727 Claims Processing Jobs - Page 10

Greeting from Medi assist TPA Pvt ltd. Hiring Medical officer for Insurance Claim processing Profile Location- Mumbai -Andheri East. Role - Medical officer Exp : 0-8 years Job description : * 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 Interested candidate can drop there resume in my Mail ID : varsha.kumari@mediassist.in We are looking for fresher or exp candidates BAMS, BHMS mail id - varsha.kumari@mediassist.in Thanks & Regards Email: varsha.kumari@mediassist.in

Roles and Responsibilities: For Payment Posting: Posting insurance and patient payments into the billing software accurately. For AR Calling: Calling insurance companies in the US to follow up on unpaid or underpaid claims. Over time allowance Gratuity

Urgent requirement for BHMS/BAMS/BDS doctors-Pune (Vadgaonsheri) 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 graduate. Good Medical & basic computer knowledge. Should have completed internship (Permanent Registration number is mandatory) Preferred -TPA or insurance sector Experience. 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

Skills Skill Medical Coding Healthcare CPT ICD-9 EMR Medical Billing Healthcare Management Revenue Cycle ICD-10 HIPAA Education Qualification No data available CERTIFICATION No data available Role Description Overview: Coder is accountable to manage day to day activities of coding the Patients chart & Diagnosis report. Responsibility Areas: Coding or auditing charts, based on requirements Updating/Clearing the production/pending reports To work closely with the team leader. To review emails for any updates Identify issues and escalate the same to the immediate supervisor Strict adherence to the company policies and procedures. Sound knowledge in Medical Coding concept. Should have 6 months to 3 Yrs of Coding Experience. Understand the client requirements and specifications of the project. Meet the productivity targets of clients within the stipulated time (Daily & Monthly) Applying the instructions/updates received from the client during production. Coding or auditing charts, based on requirements. Prepare and Maintain reports

Skills Skill Medical Coding Healthcare HIPAA CPT ICD-9 EMR Medical Billing Healthcare Management Revenue Cycle ICD-10 Education Qualification No data available CERTIFICATION No data available Responsibility Areas: Coding or auditing charts, based on requirements Updating/Clearing the production/pending reports To work closely with the team leader. To review emails for any updates Identify issues and escalate the same to the immediate supervisor Strict adherence to the company policies and procedures. Sound knowledge in Medical Coding concept. Should have 6 months to 3 Yrs of Coding Experience. Understand the client requirements and specifications of the project. Meet the productivity targets of clients within the stipulated time (Daily & Monthly) Applying the instructions/updates received from the client during production. Coding or auditing charts, based on requirements. Prepare and Maintain reports

Skills Skill Medical Coding Healthcare HIPAA CPT ICD-9 EMR Medical Billing Healthcare Management Revenue Cycle ICD-10 Education Qualification No data available CERTIFICATION No data available Role Description Overview: Coder is accountable to manage day to day activities of coding the Patients chart & Diagnosis report. Responsibility Areas: Coding or auditing charts, based on requirements Updating/Clearing the production/pending reports To work closely with the team leader. To review emails for any updates Identify issues and escalate the same to the immediate supervisor Strict adherence to the company policies and procedures. Sound knowledge in Medical Coding concept. Should have 6 months to 3 Yrs of Coding Experience. Understand the client requirements and specifications of the project. Meet the productivity targets of clients within the stipulated time (Daily & Monthly) Applying the instructions/updates received from the client during production. Coding or auditing charts, based on requirements. Prepare and Maintain reports

Works in the area of Software Engineering, which encompasses the development, maintenance and optimization of software solutions/applications.1. Applies scientific methods to analyse and solve software engineering problems.2. He/she is responsible for the development and application of software engineering practice and knowledge, in research, design, development and maintenance.3. His/her work requires the exercise of original thought and judgement and the ability to supervise the technical and administrative work of other software engineers.4. The software engineer builds skills and expertise of his/her software engineering discipline to reach standard software engineer skills expectations for the applicable role, as defined in Professional Communities.5. The software engineer collaborates and acts as team player with other software engineers and stakeholders. - Grade Specific Experience – 3 to 15 years Skills – Guidewire Developer experience with any of the detailed skill like (Policy / Billing / Claims / Integration / Configuration / Insurance Now / Portal / Rating) Insurance domain knowledge with Property & Casualty background Hands on experience in at least one of the Guidewire products (Claim/Policy/Billing) Should have knowledge on Admin data loading. Good knowledge in Web services, XML, GxModel, Messaging, Batch implementation, Integrating with 3rd Party Systems and Document composition tools like Xpressions, Thunderhead Experience on any database Oracle / SQL Server and well versed in SQL Designed & modified existing workflows (required for Billing Integration) Experience in SCRUM Agile, prefer Certified Scrum Master (CSM) Good written and oral communication Excellent analytical skills.

