157 Claim Settlement Jobs

Educational Requirements Bachelor of Engineering Service Line Enterprise Package Application Services Responsibilities A day in the life of an Infoscion As part of the Infosys consulting team, your primary role would be to actively aid the consulting team in different phases of the project including problem definition, effort estimation, diagnosis, solution generation and design and deployment You will explore the alternatives to the recommended solutions based on research that includes literature surveys, information available in public domains, vendor evaluation information, etc. and build POCs You will create requirement specifications from the business needs, define the to-be-processes and detailed functional designs based on requirements. You will support configuring solution requirements on the products; understand if any issues, diagnose the root-cause of such issues, seek clarifications, and then identify and shortlist solution alternatives You will also contribute to unit-level and organizational initiatives with an objective of providing high quality value adding solutions to customers. If you think you fit right in to help our clients navigate their next in their digital transformation journey, this is the place for you! Additional Responsibilities: Ability to work with clients to identify business challenges and contribute to client deliverables by refining, analyzing, and structuring relevant data Awareness of latest technologies and trends Logical thinking and problem solving skills along with an ability to collaborate Ability to assess the current processes, identify improvement areas and suggest the technology solutions One or two industry domain knowledge Technical and Professional Requirements: Minimum 2+ years of overall SAP experience. Must have Hands-on project experience latest SAP TPM (Trade Promotion Management) covering technical/functional skills for end-to- end configuration and customization SAP CRM, CBP, TPM, Funds management, Pricing, Claims and Settlement. Must have configuration experience of planning product hierarchy, operational planning, scenario planning, baseline planning other planning supported in CBP screen. Also, must have master data configuration knowledge in SAP CRM for SAP Trade management solution. Must have knowledge about ECC integration for master data replication, SAP SD OTC cycle, pricing, rebates, deduction claim settlement functionality. Lead and drive the CRM/ TPM process workshops and lead the Functional Design Requirement gathering, functional, technical design Budgeting, planning help to program manager. Experience in AMS project /support projects, Different ticket tracking & monitoring tools in CRM /TPM Functionality. Preferred Skills: Technology-SAP Functional-SAP Trade Management-SAP Trade Promotion Management

The candidate should be well versed with detailed backend operation processes related to MF, Life and General Insurance, and Fixed income. They must possess in-depth knowledge of all processes related to different financial asset classes. The candidate is responsible for creating and updating product process flow charts to ensure seamless and error-free processes. Experience in handling different portals related to investment execution of various financial companies is required, including expertise in handling the BSE Star Platform for MF transactions. Daily online/offline execution of MF, Insurance, General Insurance, and Fixed income products such as purchase, redemption, switch, renewal, claim settlement, and quote generation is part of the responsibilities. The candidate should prepare and maintain daily transaction reports and MIS, as well as coordinate with various companies and processing houses to resolve transaction-related issues and client queries. Multitasking and high-speed error-free transactions are expected, along with coordinating with clients for transaction-related and query resolution issues. The ideal candidate should have 0-2 years of experience in wealth advisory, financial portfolio companies, or any financial advisory firms handling backend operations. A Graduation/MBA/BBA qualification with at least 65% marks along with certifications in various asset classes is required. Skills such as being humble and soft-spoken, having excellent command over verbal and written English communication, expertise in EXCEL and PPT, high customer orientation, willingness to stretch as per workload, and a strong sense of ownership towards work and assigned tasks are essential. The salary offered will be as per company standards. Only female candidates from in and around Navi-Mumbai are eligible to apply.,

The role involves recruiting, engaging, and training Business Managers (BMs) and Personal Financial Advisors (PFAs) regularly to help them achieve the desired business targets. You will conduct regular meetings with BMs and PFAs to update them on new earning opportunities and enablement initiatives. It is essential to ensure that BMs and PFAs receive periodic training with the support of the Training Team. You will be responsible for meeting prospective customers with the team to sell product solutions. Ensuring the quality of business and persistency, such as renewals of premium, is a key aspect of the role. Additionally, you will need to enable the team to utilize the latest digital platforms effectively. Providing pre-and post-sales support, including claim settlement and nominee revision, is also part of the responsibilities. If you are interested in this opportunity, please submit your CV to 9489565290 or narmatha@jobsnta.com.,

