Hiring Claims Executive - TPA Experienced Ericson Insurance

2.0 - 7.0 years

1 - 3 Lacs

Mumbai, Navi Mumbai, Mumbai (All Areas)

Work from Office

Process health insurance claims. Should have knowledge of cashless and reimbursement. Location - Chembur. Should have knowledge of excel. Graduation mandatory. Call or send your resumes on 8097516521. TPA experience Mandatory

Posted 2 weeks ago

Apply

Medical Officer Empower Fintech

0.0 - 2.0 years

3 - 6 Lacs

Ahmedabad

Work from Office

Responsibilities: * Manage health insurance claims from start to finish. * Ensure timely TAT compliance through process improvement. * Prepare medical summaries for cashless procedures.

Posted 3 weeks ago

Apply

Associate Group leader - Claims Operations MD India Health Insurance TPA Pvt Ltd

1.0 - 6.0 years

0 - 3 Lacs

Pune

Work from Office

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 resolution

Posted 4 weeks ago

Apply

Medical officer Hiring(Non-Clinical Job) -TPA Experience required Medi Assist

2.0 - 5.0 years

3 - 5 Lacs

Noida

Work from Office

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 varsha.kumari@mediassist.in Thanks & Regards Varsjha Kumari Email - varsha.kumari@mediassist.in

Posted 1 month ago

Apply

Medical Officer HealthIndia Insurance TPA Services

1.0 - 2.0 years

3 - 4 Lacs

Hyderabad, Bangalore Rural, Chennai

Work from Office

Job description URGENT OPENING FOR MEDICAL OFFICER Workings Hours: 9 Hrs Work Mode : Office Key Responsibilities: Review and assess medical claims submitted by corporate clients against policy terms and medical guidelines. Analyze clinical documents such as medical reports, diagnostic tests, prescriptions, discharge summaries, and other relevant medical records. Verify the authenticity, appropriateness, and completeness of medical documentation related to claims. Provide medical expertise to determine the validity and admissibility of claims. Collaborate with claims processing and underwriting teams to resolve discrepancies or clarifications related to medical information. Identify potential fraud, over-utilization, or discrepancies in claims through thorough medical evaluation. Maintain up-to-date knowledge of medical terminologies, treatment protocols, and emerging health trends relevant to claims assessment. Assist in developing and updating medical claim processing guidelines and protocols. Support training and capacity-building activities for claims staff on medical aspects of claims. Ensure compliance with regulatory and company policies during claims assessment. Communicate effectively with healthcare providers, corporate clients, and internal teams to clarify medical information as needed. Generate detailed reports and documentation on claim assessments and decisions. Qualification: BHMS, BMS

Posted 1 month ago

Apply

Claims Executive Disha Investment Insurance Brokers Private Limted

3.0 - 6.0 years

4 - 6 Lacs

Bengaluru

Work from Office

Claims Executive- EB website Link: www.dishainsurance.com Job Summary: We are seeking a qualified Claims executive to help our clients in claims and any other query solution through their own skills. Our ideal Claims executive has to have in-depth 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 Roles & Responsibilities: One stop solution for all client queries and requirements Represent our company, with a comprehensive understanding of our services in the area of claim process and policy terms and conditions. Providing the timely help to clients in claim settlements in both cashless and reimbursements claims. Co-ordinating with Insurance Company in updating endorsements, CD Balance and claims reports. Co-ordinating with TPA in claim settlements, in solving the issues due to any calculation error and any data error with the MIS reports. Co-ordinating with clients, HR Head and Finance Head in resolving any issues. Maintaining MIS reports. Co-ordinating with the Retention team. Visiting clients to understand if they have any concerns and help them in fixing the issues. Visiting the TPA and Insurance Company to maintain good relationship with the customer relation team. Desired Profile/ Who should join: Should have 3 to 6 years of experience in a general insurance company/ insurance broker / surveyor Proficient in Microsoft Excel and MS office Fair knowledge about the Insurance processes Good communication skills Problem solving attitude Flexibility with calls and mails

Posted 1 month ago

Apply

Start Your Job Search Today

Browse through a variety of job opportunities tailored to your skills and preferences. Filter by location, experience, salary, and more to find your perfect fit.