Strong understanding of P&C industry & solutions with 3-15 Yrs' exp. in Duck Creek Policy Exp. in application maintenance support engagements (Commercial & Specialty insurance preferred) in configuring DuckCreek Claims product & Agile methodology Required Candidate profile Technical knowledge of DuckCreek Claims & detailed understanding on Duck creek Architecture, Data Model, UI design, processes, events & DCOD Environment,2. Exp.in integrating Duck Creek Claims product

Skill required: Property & Casualty- Claims Processing - Insurance Claims Designation: Claims Management New Associate Qualifications: Any Graduation Years of Experience: 0 to 1 years About Accenture 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 120 countries. Visit us at www.accenture.com 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 model that can meet the unique needs of each market segment.Claim processing team collects end-end data dataDevelop and deliver business solutions that support the claims process across its lifecycle, including first notice of loss, claims investigation, payment administration or adjudication, provider reimbursement (health care), subrogation and recovery. What are we looking for Ability to establish strong client relationshipAbility to handle disputesAbility to manage multiple stakeholdersAbility to meet deadlinesAbility to perform under pressure- Roles and Responsibilities: In this role you are required to solve routine problems, largely through precedent and referral to general guidelines Your primary interaction is within your own team and your direct supervisor In this role you will be given detailed instructions on all tasks The decisions that you make impact your own work and are closely supervised You will be an individual contributor as a part of a team with a predetermined, narrow scope of work Please note that this role may require you to work in rotational shifts Qualification Any Graduation

SUMMARY Looking Both Fresher/Exp candidates ready to work in A VOICE Process in Leading KOLKATA MNC. Excellent Communication Skills. WORK FROM OFFICE. Salary up to 5lpa for EXP(more than 1 year) Freshers Salary : 3.6 LPA CTC. UG/GRAD both can apply. Requirements Requirements. * Any Undergraduate / Graduate fresher and exp with excellent English communication can apply * Should have excellent communication (read/write/speak) * Should be smart and have convincing skills * Doing outbound calls and providing information * Selling products and promos * Helping customer * Comfortable to work in rotational shift Benefits Benefits. Salary for Freshers - 3.6 LPA CTC Salary Experience (1+ years exp) - Up-to 5.20 LPA CTC. PF+ESIC+HEALTH INSURANCE+ GREAT MNC CULTURE+ LUXURIOUS OFFICFE+ CABS + IJP.

Roles and Responsibilities Manage billing processes for hospitals, ensuring accurate and timely submission of claims to TPAs and insurance companies. Oversee medical billing operations, including claims processing, cash posting, and denial management. Develop and implement effective strategies to reduce claim rejections and improve revenue cycle management (RCM). Collaborate with healthcare providers to ensure compliance with NABH standards and regulations. Analyze financial data to identify trends and areas for improvement in hospital administration. Desired Candidate Profile More than 18 years of experience in medical billing (hospital administration). Degree in Hospital Administration or relevant discipline; MBA/PGDM- Finance is preferred. Strong knowledge of billing procedures, claims processing, cash posting, denial management, health care services, medical billing, NABH guidelines. * Interested candidate can share their CV at ayesha.tabassum@iqct.in