The Lead FP&A will be responsible for overseeing the financial planning, analysis, and reporting for a large and complex project. You will collaborate with various departments to provide financial insights, forecasts, and strategic recommendations to ensure the successful execution and financial performance of the project. Additionally, you will ensure continuous variance monitoring and related analytics to management for a seamless and cost-efficient delivery of the project. Your key responsibilities will include developing and maintaining detailed financial models and forecasts for the project, cost estimates, and capital expenditure requirements. You will create and manage the project budget, monitor expenditures, track variances, and ensure alignment with financial goals and project milestones. Conducting regular financial performance analysis, including variance analysis, and providing actionable insights and recommendations to improve project performance will be part of your role. You will be responsible for preparing and presenting financial reports, including monthly, quarterly, and annual updates, to senior management and project stakeholders. Ensuring the accuracy and timeliness of all financial reports, implementing and overseeing cost control measures, and identifying cost-saving opportunities and efficiencies are also essential aspects of this role. Moreover, you will need to ensure compliance with company policies, accounting standards, and regulatory requirements. Conducting financial audits and reviews as needed, leading and mentoring a team of financial analysts, and fostering a collaborative environment while providing guidance on financial analysis and reporting are crucial responsibilities. As the primary financial liaison for the project, you will communicate financial information effectively to stakeholders, including senior management, project teams, and external partners. You will work with cross-functional teams for the closure of audit points and compliance under various laws within target dates, review insurance coverage, assist in policy renewal and claim settlement, review and monitor business cases and projects for long-term sustainability, and monitor and review fixed expense budgets.,

DEPARTMENT Micro Banking REPORTS TO Branch Manager ROLE PURPOSE & OBJECTIVE This profile is directly responsible for business generation, customer acquisition and customer servicing for Deposit Products, Digital channels and Third Party Insurance products The profile role includes cross-selling to existing customers as well as acquisition of new customers through referral and family banking Offer and onboard customers on CASA and Term deposit products to customer, their family members and their references. Offer and onboard customers on Digital platforms including Mobile banking, UPI, UPI QR and download of Hello Ujjivan. Deliver prompt customer services; be accessible to customers at all times for Digital Banking and Deposit Product queries. SIZE OF THE ROLE FINANCIAL SIZE NON-FINANCIAL SIZE Approx 2 Cr. Deposit CASA, FD, RD & TPP (Product & Services) KEY DUTIES & RESPONSIBILITIES OF THE ROLE Business/ Financials Meet the set targets for overall Liability, TPP and Digital Initiatives in terms of Family Banking (Open Market) acquisition. Convert Group Loan, Individual Loan customers, their family members and referrals for available Liability, TPP and Digital Initiatives product in the branch. Open CASA and ensure customers are maintaining Monthly Average Balance for opted CASA. Actively source term deposits (FD and RD) to Family members of GL customers. Offer suitable Insurance products to customer and family members to provide adequate insurance coverage Onboard customers on digital channels including Mobile banking, UPI, UPI QR and Hello Ujjivan Ensure digital adaptation for mapped customers. Share customer insights/product related feedback with the CRM Customer (Both Internal & External) Meeting customers regularly and cross selling of overall Liability, TPP and Digital Initiatives. Meeting customers regularly and providing services related to overall Liability, TPP and Digital Initiatives. Ensure customers and Family members are educated about entire bouquet of banking products (CASA, TPP, TD and Digital Initiatives) offered by Ujjivan. Engage with customers for other account related activity like conversion for Dormant account to inactive account, linking of DBT etc., Converting existing family banking leads and providing the leads to respective business function to cross selling of other available secured loans in Ujjivan. Money Mitra assisting CRM in managing BC arrangements including Money Mitra and others. Assisting customers for digital channels usage like ATM Card, Mobile Banking, UPI, Missed-call banking, Hello Ujjivan etc. Interact with customers in a courteous and professional manner; provide prompt, efficient and accurate services Ensure timely insurance claim settlement for his/her customers Resolve customer queries/ pertaining to Family Banking and digital channels within specified timelines. Internal Process Compliance to SLA/Policies/Processes Adhering to compliance and quality guidelines in all the documentation and forms Analyze existing customer profile, leads shared and fill customer profile in AOF with accurate details, routinely check with concerned authorities for any re-work needed in already submitted AOFs. Ensuring no form pendency for sourced customers by regular follow up with branch ops team. Help to conduct the CSR activities and motivates customers to participate in the Financial & Digital Literacy Programs Give the detailed field reports to CRM and discuss field related issues. Pro-actively participate, facilitate and drive any new Digital initiative taken by the bank Assist branch staff CRO, LO in adopting all the digital initiatives of the bank for Loans as well as deposit products Innovation & Learning Being up to date about all the new digital initiatives of the bank Maintain up to date knowledge of overall Liability, TPP and Digital Initiatives and processes as well as a working knowledge of other available products offered in the branch. Ensure adherence to training man-days/ mandatory training programs for self Be up to date with any new process implementation initiative taken by the bank. MINIMUM REQUIREMENTS OF KNOWLEDGE & SKILLS Educational Qualifications Graduate in related subjects with good analytical and sales skills to be considered. Experience(Years and Core Experience Type) 0-1 year experience for Graduates Field Experience preferably in product sales, banking Certifications If required Functional Skills Fluent in regional language and English Strong communication skills Good Interpersonal skills Sales skills Willingness & Attitude to travel and do field activities Must have a two-wheeler for field visits Outgoing attitude with ability to engage with customers Should be an active smartphone user with understanding of digital platforms in personal life (e.g. Social Media, UPI, wallets, banking apps, ATM, POS) Aware user of basic office tools like Email, Word, Excel, power point Behavioral Skills Effective Communication both oral and in written Interpersonal skills Multiple product selling skills Competencies Building Relationship Driving Change Planning & Organizing Collaboration

