 4 YEARS OF EXPERIENCE IN HOSPITAL BILLING JOB REPOSIBILITIES : - The person of this designation will be responsible for auditing/entering/modifying services in order to generate accurate patient bill as per the policies and protocols of the hospital in the TAT as described by the Billing Incharge /Manager/CFO. JOB DUITIES & RESPONSIBILITY : To ensure that bills are generated as per SOP. To ensure that outstanding follow-up is done regularly and any discrepancies in outstanding amounts, as described in policy, are immediately reported to the...

Job Description: Manipal Hospitals is seeking a dedicated and detail-oriented Senior Associate for our Admission & Billing department. In this role, you will be responsible for managing patient admissions, ensuring accurate billing processes, and providing exceptional customer service to patients and their families. You will work closely with healthcare providers, insurance companies, and administrative staff to facilitate seamless patient experiences and resolve any billing inquiries or issues. Key Responsibilities: - Oversee the admission process for patients, ensuring all necessary documentation is completed and verified. - Manage billing processes, including insurance verification, patie...

Roles and Responsibilities Manage billing processes for IPD, OPD, and TPA cases. Ensure accurate and timely submission of claims to insurance companies. Coordinate with hospital departments to resolve billing discrepancies. Maintain records of all billing transactions and reports. Provide excellent customer service to patients and insurance companies. Desired Candidate Profile 2-7 years of experience in Ipd Billing or related field (Billing). Strong knowledge of medical billing procedures and regulations. Proficiency in handling multiple tasks simultaneously under pressure. Hospital Experience is mandatory. Interested candidates can share their cv at prakash.jha1@parashospitals.com / Whatsap...

HIRING FRESHERS ALSO Role & responsibilities Medical Adjudication of Health Claims Identifying Frauds Adhering to SLAs and processing the claims within the TAT as per policy Support CRM, provider, sales and grievance team QUALIFICATION - MBBS, BAMS AND BHMS ONLY. Rest won't be considered. Work from Office only. Candidate should be comfortable with Roaster timings.