About Us At CIGNA Healthcare we are guided by a common purpose to help make financial lives better through the power of every connection. Responsible Growth is how we run our company and how we deliver for our clients, teammates, communities, and shareholders every day. One of the keys to driving Responsible Growth is being a great place to work for our teammates around the world. We are devoted to being a diverse and inclusive workplace for everyone. We hire individuals with a broad range of backgrounds and experiences and invest heavily in our teammates and their families by offering competitive benefits to support their physical, emotional, and financial well-being. CIGNA Healthcare believes both in the importance of working together and offering flexibility to our employees. We use a multi-faceted approach for flexibility, depending on the various roles in our organization. Working at CIGNA Healthcare will give you a great career with opportunities to learn, grow and make an impact, along with the power to make a difference. Join us! Process Overview EU insurance claims processing for individual, employer, group, and provider. Job Description* Delivers basic technical, administrative, or operative Claims tasks. Examines and processes paper claims and/or electronic claims. Completes data entry, maintains files, and provides support. Understands simple instructions and procedures. Performs Claims duties under direct instruction and close supervision. Work is allocated on a day-to-day or task-by-task basis with clear instructions. Entry point into professional roles. Responsibilities: - Adjudicate international claims in accordance with policy terms and conditions. M Monitor SLA times to ensure your claims are settled within required time scales. Respond to all claim enquiries within set SLA performing the necessary action as required, striving for first contact resolution where possible. Communicate effectively with internal and external stakeholders to deliver excellent customer outcomes. Identify potential process improvements and make recommendations to team senior. Actively support other team members and provide resource to enable all team goals to be achieved. Carry out other adhoc tasks as required in meeting business needs. Work cohesively in a team environment. Adhere to policies and practices, training, and certification requirements. Requirements*: Working knowledge of the insurance industry and relevant federal and state regulations. Good English language communication skills, both verbal and written. Computer literate and proficient in MS Office. Excellent critical thinking and decision-making skills. Ability to meet/exceed targets and manage multiple priorities. Must possess excellent attention to detail, with a high level of accuracy. Strong interpersonal skills. Strong customer focus with ability to identify and solve problems. Ability to work under own initiative and proactive in recommending and implementing process improvements. Ability to organise, prioritise and manage workflow to meet individual and team requirements. Experience in medical administration, claims environment or Contact Centre environment is advantageous but not essential. Education* : Graduate (Any) - medical, Paramedical, Commerce, Statistics, Mathematics, Economics or Science. Experience Range* : Minimum 2 years and up to 4 years of experience in processing of global healthcare insurance claims. Foundational Skills- Expertise in EU insurance claims processing Work Timings* : 1:00-10:00 PM IST Job Location*: Bengaluru (Bangalore)

