766 Claims Processing Jobs - Page 24

Department - Claims Auto Role & responsibilities Closing Ratio/Minimize cost : Negotiate with dealers ; Avoid cost wastage in workshops; Regular training of claims policies ; Faster settlements Re-open ratio/Segmentation of vehicles: Separating the Claims according to Vehicles and minimizing the expenses Repair claims: Timely follow up with agent; visit the workshop within 48hrs of receiving the claim and follow up within 2days. Maintain the Hygiene/TAT(Total Around Time) : Proper evaluation on customer claims ; Claims should be closed within defined TAT (i.e.; Approval or rejection) Sort out claims related issues according to Regulations. Policy Compliance : Ensure that the claims process adheres to the insurance company's policies and guidelines. Customer Service : Communicate with policyholders, repair shops, and other relevant stakeholders to provide updates, explain assessment findings, and address any queries or concerns. Compliance with Regulations : Ensure compliance with local, state, and national regulations regarding motor vehicle assessments, repairs, and insurance claim processes. Negotiation Skills : Engage in negotiations with repair shops, policyholders, and other involved parties to reach mutually agreeable settlements. Fraud Detection : Detect and report any suspected cases of fraud or misrepresentation during the assessment process and work closely with the investigation team to gather evidence if necessary. Preferred candidate profile - Diploma in Automobile/Mechanical (10+2+3) or BE in Automobile/Mechanical - 2-4 years experince in any of the automobile workshop specially in body shop or in an insurance company in motor claims dept.

Dear Candidate, Greetings from AGS Health! Job Title: Process Associate/Sr Process Associate Job Role: Responsible for calling US Insurance companies on behalf of doctors/physicians and following up on outstanding Accounts Receivable. Should have basic knowledge of the entire RCM (Revenue Cycle Management) Perform analysis of accounts receivable data and understand the reasons for pending claims in AR and the top denial reasons Process : International Voice process - AR Calling Interview Process: Rounds off interviews: 1. HR screening 2. Online Assessment Test 3. Operational/Technical Round Transport: Two-way transport is available based on boundary limits. Location: Western Pearl, Kondapur, Kothaguda, Hyderabad - 5000884 Job Type: Full-time, Regular / Permanent Benefits: 5 days work Work from the Office PF ESI Health insurance Performance bonus Required Skills: Minimum 1 year of experience in AR calling Calling experience on Denial Management - Physician Billing/Hospital Billing Should be comfortable working with Night shifts Good Communication skills Looking for an aspirant who can join us immediately. Interested candidates can WhatsApp their resume to 9150092587 Regards, Shashank Rao HR- Talent Acquisition AGS Health

Job Track Description Requires formal education and relevant expertise in a professional, sales, or technical area. Performs technical-based activities. Contributes to and manages projects. Uses deductive reasoning to solve problems and make recommendations. Interfaces with and influences key stakeholders. Leverages previous knowledge and expertise to achieve results. Ability to complete work self-guided. A college or university degree required. General Profile Requires knowledge and experience in own field. Will acquire higher-level knowledge and skills while on the job. Develops an understanding of the company, processes, and customers. Uses existing procedures to solve standard problems. Requires moderate guidance and direction from others. Functional Knowledge Requires expanded conceptual understanding of theories, practices, and procedures. Business Expertise Uses an understanding of key business drivers to accomplish work. Impact Impacts a team, by example, through the quality service and information provided. Follows standardized practices and procedures to achieve objectives and meet deadlines. Leadership No supervisory responsibilities. Provides guidance to new team members. Problem Solving Uses existing procedures and technical experience to solve problems. Interpersonal Skills Exchanges complex information and ideas effectively. Responsibility Statements Partners with 1 client depending on scale and scope. Serves as liaison between end-users and product development teams. Works closely with end-users to analyze, define, model, and document project requirements and communicates to development teams. Analyzes requirements and defines technology solutions. Leverages a blend of proven domain knowledge system understanding to define a go-to approach for system construction. Mentors a small team of business analysts for a client portfolio. Produces detailed component specifications and translates these into detailed designs for implementation. Partners with the development team to identify solutions. Ensures designs follow regulatory requirements. Works without supervision with extensive latitude for decision making. Performs other duties as assigned. Complies with all policies and standards. Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law. People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by submitting their request through this form that must be downloaded:click here to access or download the form. Complete the form and then email it as an attachment toFTADAAA@conduent.com.You may alsoclick here to access Conduent's ADAAA Accommodation Policy. At Conduent we value the health and safety of our associates, their families and our community. For US applicants while we DO NOT require vaccination for most of our jobs, we DO require that you provide us with your vaccination status, where legally permissible. Providing this information is a requirement of your employment at Conduent.