As a diligent individual within the role, you will be responsible for verifying TPA documents before submission. It will be essential to maintain accurate records of all TPA cases, including approvals and rejections, to facilitate audits and follow-up procedures effectively. Effective communication with insurance companies and TPA coordinators will be crucial in addressing queries and ensuring all necessary information is provided. Furthermore, you will play a key role in preparing and submitting final discharge summaries, bills, and other essential documents required for claim settlement. Monitoring the approval status and handling enhancement requests will also be part of your responsibilities. This full-time position requires a Bachelor's degree, with previous experience in TPA for at least 1 year being preferred. The work location for this role is in person, and the application deadline is set for 17/07/2025.,

1. Looking after the corporate client & their empanelment’s 2. Preparing bills of TPA, ESIC, ECHS, CGHS and other Private clients Independently. 3. Handling all queries related to patients. Call me on +91 97739 85718

Job Description: Prepare ILAs, Final Survey Reports, and requirement letters. Maintain records of claim intimation, surveyor visits, document status, and report. Follow up with insured and internal teams to minimize TAT Update data in CMS software Health insurance Provident fund

Role & responsibilities i) Health Check-Ups Annual medical health check-ups for all employees are planned and scheduled on time, and reports for critical illness are to be shared within 1 hour from the incident reported. ii) Claim Reimbursement Employee claim reimbursement is to be processed and paid out within defined timeline from the final bill submission iii) Employee Connect Ensuring employees who are unwell/hospitalised are met/spoken to and tracking records of such employees are maintained every week. Providing on-time information to employees related to the ESIC / Mediclaim process and generating unique code from ICICI iv) Process Information Annual Health Check-ups as per schedule On-time payment of Claim Reimbursement Timely resolution of ESIC/Mediclaim Query Prompt connect and support to Unwell/Hospitalized Employees Preferred candidate profile Competencies (Skills essential to the role): Insurance and claims knowledge Accuracy and Timeliness Vendor Management Good communication both verbal and written Good interpersonal skills and ability to work with cross-functional teams Ability to work independently Educational Qualification / Other Requirement: Bachelor’s Degree MS-Office & G-Suite