for individual, employer, group, and provider. Delivers basic technical, administrative, or operative Claims tasks. Examines and processes paper claims and/or electronic claims. Completes data entry, maintains files, and provides support. Understands simple instructions and procedures. Performs Claims duties under direct instruction and close supervision. Work is allocated on a day-to-day or task-by-task basis with clear instructions. Adjudicate international claims in accordance with policy terms and conditions. M. Monitor SLA times to ensure your claims are settled within required time scales. Respond to all claim enquiries within set SLA performing the necessary action as required, striving for first contact resolution where possible. Communicate effectively with internal and external stakeholders to deliver excellent customer outcomes. Identify potential process improvements and make recommendations to team senior. Actively support other team members and provide resource to enable all team goals to be achieved. Carry out other adhoc tasks as required in meeting business needs. Work cohesively in a team environment. Adhere to policies and practices, training, and certification requirements. Working knowledge of the insurance industry and relevant federal and state regulations. Good English language communication skills, both verbal and written. Computer literate and proficient in MS Office. Excellent critical thinking and decision-making skills. Ability to meet/exceed targets and manage multiple priorities. Must possess excellent attention to detail, with a high level of accuracy. Strong customer focus with ability to identify and solve problems. Ability to work under own initiative and proactive in recommending and implementing process improvements. Ability to organise, prioritise and manage workflow to meet individual and team requirements. Experience in medical administration, claims environment or Contact Centre environment is advantageous but not essential. Education*: Graduate (Any) - medical, Paramedical, Commerce, Statistics, Mathematics, Economics or Science. Experience Range*: Minimum 2 years and up to 4 years of experience in processing of global healthcare insurance claims. Expertise in EU insurance claims processing. Join us in driving growth and improving lives. Process Overview. Requirements*. Strong interpersonal skills. Foundational Skills-. . Responsible Growth is how we run our company and how we deliver for our clients, teammates, communities, and shareholders every day. One of the keys to driving Responsible Growth is being a great place to work for our teammates around the world. We are devoted to being a diverse and inclusive workplace for everyone. We hire individuals with a broad range of backgrounds and experiences and invest heavily in our teammates and their families by offering competitive benefits to support their physical, emotional, and financial well-being. CIGNA Healthcare believes both in the importance of working together and offering flexibility to our employees. We use a multi-faceted approach for flexibility, depending on the various roles in our organization. Working at CIGNA Healthcare will give you a great career with opportunities to learn, grow and make an impact, along with the power to make a difference. Join us! Process Overview EU insurance claims processing for individual, employer, group, and provider. Job Description* Delivers basic technical, administrative, or operative Claims tasks. Examines and processes paper claims and/or electronic claims. Completes data entry, maintains files, and provides support. Understands simple instructions and procedures. Performs Claims duties under direct instruction and close supervision. Work is allocated on a day-to-day or task-by-task basis with clear instructions. Entry point into professional roles. Responsibilities: - Adjudicate international claims in accordance with policy terms and conditions. M Monitor SLA times to ensure your claims are settled within required time scales. Respond to all claim enquiries within set SLA performing the necessary action as required, striving for first contact resolution where possible. Communicate effectively with internal and external stakeholders to deliver excellent customer outcomes. Identify potential process improvements and make recommendations to team senior. Actively support other team members and provide resource to enable all team goals to be achieved. Carry out other adhoc tasks as required in meeting business needs. Work cohesively in a team environment. Adhere to policies and practices, training, and certification requirements. Requirements*: Working knowledge of the insurance industry and relevant federal and state regulations. Good English language communication skills, both verbal and written. Computer literate and proficient in MS Office. Excellent critical thinking and decision-making skills. Ability to meet/exceed targets and manage multiple priorities. Must possess excellent attention to detail, with a high level of accuracy. Strong interpersonal skills. Strong customer focus with ability to identify and solve problems. Ability to work under own initiative and proactive in recommending and implementing process improvements. Ability to organise, prioritise and manage workflow to meet individual and team requirements. Experience in medical administration, claims environment or Contact Centre environment is advantageous but not essential. Education* : Graduate (Any) - medical, Paramedical, Commerce, Statistics, Mathematics, Economics or Science. Experience Range* : Minimum 2 years and up to 4 years of experience in processing of global healthcare insurance claims. Foundational Skills- Expertise in EU insurance claims processing Work Timings* : 1:00-10:00 PM IST Job Location*: Bengaluru (Bangalore) About The Cigna Group Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. for individual, employer, group, and provider. Ability to work under own initiative and proactive in recommending and implementing process improvements. Back to search results Previous job Next job JOB DESCRIPTION Driving Growth. Improving Lives.

Job Description: We are looking for a detail-oriented and proactive AR Follow-Up Executive to join our Revenue Cycle Management (RCM) team. The ideal candidate will be responsible for following up on outstanding claims with insurance companies to ensure timely reimbursement for healthcare services To apply, Call/WhatsApp HR Palak 9289050069 Key Responsibilities: Review and analyze unpaid or denied medical claims. Follow up with insurance carriers via phone or online portals. Resolve claim rejections and denials by identifying root causes. Update the billing system with action taken and next steps. Meet daily productivity and quality targets. Requirements: 13 years of experience in AR follow-up (US healthcare domain). Strong understanding of the denial management process. Good communication skills and ability to work in a fast-paced environment.

Hiring for a Record Retrieval Specialist #Shift-Us Shift Timing #Location: Ahmedabad, Gujarat # Minimum 6 months of Experience Required in the International Voice process #Fluent English Required Meal Facility is also available

International Voice Process Shift - US Shift 5days working Location - Ahmedabad Food is Available

Hiring for a Record Retrieval Specialist #Shift-Us Shift Timing #Location: Ahmedabad, Gujarat # Minimum 6 months of Experience Required in the International Voice process #Fluent English Required Meal Facility is also available