JOB TITLE Technical Business Analysis Engineer II RESPONSIBILITIES May perform one or more of the following: Requirement/Analysis Ability to comprehend Business Requirement Documents (BRD) Maintain and Update Data/Vendor Interfaces BRD Interprets requirements to create systems specifications documents to build and execute system. Perform Data Analysis, Audit, and associated research and provide subsequent resolutions. Understanding of database/SQL Query Writing Work alongside with Sr. members or individually (as required) to assist in smooth integration/transition of processes and create/maintain documentations for the same. Responsible for solving the data and Vendor files related issues and preparation of annual calendar, as applicable. Execute & Manage the assigned tasks {Data Analysis, Vendor files, Requirement Analysis} specific to your Tower HW Domain knowledge is good to have. Process Ability to think and conceptualize and/or implement ideas of process automation. Follow the standard practices and procedures specific to your Tower. Accountability/Communication Work independently on tasks assigned. Should be able to Coach & mentor team members. Demonstrate ownership on work assigned to self and immediate sub-ordinates. Manage Offshore/Onshore interaction and stakeholder communication as per the business needs. Update all documentation with task details and provide regular updates to team. All other tasks as assigned. Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law. People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by submitting their request through this form that must be downloaded:click here to access or download the form. Complete the form and then email it as an attachment toFTADAAA@conduent.com.You may alsoclick here to access Conduent's ADAAA Accommodation Policy. At Conduent we value the health and safety of our associates, their families and our community. For US applicants while we DO NOT require vaccination for most of our jobs, we DO require that you provide us with your vaccination status, where legally permissible. Providing this information is a requirement of your employment at Conduent.

More than 6 years of experience in Business Analysis or related experience in IT Demonstrates good learning agility to understand the Product components Responsible for analyzing and understanding of business and functional requirements Translating complex business needs and requirements in detail and be able to translate them into functional and technical specifications . Work closely with developers and end users to ensure technical and functional compatibility Conducting detailed gap analysis of a product versus the requirements and doing Impact Analysis Creates project specific planning and scope documentation and secures stakeholder sign off Perform System Testing toensure the delivery of quality product and UAT support from a functional perspective Prepare release notes for new changes/enhancement done in the system Creates end-user documentation (e.g., user guides, process flow charts, training materials) Presents complex data and analysis in an easily understood format so it is suitable across diverse groups with varying abilities Facilitates cross functional communication and recognizes need to engage other stakeholders and SME's in a project Acts as a liaison between commercial and technical functions Strong problem-solving and analytical skills Understanding of Project Life Cycle and STLC Strong team player Work in TFS/Azure DevOps, tracking user stories and managing sprints Ability to work with a sense of urgency and attention to detail Excellent oral and written communication skills Preferred Experience in SQL queries Experience in ETL/EDI processes and Reports Experience of US Healthcare payer domain Knowledge of health insurance industry - Claims processing, ICD 9/10, Medicare, or Medicaid Experience in UML Modeling Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law. People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by submitting their request through this form that must be downloaded:click here to access or download the form. Complete the form and then email it as an attachment toFTADAAA@conduent.com.You may alsoclick here to access Conduent's ADAAA Accommodation Policy. At Conduent we value the health and safety of our associates, their families and our community. For US applicants while we DO NOT require vaccination for most of our jobs, we DO require that you provide us with your vaccination status, where legally permissible. Providing this information is a requirement of your employment at Conduent.