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Job Description (JD) - CRM Job Title: CRM - Auto Claims, Voice Process Location: ACKO Building, Confident Pride, Near Silk Board Junction, Bangalore Employment Type: Full-Time, Rotational Shift Job Summary : We are seeking a dynamic and customer-focused Auto Insurance Claims Executive to join our front-end operations team. The ideal candidate will have a Bachelor's degree in Automobile /Mechanical Engineering (BE/B.Tech Automobile/Mechanical ) or a Diploma in Automobile/Mechanical Engineering (DAE), coupled with 3 years of customer service experience . The role involves direct interaction with customers, handling auto insurance claims, addressing inquiries, and providing timely and empathetic solutions. Candidates must demonstrate excellent communication skills and a service-oriented mindset. Key Responsibilities Handle front-line customer interactions related to auto insurance claims. Guide customers through the claims process with clarity, accuracy, and empathy. Coordinate with surveyors, workshops, and internal teams to ensure smooth and efficient claims processing. Manage documentation and updates in the claims management system. Resolve customer queries, concerns, or escalations promptly and professionally. Maintain high standards of customer service and ensure compliance with service level agreements (SLAs). Provide feedback and suggestions to improve the claims experience and internal processes. Required Qualifications and Skills Educational Background: o Mandatory: BE/BTech in Automobile/Mechanical Engineering or Diploma (DAE) in Automobile/Mechanical Engineering. Experience: o Minimum 2-3 years of customer service experience, preferably in the auto insurance or automotive service domain. o Prior front-end or client-facing experience in a claims-related role is highly desirable. Communication Skills: o Excellent command of English (verbal and written), with proficiency in Hindi and relevant regional languages as required. o Strong interpersonal skills with a problem-solving attitude. Other Competencies: o Empathy and patience in dealing with distressed or dissatisfied customers. o Basic understanding of auto insurance policies and vehicle assessment processes. o Proficiency in CRM tools and claim processing systems is a plus. Preferred Candidate Profile • Passionate about delivering high-quality customer experiences. • Adaptable to dynamic work environments and shift timings. • Excels in cross-functional collaboration and remains composed and focused in challenging situation

• 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 deny the claims as per the terms and conditions within the TAT. Interested candidate can share your resume to varsha.kumari@mediassist.in

Roles and Responsibilities Handle claims from receipt to settlement, ensuring timely and accurate processing. Verify claim documents, including medical records, bills, and reports. Coordinate with hospitals, doctors, and other stakeholders for necessary documentation. Conduct thorough investigations into complex cases to resolve disputes efficiently. Ensure compliance with regulatory requirements and company policies.

1. Conducting surveys in field and assessment of loss. 2. Coordinating with insured for claim documents & processing. 3. Monitor the process flow of allotted claims from registration to settlement. 4. Coordinating with repairer on settlement and payment reconciliation. 5. Building relationship with internal and external customer Education - Diploma, BE -Mechanical/Automobile

The main responsibility of this role is to recruit, engage, and train Branch Managers (BMs) and PFAs regularly to help them achieve their business targets. You will be conducting regular meetings with BMs and PFAs to update them on new earning opportunities and enablement initiatives. It is crucial to ensure that BMs and PFAs receive periodic training with the support of the Training Team. You will also be meeting prospective customers with the team to sell product solutions and ensuring the quality of business and persistency, especially in terms of premium renewals. Another key aspect of this role is to enable the team to utilize the latest digital platforms effectively. Moreover, you will be providing pre- and post-sales support, such as claim settlement and nominee revision. If you are interested in this position, please drop your CV to 9489565290 or email it to narmatha@jobsnta.com.,

Job Title: Sr Manager Health Insurance Claims Location: Bangalore (Hybrid) Company: Pazcare Type: Full-time About Pazcare Pazcare is transforming employee healthcare and wellness for 2000+ companies including Mamaearth, Chaayos, Mindtickle, and more. We simplify health insurance and wellness benefits, giving HR teams superpowers through real-time claim tracking, analytics, and stellar employee experiences. Role Overview As a Claims Manager, you will be the frontline owner of ensuring claims are settled within the agreed turnaround time (TAT) across TPAs. You will play a critical role in driving TPA performance, resolving escalations, and advocating on behalf of our clients to ensure no valid claim is wrongly repudiated. Key Responsibilities Ensure all reimbursement and cashless claims are processed within the committed TAT across clients. Track, analyze, and manage TAT performance of multiple TPAs; escalate and hold them accountable for delays or service gaps. Reopen wrongly repudiated claims with TPAs/insurers and fight for fair resolution on behalf of clients. Collaborate closely with the customer success and insurance teams to address claim escalations proactively. Drive continuous process improvement in claims handling and communication workflows. Maintain internal dashboards and reports to track SLAs and spot trends. Requirements 3+ years of experience in health insurance claims (TPA/insurance broker/insurer preferred). Strong understanding of reimbursement, cashless claim processes, and IRDAI guidelines. Assertive communicator with negotiation skills to handle TPAs and insurers. Analytical mindset with ability to identify patterns in delays or rejections. Empathy for the end user the employee or HR dealing with a health issue. Why Join Pazcare? Work with a mission-driven, fast-growing team redefining how India experiences employee health benefits. Ownership of high-impact outcomes and the opportunity to shape the future of claims at scale. Be part of a culture that values transparency, speed, and customer-first thinking.