Project Role : Business Architect Project Role Description : Define opportunities to create tangible business value for the client by leading current state assessments and identifying high level customer requirements, defining the business solutions and structures needed to realize these opportunities, and developing business case to achieve the vision. Must have skills : GuideWire ClaimCenter Good to have skills : NA Minimum 7.5 year(s) of experience is required Educational Qualification : Any Degree Minimum 15 years full time Summary: As a Business Architect, you will be responsible for leading current state assessments, identifying high-level customer requirements, and developing business solutions and structures to create tangible business value for the client. Your typical day will involve defining opportunities, developing business cases, and achieving the vision using your expertise in GuideWire ClaimCenter. Roles & Responsibilities: - Lead current state assessments and identify high-level customer requirements. - Define opportunities to create tangible business value for the client. - Develop business solutions and structures needed to realize these opportunities. - Develop business cases to achieve the vision. - Utilize expertise in GuideWire ClaimCenter to deliver impactful solutions. - Work directly with the client gathering requirements to align technology with business strategy and goals - GuideWire ClaimCenter ie FNOL, claim closure, exposures, reserves - Good experience in Property and Casualty - Working knowledge of SOAP / REST web service - Should be able to create/ consume the web services in Java - Understanding of XML, XSD - Knowledge of messaging, plugins Professional & Technical Skills: - Must To Have Skills: Expertise in GuideWire ClaimCenter. - Good To Have Skills: Knowledge of other insurance platforms. - Strong understanding of business architecture principles and practices. - Experience in leading current state assessments and identifying high-level customer requirements. - Experience in developing business solutions and structures to create tangible business value for the client. - Experience in developing business cases to achieve the vision. - Good to have Guidewire Developer in Integration/ Configuration, GOSU scripting and Java Enterprise Edition - Good to have Experts internally and externally for their deep functional or industry expertise, domain knowledge, or offering expertise - Basic SQL and Database knowledge Additional Information: - The candidate should have a minimum of 7.5 years of experience in Business Architecture. - The ideal candidate will possess a strong educational background in business administration, computer science, or a related field, along with a proven track record of delivering impactful business-driven solutions. - This position is based at our Bengaluru office. Any Degree Minimum 15 years full time

Project Role : Business Architect Project Role Description : Define opportunities to create tangible business value for the client by leading current state assessments and identifying high level customer requirements, defining the business solutions and structures needed to realize these opportunities, and developing business case to achieve the vision. Must have skills : GuideWire BillingCenter / GuideWire ClaimCenter /Guidewire Integration Good to have skills : NA Minimum 7.5 year(s) of experience is required Educational Qualification : Any Degree Minimum 15 years full time Summary: As a Business Architect, you will be responsible for leading current state assessments and identifying high-level customer requirements, defining the business solutions and structures needed to realize these opportunities, and developing a business case to achieve the vision. Your typical day will involve working with GuideWire BillingCenter and collaborating with cross-functional teams to create tangible business value for the client. Roles & Responsibilities: - Lead current state assessments and identify high-level customer requirements. - Define the business solutions and structures needed to realize opportunities. - Develop a business case to achieve the vision. - Collaborate with cross-functional teams to create tangible business value for the client. - Utilize GuideWire BillingCenter to implement business solutions. - Work directly with the client gathering requirements to align technology with business strategy and goals - Well versed with OOTB BC functionalities - Should be able to explain OOTB features and capture user requirements - Perform gap analysis to identify configuration and customization scope - Suggest solutions for business based on their requirements while aligning to the OOTB configuration as much as possible Professional & Technical Skills: - Must To Have Skills: Expertise in GuideWire BillingCenter. - Good To Have Skills: Knowledge of other GuideWire products. - Strong understanding of business architecture principles and practices. - Experience in leading current state assessments and identifying high-level customer requirements. - Experience in developing business cases to achieve the vision. - Good to have OOTB understanding of Invoicing Delinquency, Payments, Commission, General Ledger etc, OOTB Data Model - Experience in Property and Casualty - Basic SQL and Database knowledge Additional Information: - The candidate should have a minimum of 7.5 years of experience in GuideWire BillingCenter. - The ideal candidate will possess a strong educational background in business architecture, computer science, or a related field, along with a proven track record of delivering impactful business-driven solutions. - This position is based at our Bengaluru office.