The candidate should be working as a Quality Analyst / Trainer in the US healthcare industry for the Claims Adjudication Payment Integrity process. Qualification - Graduate Shift - US rotational shifts Work Location - Chennai and Bangalore Required Candidate profile Immediate Joiners OR Max 1 month notice period candidates can apply Contact Sr. HR Kenedy at 9620999035 for more details.

Roles and Responsibilities Manage end-to-end claims processing, including investigation, settlement, and reconciliation. Oversee insurance billing and TPA (Third Party Administrator) processes. Ensure compliance with regulatory requirements and industry standards for healthcare services. Develop and implement effective strategies to reduce claim denial rates and improve revenue cycle management. Collaborate with internal stakeholders to resolve complex claims issues.

The candidate should be working as a Team Leader/SME in the US healthcare industry for the Claims Adjudication Payment Integrity process. Qualification - Graduate Shift - US rotational shifts Work Location - Chennai and Bangalore Required Candidate profile Immediate Joiners OR Max 1 month notice period candidates can apply Contact Sr. HR Kenedy at 9620999035 for more details.

Skill required: Group Core Benefits- Claims Case Mgmt. Group Disability Insurance Designation: Claims Management Analyst Qualifications: Any Graduation Years of Experience: 3 to 5 years About Accenture Accenture is a global professional services company with leading capabilities in digital, cloud and security.Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. We embrace the power of change to create value and shared success for our clients, people, shareholders, partners and communities.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.Team prepares a case studyGroup disability coverage is tied to employment. If change or loss of job, the coverage is not portable. The cost of group coverage can also change from year to year. It is a sort of insurance that pays out if a policyholder is unable to work and earn an income due to a disability. What are we looking for Problem-solving skillsWritten and verbal communicationCollaboration and interpersonal skillsAbility to meet deadlinesProcess-orientation Roles and Responsibilities: In this role you are required to do analysis and solving of lower-complexity problems Your day to day interaction is with peers within Accenture before updating supervisors In this role you may have limited exposure with clients and/or Accenture management You will be given moderate level instruction on daily work tasks and detailed instructions on new assignments The decisions you make impact your own work and may impact the work of others You will be an individual contributor as a part of a team, with a focused scope of work Please note that this role may require you to work in rotational shifts Qualification Any Graduation

Skill required: Group Core Benefits - Group Disability Insurance Designation: Insurance Operations Associate Qualifications: Bachelor of Dental Surgery/Bachelor of Pharmacy/Bachelor in Physiotherapy Years of Experience: 1 to 3 years About Accenture Accenture is a global professional services company with leading capabilities in digital, cloud and security.Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. We embrace the power of change to create value and shared success for our clients, people, shareholders, partners and communities.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.The benefits of having a strong core include injury prevention, reduction of back pain, improved lifting mechanics, balance, stability, and posture, as well as improved athletic performance.Group disability coverage is tied to employment. If change or loss of job, the coverage is not portable. The cost of group coverage can also change from year to year. It is a sort of insurance that pays out if a policyholder is unable to work and earn an income due to a disability. What are we looking for Ability to establish strong client relationshipAbility to handle disputesAbility to manage multiple stakeholdersAbility to meet deadlinesAbility to perform under pressure0-5 years of experience in Medical Underwriting work.Possess excellent medical knowledge, including a strong grasp of medical terminologies and complex and complex disease condition.Knowledge of MS Office Tools and good computer knowledge.Graduate/Postgraduate in Life Sciences, B. Pharma, Bachelor in Physiotherapy, BHMS.Open to flexible shifts based on business requirements.Good verbal & written communication skillsGood typing skills and attention to detail.Good time management skills. Ability to work independently Roles and Responsibilities: In this role you are required to solve routine problems, largely through precedent and referral to general guidelines Your expected interactions are within your own team and direct supervisor You will be provided detailed to moderate level of instruction on daily work tasks and detailed instruction on new assignments The decisions that you make would impact your own work You will be an individual contributor as a part of a team, with a predetermined, focused scope of work Please note that this role may require you to work in rotational shiftsEvaluating the eligibility of applicants seeking an insurance policy. Reviewing each person s medical history and other factors such as age.Calculating individual risk and determining appropriate coverage and premium amounts.Assessing the risk involved in insuring an individual.Reviewing application files for life & disability products policies and determining eligibility coverage, premium rates, and exclusion policies.Complies with all regulatory requirements, procedures, and Federal/State/Local regulations.Review medical reports, data, and other records to assess the risk involved in insuring a potential policyholder.Ensure Quality Control standards that have been set are adhered to.Excellent organizational skills with ability to identify and prioritize high value transactions.Completing assigned responsibilities and projects within timelines apart from managing daily BAU. Qualification Bachelor of Dental Surgery,Bachelor of Pharmacy,Bachelor in Physiotherapy