Responsibilities: Ensure timely claim settlements within policy limits. Manage health claims from intake to payment. Process mediclaim & TPA claims with accuracy. Collaborate with insurers on claim resolution. Health insurance Annual bonus

As a Sales Relationship Manager, your primary responsibility will be to establish and nurture strong relationships with the sales team of our channel partners. You will be expected to achieve your sales targets in alignment with the channel strategy set by the organization. Collaborating closely with the channel sales team, you will engage with potential customers to promote and sell our insurance solutions. Additionally, you will be required to provide both pre and post-sales support, including assisting with claim settlements. Maintaining the quality of business and ensuring persistency, particularly in terms of premium renewals, will be a key aspect of your role. You will also play a vital role in equipping the channel sales team with the necessary skills to leverage the latest digital platforms effectively. We are looking for candidates who have completed their graduation and possess a minimum of 4 years of experience in the life insurance sector. The ideal applicant will have a pleasant personality, excellent communication skills, and a proactive attitude towards achieving goals. If you thrive in a challenging environment that involves meeting and surpassing sales targets, we encourage you to apply for this position.,

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 Function Medical Officer/Consultant Claims PA/RI Approver Reporting to Location Assistant Manager Claims Mumbai Educational Qualification Shift BHMS, , BAMS, MBBS(Indian registration Required) Rotational Shift (for female employee shift ends at 8:30 PM) 6 rotational week offs Provided per month Week offs Related courses attended None Management Level Junior Management Level Industry Type Hospital/TPA/Healthcare/Insurance Roles and 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. • • • Responsibilities 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 deny the claims as per the terms and conditions within the TAT. • Handle escalations and responding to mails accordingly. • • • • Error-free processing (100% Accuracy) Maintaining TAT Productivity (Achieve the daily targets) Key Results and Outcomes driven by this role: 0- 5 years Relevant Experience No of years of experience 0-5 years None Demonstrated abilities if any Technical Competencies • Analytical Skills • • Basic Computer knowledge Type writing skills • • Communication skills Decision Making Behavioral competencies

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 Function Medical Officer/Consultant Claims PA/RI Approver Reporting to Location Assistant Manager Claims Mumbai/Bangalore Educational Qualification Shift BHMS, , BAMS, MBBS(Indian registration Required) Rotational Shift (for female employee shift ends at 8:30 PM) 6 rotational week offs Provided per month Week offs Related courses attended None Management Level Junior Management Level Industry Type Hospital/TPA/Healthcare/Insurance Roles and 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. • • • Responsibilities 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 deny the claims as per the terms and conditions within the TAT. • Handle escalations and responding to mails accordingly. • • • • Error-free processing (100% Accuracy) Maintaining TAT Productivity (Achieve the daily targets) Key Results and Outcomes driven by this role: 0- 5 years Relevant Experience No of years of experience 0-5 years None Demonstrated abilities if any Technical Competencies • Analytical Skills • • Basic Computer knowledge Type writing skills • • Communication skills Decision Making Behavioral competencies