Claims Analyst The job profile for this position is Claims Analyst, which is a Band 2 Senior Contributor Career Track Role. Excited to grow your career? We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply! Our people make all the difference in our success. YOUR JOB As an SME you will support the supervisor and team manager in your relevant process. Key to the role will be building/maintaining an in-depth knowledge of (part of) the process to continuously improve the processes and share that knowledge to deliver a high quality customer centric service offering. Your role includes: - Being responsible for managing a portfolio of key clients: you engage with clients to build relationships and you educate, i.e. communicating directly via email and telephone, or processing claims within the agreed service levels (based on the process you belong to) - Building and maintaining a solid in depth knowledge in (part of) your process - Being an expert user of any of the used tools within the team and/or any of the partner set-ups in place - Being the organizational ambassador for your knowledge area within your own team and across the wider organization. You are the go to person in case of questions on your area of expertise. - In that role, being able to represent the Process / Organisation in (enterprise wide) projects, stakeholder meetings, or act as a relationship manager towards some of our (internal/external) strategic partners or act as a trainer. - Option to take over SPOC role for particular clients/accounts if required - Being proactive in identifying improvement/enhancement opportunities and be active in seeking and sharing ideas for innovation in business processes. - Striving to provide excellent service to our members and clients - Playing an active role in a culture of continuous improvement - Taking ownership of any escalated cases and providing updates to the Supervisor on any issues - Taking ownership of solving any issues (if applicable) in your area of expertise - Proactively addressing and/or escalating any risks - Developing/maintaining proactive/effective business relationships, both internally and externally to ensure a seamless delivery of service. Specific for Claims SME s: - Support the financial verification of the team, including approval of manual payments - Support of quality audits (financial verification + extra verification) with a clear focus on the financial and procedural accuracy company KPI s. You document your findings, share them with the supervisor and you discuss corrective actions on individual and team level with the Supervisor. - Responsible to provide training on specific topics where you act as a subject matter expert, be it a process or a client, including the lead of the training organisation and coordination. - Support the on boarding and training phase of newbies, or colleagues taking up new accounts, including their performance reporting. YOUR PROFILE/SKILLS Strong performance track record International mind-set, with holistic and able to work remotely with peers across locations 2 years of Cigna experience Good communication skills, and knowledge of Window tools, e.g. Excel, PowerPoint, Windows A growth mind set with a positive attitude towards change and the ability to play an active role in implementing change initiatives within your own process Action-orientated problem-solving attitude Able to seek out best practice in order to effectively deal with diverse, complex and highly sensitive issues Accountability - assume ownership for achieving personal results and collective team goals

Job Description: A talented application Guidewire Claims Center Technical Lead with deep knowledge of Guidewire Claim Centre & Guidewire Products. Must be skilled in all aspects of Guidewire implementation, from design and configuration to customization and support after the solution goes live. Well versed with Latest Guidewire offering, products, innovation, and best practices. Work with Customer Architects, Lead Engineers, Solution architects to identify the solutions that are relevant to business problems and targeted architecture. Identify, create, extend, and maintain reusable architectural patterns & solutions and to facilitate development of future solutions Prepare detailed designs for complex features and assist developers with implementation. Guide the Tech leads and Teams on ground on implementation and execution challenges. Create Guidewire SAAS best practices, product standards, quality assurance norms and guidelines. and track until implement into the projects. Review code and ensure developers are adhering to standards, Guidewire best practices and properly addressing. Create detailed design document/technical specifications, for select Guidewire Claimcenter, Digital and Edge services-based projects. Track the teams on efficient and quality code based on given specifications. Create Guidewire Accelerators and white papers. Required Skills: Strong Guidewire Product knowledge and Insurance domain knowledge. Guidewire Ace certified in configuration and Integration. Minimum of 4+ years experience in a Guidewire Technical Lead role. Must have Guidewire cloud experience. Minimum of 4 to 7 years of hands-on experience in Guidewire Claims centre Configuration, Integration and Testing Frameworks. Proven development experience in Object Oriented Programming (such as Java) and SQL. Experience supporting Property & Casualty Insurance to understand and analyse the business needs of the customer. Should have Guidewire SAAS implementation experience. Prior experience with Apache and JBOSS Application servers. Experience with either XML, GUnit, Jenkins, GIT/Subversion/TFS, Code Coverage and Code Scan Plugin/Tools. Prior experience with Application Servers like WebSphere, WebLogic, JBoss and/or Tomcat. Good To have Expertise in designing the overall solutions on Guidewire Products like Jutro, cloud API’s, Integration framework. Expertise in writing G Unit test cases and integrate them to build/pipeline. Background in consulting or equivalent in a customer-facing role in professional services. Ability to handle technical leadership tasks (Solution Design, estimating, delivery of technical training/education). Ability to become certified in multiple Guidewire Insurance Suite products and develop a thorough understanding of product platform, including all integration technologies. Demonstrable proficiency in designing, implementing and supporting packaged vendor products. Prior experience with Database Servers like SQL Server, Oracle, and/or DB2. Ability to engage different stakeholders (Configuration, Integration, Middleware and Legacy teams) to resolve issues.