Skill required: Group Core Benefits- Claims Case Mgmt. Group Disability Insurance Designation: Claims Management Senior Analyst Qualifications: Any Graduation Years of Experience: 5 to 8 years About Accenture Accenture is a global professional services company with leading capabilities in digital, cloud and security.Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. We embrace the power of change to create value and shared success for our clients, people, shareholders, partners and communities.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.Team prepares a case studyGroup disability coverage is tied to employment. If change or loss of job, the coverage is not portable. The cost of group coverage can also change from year to year. It is a sort of insurance that pays out if a policyholder is unable to work and earn an income due to a disability. What are we looking for Problem-solving skillsWritten and verbal communicationCollaboration and interpersonal skillsAbility to meet deadlinesProcess-orientation Roles and Responsibilities: In this role you are required to do analysis and solving of increasingly complex problems Your day to day interactions are with peers within Accenture You are likely to have some interaction with clients and/or Accenture management You will be given minimal instruction on daily work/tasks and a moderate level of instruction on new assignments Decisions that are made by you impact your own work and may impact the work of others In this role you would be an individual contributor and/or oversee a small work effort and/or team Please note that this role may require you to work in rotational shifts Qualification Any Graduation

Skill required: Group Core Benefits - Group Disability Insurance Designation: Insurance Operations Analyst Qualifications: Any Graduation Years of Experience: 3 to 5 years About Accenture Accenture is a global professional services company with leading capabilities in digital, cloud and security.Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song all powered by the worlds largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. We embrace the power of change to create value and shared success for our clients, people, shareholders, partners and communities.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.The benefits of having a strong core include injury prevention, reduction of back pain, improved lifting mechanics, balance, stability, and posture, as well as improved athletic performance.Group disability coverage is tied to employment. If change or loss of job, the coverage is not portable. The cost of group coverage can also change from year to year. It is a sort of insurance that pays out if a policyholder is unable to work and earn an income due to a disability. What are we looking for Adaptable and flexibleAbility to perform under pressureProblem-solving skillsAbility to work well in a teamPrioritization of workloadTower:Group InsuranceLevel 1:Employee BenefitLevel 2:Claims ProcessingMust have/ minimum requirement2+ years of experience in Insurance Disability Claims Processing.Knowledge of MS Office Tools and good computer knowledge. Roles & Responsibilities:Processing Disability insurance claims, calculating overpayments and Underpayments.Review and assess complex Disability claims to determine benefits and eligibility for payment.Research and verify claims information including policy details, claims document validation, calculating benefit amount and other relevant documentation.Identify the correct payee or beneficiary to release the claims payment.Complies with all regulatory requirements, procedures, and Federal/State/Local regulations.Research on any queries/ requests sent by the Business Partners/Client Support Teams and replying the same with minimum response time.Taking active participation in process improvements and automation.Ensure Quality Control standards that have been set are adhered to.Excellent organizational skills with ability to identify and prioritize high value transactions.Completing assigned responsibilities and projects within timelines apart from managing daily BAU.Skillset:Graduate in any stream.Open to flexible shifts based on business requirements.Good verbal & written communication skillsGood typing skills and attention to detail.Time management skills. Ability to work independently Roles and Responsibilities: In this role you are required to do analysis and solving of lower-complexity problems Your day to day interaction is with peers within Accenture before updating supervisors In this role you may have limited exposure with clients and/or Accenture management You will be given moderate level instruction on daily work tasks and detailed instructions on new assignments The decisions you make impact your own work and may impact the work of others You will be an individual contributor as a part of a team, with a focused scope of work Please note that this role may require you to work in rotational shifts Qualification Any Graduation