Join our dynamic international business team across Bangalore and Hyderabad Job Description Claims Service Support (CSS) - AM/Manager Summary: We at Prudent Insurance Brokers, are seeking an experienced Employee Benefit-Claims Service Support professional for our International Business (IB) vertical. Employee Benefits Practice at Prudent is a strategic business unit dedicated to strengthening Prudent’s global brand in the international market. The individual will be responsible to Serve as primary point of contact for all employee claim queries etc. We are committed to delivering bespoke Benefit & Total Reward Solutions with high standards of service excellence, world-class advisory and consultancy support for MNC clients who have their operations in India. Our team forms a bridge of trust between the expectations of senior stakeholders globally and the seamless delivery of these best practices in India. Roles & Responsibilities: • 1) Exceptional Employee Experience Support system by Prudent Serve as primary point of contact for all employee claim queries and own the process of developing strong employee relationships & engagement 2) Facilitating the cashless and reimbursement process: Ensuring employees understand the steps involved in both cashless and reimbursement claims. Offering exceptional support and guidance to employees/HR throughout the entire process to ensure a smooth experience. 3) E-cards/network hospitals: To provide employees e-cards and information about network hospitals. 4) Providing claim-related queries: Addressing questions about claim status, claim deductions, and explanations of queries. 5) TPA Co-ordination: Co-ordinating with TPA daily to ensure the smooth functioning of employee-related queries 6) Employee Engagement & Support SPOC: Daily tracking of claims on status/rejections/deductions and providing the report to MCS Desired profile/who should join: Good listening & communication skills Should have good technical knowledge about Employee health Insurance/ General Insurance products. (Cashless/Reimbursements) Experience in General Insurance/ Insurance Brokers Years of experience: 2 to 5 years Education qualification: Bachelor's Degree, Master's Degree Good knowledge of the TPA/Insurance processes Well-versed in health insurance policy conditions Well-versed with current medical practices & advancements Should know about IRDAI health regulation If the opportunity interests you, kindly share your updated CV with Tanay Srivastava (tanay.srivastava@prudentbrokers.com) or Yogesh Nagar (Yogesh.nagar@prudentbrokers.com) with the subject ‘’Claims role_*Location*’’ Role & responsibilities

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 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 deny the claims as per the terms and conditions within the TAT. Handle escalations and responding to mails accordingly. Work From Office only Interested candidates can share their CVs to Dona- 9632777628

I am hiring for this position for one of our Life Insurance clients. Role & responsibilities Prudent claim Assessment and management of end-to-end claim settlement /repudiations, including Life, Group claims Coordinate with Reinsurers /sales/customers for closure of claims within the regulatory framework and timelines Direct and oversee the maintenance of complete and accurate claim management records. Managing the claim teams on day-to-day claims transactions, guidance on claims philosophy, regulatory, and audit procedures Ensuring daily claim deliverables are met and claims decisions within prescribed SLA with quality Ensure customer centric approach while delivering sensitive area of death claims. Accuracy and Speed in delivery Customer satisfaction Quality in claims assessment/approvals Preferred candidate profile Graduate with required communication skills, A minimum of five to seven years progressively responsible previous insurance industry experience. Life Insurance domain knowledge Decision-making skills. MIS, MS Excel, Workflows , Group Asia and Life Asia system knowledge

Role & responsibilities Seamless processing of Insurance Claims till the closure & recovery of the cost incurred in repair. Co-ordination with third party service providers with respect to timely collection of claim documents, verification of the documents and submission to the insurer for settlement. Ensuring 100% documents are checked and verified to achieve FTR > 98%. Ensuring compliance with all applicable processes, policies & standards and adherence to timelines. Analysis of claims data to identify trends and potential areas for improvements in the claims handling process Propose and assist in the implementation of improvements in the claims handling process to enhance efficiency & accuracy and also help in minimizing losses. Implementation of automation to enhance efficiency and reduce turn around time. Data management & publishing of key dashboards the internal/external stakeholders involved. Maintain and update of various data sets required for the business through various channels Ability to handle team and constantly reviewing the team performance. Ability to manage team by setting clear goals, providing regular feedback and coaching, fostering open communication and collaboration, recognizing and leveraging individual strengths, addressing conflicts constructively Preferred candidate profile 6+ years of experience in processing insurance claims Experience with Affinity product claims is highly preferred

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 to pass or clear the Health Insurance claims. Qualifications Bachelor's degree. Previous experience in TPA management or Banking. Good interpersonal and communication skills. Isha Thakur 9056448144 HRD