Job Tile Assistant Manager List of Responsibilities Team Handling: FLP, Billing, Combined, FA, DMS Specific Geography Responsibility for Coordination and Claims Processing/ Marketing Escalations/ Claims Escalations from All Verticals / IT Co ordination DAC/Audit: Response /Rectification /Counselling along with OH Payment query Pending TAT Monitoring Reimbursement Claims Processing Tabulation / Arithmetic Calculations checks as per the agreed Terms/Policy Terms of Reimbursement File Coordination with Medical Processors Referring back for insufficient documents /Rejection Cashless Claim Processing Tabulation / Arithmetic Calculations checks as per the agreed Terms/Policy Terms Coordination with Medical Processors Job Description: Communicating with insurance agents and beneficiaries. Preparing claim forms and related documentation. Reviewing claim submissions and verifying the information. Recording and maintaining insurance policy and claims information in a database system. Determining policy coverage and calculating claim amounts. Processing claim payments. Performing other clerical tasks, as required. Job Qualifications and Requirements Any Degree At least 4 years of experience as a claims processor or in a related role. Working knowledge of the insurance industry and relevant federal and state regulations. Computer literate and proficient in MS Office. Excellent critical thinking and decision-making skills. Good administrative and organizational skills. Strong customer service skills. Ability to work under pressure. High attention to detail.

Hiring For OPTUM With the Payroll of J2W Experience: 6months to 3Year Location Hyderabad Work module Work from office Cab facility - Both way cab provided CTC :2.4 LPA Notice period Immediate Nature of work: Non-Voice Role: Billing & Enrollment Associate (Contractual/Temp Would be converted purely based on performance) Skills Required Good verbal and written communication skills, Ability to multi-task, Critical thinking abilities, open and ready to work on feedback Quality focused, Good Analytical skills. Proficiency with Windows, MS Office and basis computer skills Demonstrate skills necessary to interpret regulations and guidelines Ability to interact positively with internal and external customers Selection process: Candidates need to be available in Optum premises during the Interview process, no scope of virtual interview. 1st round Typing Assessment (30 WPM, 95% accuracy) 2nd round Written assessment (Analytical, Reasoning, US Healthcare) 3rd round Line Manager Round 4th round Final Round Need to carry pens along Need to be in formal attire Shift timings: 5:45 PM to 3:15 AM (Night shift Salaries + Incentives: Package 2.4 LPA + Additional Incentives Incentives Rs.400 for 100% attendance (monthly) Rs.200 is allocated towards team outings and team refreshment activities (monthly) Top 10% of the performers would receive a GV worth Rs.1000 (monthly) Rs.400 per month towards Project retention bonus which would be accumulated and released along with FnF. Candidates serving the entire tenure of the program are eligible for it. INTERESTED CONTACT HR : 9606973198 PRIYA NOTE : NO BE/BTECH,MCA, & NO EX Employee of Optum

Role :Relationship Manager Skill-Good Communication skill with Healthtech&healthcare domain Location:Chennai Company:ViFin Industry: Fintech -Hospital Claim Settlement Process&Insurance Affordability Experince 1+years Contact 9962442924/7825845773

Hiring Alert Medical Officer (Claims) | Contract Role Location: IBC KNOWLEDGE PARK, Bhavani Nagar, S.G. Palya, Bengaluru, Karnataka 560029 Company: Medi Assist Insurance TPA Private Limited CTC: 3.4 LPA Timing: 9:30 AM 6:00 PM | MonFri (Rotational Saturdays working) Duration: 12-month contract (with chance of contract extension/on-roll conversion) Eligibility: BAMS or BHMS graduates only 0–3 years experience (freshers welcome!) Role Overview: You will scrutinize and process insurance claims based on policy terms, verify treatment/diagnosis, raise queries for incomplete documents, and ensure accurate and timely closure of claims. Key Skills: Strong medical understanding Basic computer & typing skills Good communication Send your resume to: pavana.praveen@mediassist.in prathiba.b@mediassist.in