Dear Candidate, We are hiring a Zig Developer to build bare-metal, embedded, or systems-level applications with minimal runtime overhead. Key Responsibilities: Develop applications in Zig with a focus on performance and safety Replace or extend C code with cleaner Zig equivalents Work on cross-compilation for embedded or platform-specific builds Contribute to tooling, kernel development, or embedded firmware Optimize binary sizes and compile times Required Skills & Qualifications: Strong grasp of Zig and its manual memory management Familiar with low-level programming , C interop , and cross-compilation Experience with bare-metal systems or firmware is a plus Bonus: Kernel development or OS-level contributions Note: If interested, please share your updated resume and preferred time for a discussion. If shortlisted, our HR team will contact you. Kandi Srinivasa Delivery Manager Integra Technologies

Candidates with >5 years experience in TPA/Insurance Desk, apply for the position of Senior Manager.

Role & responsibilities : The end-to-end insurance process, from a customer's perspective, involves multiple steps, including initiating a claim, submitting necessary documents, and eventually receiving payment . For insurers, it involves verifying the claim, assessing the loss, and processing the claim for settlement.

Candidate should be working as a Team leader / Quality analyst / Trainer / SME on papers in US Healthcare for Claims adjudication process. Qualification - Graduate Shift - US rotational shifts Work Location - Chennai / Bangalore Required Candidate profile Immediate Joiners OR Max 1 month notice period candidates can apply Call HR Sadiq @ 8904378561 for more details.

Hiring a Certified Medical Coder with strong expertise in both coding and auditing. Responsible for accurate code assignment, compliance, and detailed audits to ensure proper billing. Must be well-versed in ICD, CPT, HCPCS, and healthcare regulations

Hiring for Liability, Marine and Medical Malpractices Senior Analyst role End-to-end claims adjusting experience Graduation mandatory Salary: 7.5LPA (depending on last drawn CTC) Call: 8291772291

Claims Specialist Exp- 2+ Years Loc- Pune Skills- Claims, Dispute, Claims Mgt, Reason Codes, SAP, etc Pkg- 5.5 LPA Aparupa 9311697179 Aparupa.imaginators@gmail.com

Job Title : Analyst Qualification : Any Graduate Experience :F resher Must Have Skills : > Good working knowledge of the Microsoft office, particularly Excel & PowerPoint > Relevant Claims/risk management/Accounting Knowledge experience as a minimum according to the role Good to Have Skills : l Excellent analytical problem-solving skills. l Strong communication skills, both orally and in writing. l Commercial awareness a commercial and pragmatic approach to managing compliance. l IT literate knowledge of Microsoft office packages needed. Roles and Responsibilities : Accounts: l Good understanding of financial statementsand accounting concepts l Strong analytical skills l Excellent knowledge of Microsoft office is essential andadvanced Excel skills l Maintain and manage carrier accounts and settlements l Perform financial analysis and reporting Risk managements: l Collaborate with various teams for performing day-to-dayactivities ensuring effective risk management: l Engage with different departments to integrate risk management practices into their daily operations. l Identify potential risks and develop strategies to mitigate them in collaboration with cross-functional teams. l Ensure that risk management policies are consistently applied and adhered to across the organization. Claims: l Adjudicate international claims in accordance with policy terms and conditions to meet personal and team productivity and quality goals. l Respond within the time commitment given to enquiries regarding plan design, eligibility, claims status and perform necessary action as required, with first issue/call resolution where possible. l Handling and resolving complex claim issues l Collaborating with internal teams to ensure accurate claims processing l Providing support in claims settlement negotiations l Maintaining detailed documentation of claims activities Location : Bangalore CTC Range : 3.7 lpa (lakh per annum) Notice period : Immediate Shift Timings : Early morning / Afternoon shift Mode of Interview : Virtual Mode of Work : Hybrid Mode of Hire : Permanent Thanks & Regards, Amala Subject Matter Expert Black and White Business Solutions Pvt Ltd Bangalore, Karnataka, INDIA. Direct Number: 080-67432458 Send Resumes to amala@blackwhite.in www.blackwhite.in ******DO REFER YOUR FRIENDS AND FAMILY******

Job Title : Analyst Qualification : Any Graduate Experience : Fresher Must Have Skills : > Good working knowledge of the Microsoft office, particularly Excel & PowerPoint > Relevant Claims/risk management/Accounting Knowledge experience as a minimum according to the role Good to Have Skills : l Excellent analytical problem-solving skills. l Strong communication skills, both orally and in writing. l Commercial awareness a commercial and pragmatic approach to managing compliance. l IT literate knowledge of Microsoft office packages needed. Roles and Responsibilities : Accounts: l Good understanding of financial statements and accounting concepts l Strong analytical skills l Excellent knowledge of Microsoft office is essential and advanced Excel skills l Maintain and manage carrier accounts and settlements l Perform financial analysis and reporting Risk managements: l Collaborate with various teams for performing day-to-day activities ensuring effective risk management: l Engage with different departments to integrate risk management practices into their daily operations. l Identify potential risks and develop strategies to mitigate them in collaboration with cross-functional teams. l Ensure that risk management policies are consistently applied and adhered to across the organization. Claims: l Adjudicate international claims in accordance with policy terms and conditions to meet personal and team productivity and quality goals. l Respond within the time commitment given to enquiries regarding plan design, eligibility, claims status and perform necessary action as required, with first issue/call resolution where possible. l Handling and resolving complex claim issues l Collaborating with internal teams to ensure accurate claims processing l Providing support in claims settlement negotiations l Maintaining detailed documentation of claims activities Location : Bangalore CTC Range : 3.1 lpa (lakh per annum) Notice period : Immediate Shift Timings : Early morning / Afternoon shift Mode of Interview : Virtual Mode of Work : Hybrid Mode of Hire : Permanent Note : NA -- Thanks & Regards, HR Sneha Staffing Analyst Black and White Business Solutions Pvt Ltd Bangalore,Karnataka,INDIA. Direct Number: 8067432406|Whatsapp:8951047887| sneha.v@blackwhite.in | www.blackwhite.in

Designation: Associate Vice President / Senior Manager / Manager - Liability & Speciality Products. (Depending on the seniority of the candidate). Location: Mumbai, Delhi Organisation: One of the Leading Insurance Broking Companies in India. Reporting to: The Vice President- Liability & Speciality Products. Key Accountabilities: Underwriting liability proposals of all lines of business, and rating them. Coordinate with the Sales team and Brokers of the entire Zone; and assisting them in converting business. Assist in Product development and Product filing. To ensure renewal and identify possibilities of up-sell/cross- sell. Coordinate with the Claims Team & other stake-holders. Requirements: At least 3 to 15 years in Liability Underwriting.

Experience: 8+ years with a focus on hospital/healthcare design. Responsibilities: Lead architectural design, regulatory compliance, functional planning. As the Lead Architect, you will be a key member of the architectural team, responsible for providing technical leadership and expertise in designing and developing complex and innovative solutions. Your role involves leading the architectural design process, collaborating with cross-functional teams, and ensuring the successful implementation of architectural solutions. You will play a critical role in shaping the overall technology landscape and driving the organization's technical vision. Key Responsibilities: Architectural Design: Lead the design and development of architectural solutions that align with the organization's business objectives and technology strategy. Technical Leadership: Provide technical leadership to the architectural team, guiding and mentoring other architects and technical professionals. Solution Planning: Collaborate with stakeholders to understand their requirements and translate them into architectural blueprints and designs. System Integration: Design and oversee the integration of various systems and applications to ensure seamless communication and data flow. Technology Evaluation: Evaluate and recommend appropriate technologies, tools, and frameworks to support the organization's technical goals. Scalability and Performance: Address scalability and performance considerations in architectural design to accommodate future growth and demand. Security and Compliance: Ensure that architectural solutions meet security and compliance requirements, implementing best practices for data protection. Collaboration: Work closely with software developers, engineers, and project managers to ensure the successful implementation of architectural designs. Documentation: Create and maintain architectural documentation, including diagrams, design specifications, and technical documentation.

Responsible for handling cargo claims. Responsible for the management and administration of all claims filed Globally. Responsible for the coordination with local Front desk and guiding them with regards to claim handling. Provide proactive, efficient, and fair but firm claims and recovery management and obtain best possible claims and recovery settlement for the Group. Provide technical expertise and advice related to incidents, claims matter and loss prevention initiatives. Key Responsibilities Claims - Handling cargo Claims as per the set guidelines. Having a customer centric approach at the same time keeping in mind the legal requirement and closing claim within legal ambit Establish appropriate claims handling relationship in respective management area. Assess and document factual background of claims matters; establish and update claims file. Safeguard rights of recovery and drive recovery actions. Liaise with internal and external stakeholders, such as claimants (customer, recovery agents, lawyer, under writer and P&I) third party claims administrators etc. Enter and update data in the claims data base (case management) according to corporate guideline. Manage and settle claims matters in accordance with corporate guideline. Provide advice and support to Local claim desk related to any claims matters. Keeping data quality at top level. Formulate, drive and/or support loss prevention initiatives. Decision Making Authority As per Organization guidelines Function Market & Industry Knowledge / Domain Knowledge / Process working / Education: Graduate from recognized university LLB / LLM or MBA degree would be preferable. Experience: Minimum of 2 years of working experience within Shipping, Logistics, Marine surveyor, or insurance Industry. Exposure to shipping operations preferable. Experience in core claims handling (which includes independent claim settlement) will be an added advantage. Special Skills (Functional/Technical): Good Analytical skills. The knowledge of structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar. The knowledge of local maritime laws, legal codes, court procedures, precedents, government regulations, executive orders, agency rules, and the political process directly impacting claims handling of the region. Good Comprehension skills Excellent team player Well organized to carry out multi-tasks Flexible with changes Take ownership and responsibility of the job assigned Eye for the details.

Qualifacts Systems, Inc. is looking for RCMS AR Specialist II to join our dynamic team and embark on a rewarding career journey Billing & Invoicing: Generate and review accurate invoices through the RCMS platform for self-pay and third-party payers. Validate charge capture data from clinical and services departments prior to billing. Payment Posting & Reconciliation: Post payments, adjustments, and write-offs in RCMS and general ledger systems. Reconcile daily cash buckets and investigate discrepancies between bank deposits and system postings. Denial & AR Follow-Up: Monitor aging reports and aging buckets in RCMS; prioritize and manage escalation of past-due accounts. Research claim denials and rejections; prepare and submit appeals or corrected claims to payers. Patient & Payer Inquiry Resolution: Act as primary point of contact for patient billing inquiriesexplain statements, provide payoff quotes, arrange payment plans. Interface with insurance carriers to resolve coverage, eligibility, and claims-status questions. Reporting & Analysis: Produce weekly/monthly AR performance reports (days in AR, net collection rate, denial %, etc.). Analyze trends to recommend process improvements and reduce avoidable denials or write-offs.